From e0d117b12c7c009a10892fd3a89ed3fd19abf32f Mon Sep 17 00:00:00 2001
From: Jason Walonoski <jwalonoski@mitre.org>
Date: Wed, 26 Apr 2017 14:59:20 -0400
Subject: [PATCH 1/5] Update gems to 3.0.0.

---
 Gemfile                |  2 +-
 Gemfile.lock           | 18 ++++++++++++------
 fhir_scorecard.gemspec |  4 ++--
 3 files changed, 15 insertions(+), 9 deletions(-)

diff --git a/Gemfile b/Gemfile
index 9d7f545..5e41039 100644
--- a/Gemfile
+++ b/Gemfile
@@ -5,7 +5,7 @@ gem 'rake'
 gem 'pry'
 
 # gem 'fhir_models', :path => '../fhir_models'
-# gem 'fhir_models', :git => 'https://github.com/fhir-crucible/fhir_models.git', :branch => 'master'
+gem 'fhir_models', :git => 'https://github.com/fhir-crucible/fhir_models.git', :branch => '3.0.0-release'
 
 group :test do
   gem 'simplecov', :require => false
diff --git a/Gemfile.lock b/Gemfile.lock
index 54056ac..b0c4dc6 100644
--- a/Gemfile.lock
+++ b/Gemfile.lock
@@ -1,8 +1,18 @@
+GIT
+  remote: https://github.com/fhir-crucible/fhir_models.git
+  revision: 767ea007a16a20a9522586072999b4e4e04a3e9c
+  branch: 3.0.0-release
+  specs:
+    fhir_models (3.0.0)
+      bcp47 (>= 0.3)
+      date_time_precision (>= 0.8)
+      mime-types (>= 1.16, < 3)
+      nokogiri (>= 1.6)
+
 PATH
   remote: .
   specs:
     fhir_scorecard (1.8.1)
-      fhir_models (~> 1.8)
 
 GEM
   remote: https://rubygems.org/
@@ -15,11 +25,6 @@ GEM
     coderay (1.1.1)
     date_time_precision (0.8.1)
     docile (1.1.5)
-    fhir_models (1.8.3)
-      bcp47 (>= 0.3)
-      date_time_precision (>= 0.8)
-      mime-types (>= 1.16, < 3)
-      nokogiri (>= 1.6)
     i18n (0.8.1)
     json (2.0.3)
     method_source (0.8.2)
@@ -51,6 +56,7 @@ PLATFORMS
 
 DEPENDENCIES
   awesome_print
+  fhir_models!
   fhir_scorecard!
   minitest (~> 5.3)
   minitest-reporters
diff --git a/fhir_scorecard.gemspec b/fhir_scorecard.gemspec
index c79f9df..c52c7c8 100644
--- a/fhir_scorecard.gemspec
+++ b/fhir_scorecard.gemspec
@@ -7,9 +7,9 @@ Gem::Specification.new do |s|
   s.email = "jwalonoski@mitre.org"
   s.homepage = "https://github.com/fhir-crucible/fhir_scorecard"
   s.authors = ["Jason Walonoski"]
-  s.version = '1.8.1'
+  s.version = '3.0.0'
 
   s.files = s.files = `git ls-files`.split("\n")
 
-  s.add_runtime_dependency 'fhir_models', '~> 1.8'
+  # s.add_runtime_dependency 'fhir_models', '~> 1.8'
 end

From 30d042069778510bb63522c2429803c0d71bb30c Mon Sep 17 00:00:00 2001
From: Jason Walonoski <jwalonoski@mitre.org>
Date: Wed, 26 Apr 2017 15:31:00 -0400
Subject: [PATCH 2/5] Update US Core.

---
 .../us_core/CapabilityStatement-client.json   |  346 +-
 .../us_core/CapabilityStatement-server.json   |  778 ++-
 .../us_core/CodeSystem-careplan-category.json |   14 +-
 .../us_core/CodeSystem-careteam-status.json   |   39 -
 lib/resources/us_core/CodeSystem-cdcrec.json  | 4883 +++++++++++++++++
 .../CodeSystem-condition-category.json        |    7 +-
 lib/resources/us_core/ConceptMap-ndc-cvx.json | 2127 +++++++
 ...Guide.json => ImplementationGuide-ig.json} |  310 +-
 ...Definition-us-core-allergyintolerance.json |  245 +-
 .../StructureDefinition-us-core-birthsex.json |   35 +-
 .../StructureDefinition-us-core-careplan.json | 1049 ++--
 .../StructureDefinition-us-core-careteam.json |  339 +-
 ...StructureDefinition-us-core-condition.json |  344 +-
 .../StructureDefinition-us-core-device.json   |  613 ++-
 ...reDefinition-us-core-diagnosticreport.json |  595 +-
 .../StructureDefinition-us-core-direct.json   |   31 +-
 ...StructureDefinition-us-core-ethnicity.json |  128 +-
 .../StructureDefinition-us-core-goal.json     |  505 +-
 ...uctureDefinition-us-core-immunization.json | 1112 ++--
 .../StructureDefinition-us-core-location.json |  190 +-
 ...tructureDefinition-us-core-medication.json |  598 +-
 ...eDefinition-us-core-medicationrequest.json |  786 ++-
 ...efinition-us-core-medicationstatement.json |  626 ++-
 ...Definition-us-core-observationresults.json | 1405 ++---
 ...uctureDefinition-us-core-organization.json |  477 +-
 .../StructureDefinition-us-core-patient.json  |  509 +-
 ...ctureDefinition-us-core-practitioner.json} |  689 +--
 ...StructureDefinition-us-core-procedure.json |  924 ++--
 ...uctureDefinition-us-core-profile-link.json |  259 +
 .../StructureDefinition-us-core-race.json     |  128 +-
 ...ctureDefinition-us-core-smokingstatus.json |  561 +-
 ...tructureDefinition-us-core-vitalsigns.json | 1031 +++-
 .../us_core/ValueSet-detailed-ethnicity.json  |   18 +-
 .../us_core/ValueSet-detailed-race.json       |   18 +-
 ...n => ValueSet-omb-ethnicity-category.json} |   13 +-
 ...e.json => ValueSet-omb-race-category.json} |   17 +-
 .../us_core/ValueSet-simple-language.json     |   59 +
 .../us_core/ValueSet-us-core-birthsex.json    |   10 +-
 ...ueSet-us-core-careteam-provider-roles.json |   11 +-
 .../ValueSet-us-core-careteam-status.json     |   21 -
 .../ValueSet-us-core-condition-category.json  |    7 +-
 .../us_core/ValueSet-us-core-cvx.json         |   11 +-
 .../ValueSet-us-core-immunization-status.json |   57 -
 .../ValueSet-us-core-medication-codes.json    |    9 +-
 .../ValueSet-us-core-narrative-status.json    |    9 +-
 .../ValueSet-us-core-ndc-vaccine-codes.json   |    7 +-
 ...us-core-observation-ccdasmokingstatus.json |   11 +-
 ...-core-observation-ccdavitalsignresult.json |   80 -
 ...ueSet-us-core-observation-value-codes.json |   11 +-
 .../us_core/ValueSet-us-core-problem.json     |    9 +-
 ...n => ValueSet-us-core-procedure-code.json} |   17 +-
 .../ValueSet-us-core-procedure-icd10pcs.json  |   13 +-
 .../ValueSet-us-core-provider-role.json       |   11 +-
 .../ValueSet-us-core-provider-specialty.json  |   11 +-
 .../ValueSet-us-core-substance-ndfrt.json     |    9 +-
 .../ValueSet-us-core-substance-rxnorm.json    |    9 +-
 .../ValueSet-us-core-substance-sct.json       |    9 +-
 .../us_core/ValueSet-us-core-substance.json   |   15 +-
 .../us_core/ValueSet-us-core-ucum.json        |   39 -
 lib/resources/us_core/spec.internals          |  152 +-
 60 files changed, 16862 insertions(+), 5484 deletions(-)
 delete mode 100755 lib/resources/us_core/CodeSystem-careteam-status.json
 create mode 100755 lib/resources/us_core/CodeSystem-cdcrec.json
 create mode 100755 lib/resources/us_core/ConceptMap-ndc-cvx.json
 rename lib/resources/us_core/{ImplementationGuide.json => ImplementationGuide-ig.json} (92%)
 rename lib/resources/us_core/{StructureDefinition-us-core-pract.json => StructureDefinition-us-core-practitioner.json} (61%)
 create mode 100755 lib/resources/us_core/StructureDefinition-us-core-profile-link.json
 mode change 100755 => 100644 lib/resources/us_core/StructureDefinition-us-core-vitalsigns.json
 rename lib/resources/us_core/{ValueSet-omb-ethnicity.json => ValueSet-omb-ethnicity-category.json} (60%)
 rename lib/resources/us_core/{ValueSet-omb-race.json => ValueSet-omb-race-category.json} (51%)
 create mode 100755 lib/resources/us_core/ValueSet-simple-language.json
 delete mode 100755 lib/resources/us_core/ValueSet-us-core-careteam-status.json
 delete mode 100755 lib/resources/us_core/ValueSet-us-core-immunization-status.json
 delete mode 100755 lib/resources/us_core/ValueSet-us-core-observation-ccdavitalsignresult.json
 rename lib/resources/us_core/{ValueSet-us-core-procedure-type.json => ValueSet-us-core-procedure-code.json} (59%)
 delete mode 100755 lib/resources/us_core/ValueSet-us-core-ucum.json

diff --git a/lib/resources/us_core/CapabilityStatement-client.json b/lib/resources/us_core/CapabilityStatement-client.json
index 7b9d06d..d525dbe 100755
--- a/lib/resources/us_core/CapabilityStatement-client.json
+++ b/lib/resources/us_core/CapabilityStatement-client.json
@@ -2,24 +2,26 @@
   "resourceType": "CapabilityStatement",
   "id": "client",
   "text": {
-    "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n\t\t\t<h2>US Core Requestor</h2>\n\t\t\t<p>(Requirements Definition)</p>\n\t\t\t<p>Published: 2015-04-02 (draft)</p>\n\t\t\t<p>Published by: <b>U.S. Office of the National Coordinator (ONC)</b></p>\n\t\t\t<p>This profile defines the expected capabilities of the US Core Requestor actor when conforming to the US Core IG.</p>\n\t\t\t<h2>General</h2>\n\t\t\t<table>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>FHIR Version:</th>\n\t\t\t\t\t\t<td>1.8.0</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Accepts elements from future versions:</th>\n\t\t\t\t\t\t<td>extensions</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Supported formats:</th>\n\t\t\t\t\t\t<td>xml, json</td>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<h2>REST  behavior</h2>\n\t\t\t<p>The US Core Requestor SHOULD support querying of one or more FHIR resources using appropriate US Core profile(s), RESTful operations defined for the profile and Search parameters identified for the profile.</p>\n\t\t\t<p>\n\t\t\t\t<b>Security:</b>\n\t\t\t</p>\n\t\t\t<p>US Core Requestors SHALL implement applicable security requirements documented in the US Core IG.</p>\n\t\t\t<h3>Profile summary</h3>\n\t\t\t<table class=\"grid\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Profile (Resource)</th>\n\t\t\t\t\t\t<th>Search</th>\n\t\t\t\t\t\t<th>Read</th>\n\t\t\t\t\t\t<th>Read Version</th>\n\t\t\t\t\t\t<th>Instance History</th>\n\t\t\t\t\t\t<th>Resource History</th>\n\t\t\t\t\t\t<th>Create</th>\n\t\t\t\t\t\t<th>Update</th>\n\t\t\t\t\t\t<th>Delete</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/current/daf/daf-core-patient.html\"/> (Patient)</th>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Patient-search-type\" title=\"Allows discovery of existing US Core patient resources using different search criteria\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Patient-read\" title=\"Allows retrieval of a specific US Core patients by id\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Patient-vread\" title=\"Allows retrieval of a historical version of a US Core patient instance\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Patient-history-instance\" title=\"Allows review of changes to US Core patient instance over time\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/current/daf/daf-core-allergyintolerance.html\"/> (AllergyIntolerance)</th>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#AllergyIntolerance-search-type\" title=\"Allows discovery of existing US Core AllergyIntolerance resources using different search criteria\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#AllergyIntolerance-read\" title=\"Allows retrieval of a specific US Core AllergyIntolerance by id\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#AllergyIntolerance-vread\" title=\"Allows retrieval of a historical version of a US Core AllergyIntolerance instance\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#AllergyIntolerance-history-instance\" title=\"Allows review of changes to US Core AllergyIntolerance instance over time\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/current/daf/daf-core-careplan.html\"/> (CarePlan)</th>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#CarePlan-search-type\" title=\"Allows discovery of existing US Core careplan resources using different search criteria\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#CarePlan-read\" title=\"Allows retrieval of a specific US Core careplan by id\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#CarePlan-vread\" title=\"Allows retrieval of a historical version of a US Core careplan instance\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#CarePlan-history-instance\" title=\"Allows review of changes to US Core careplan instance over time\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/current/daf/daf-core-careteam.html\"/> (CarePlan)</th>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#CarePlan-search-type\" title=\"Allows discovery of existing US Core careteam resources using different search criteria\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#CarePlan-read\" title=\"Allows retrieval of a specific US Core careteam by id\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#CarePlan-vread\" title=\"Allows retrieval of a historical version of a US Core careteam instance\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#CarePlan-history-instance\" title=\"Allows review of changes to US Core careteam instance over time\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/current/daf/daf-core-condition.html\"/> (Condition)</th>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Condition-search-type\" title=\"Allows discovery of existing US Core condition resources using different search criteria\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Condition-read\" title=\"Allows retrieval of a specific US Core condition by id\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Condition-vread\" title=\"Allows retrieval of a historical version of a US Core condition instance\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Condition-history-instance\" title=\"Allows review of changes to US Core condition instance over time\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/current/daf/daf-core-device.html\"/> (Device)</th>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Device-search-type\" title=\"Allows discovery of existing US Core device resources using different search criteria\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Device-read\" title=\"Allows retrieval of a specific US Core device by id\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Device-vread\" title=\"Allows retrieval of a historical version of a US Core device instance\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Device-history-instance\" title=\"Allows review of changes to US Core device instance over time\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/current/daf/daf-core-goal.html\"/> (Goal)</th>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Goal-search-type\" title=\"Allows discovery of existing US Core goal resources using different search criteria\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Goal-read\" title=\"Allows retrieval of a specific US Core goal by id\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Goal-vread\" title=\"Allows retrieval of a historical version of a US Core goal instance\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Goal-history-instance\" title=\"Allows review of changes to US Core goal instance over time\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/current/daf/daf-core-immunization.html\"/> (Immunization)</th>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Immunization-search-type\" title=\"Allows discovery of existing US Core immunization resources using different search criteria\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Immunization-read\" title=\"Allows retrieval of a specific US Core immunization by id\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Immunization-vread\" title=\"Allows retrieval of a historical version of a US Core immunization instance\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Immunization-history-instance\" title=\"Allows review of changes to US Core immunization instance over time\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/current/daf/daf-core-diagnosticreport.html\"/> (DiagnosticReport)</th>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#DiagnosticReport-search-type\" title=\"Allows discovery of existing US Core diagnosticreport resources using different search criteria\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#DiagnosticReport-read\" title=\"Allows retrieval of a specific US Core diagnosticreport by id\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#DiagnosticReport-vread\" title=\"Allows retrieval of a historical version of a US Core diagnosticreport instance\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#DiagnosticReport-history-instance\" title=\"Allows review of changes to US Core diagnosticreport instance over time\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/current/daf/daf-core-resultobs.html\"/> (Observation)</th>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Observation-search-type\" title=\"Allows discovery of existing US Core resultobs resources using different search criteria\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Observation-read\" title=\"Allows retrieval of a specific US Core resultobs by id\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Observation-vread\" title=\"Allows retrieval of a historical version of a US Core resultobs instance\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Observation-history-instance\" title=\"Allows review of changes to US Core resultobs instance over time\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/us/core/us-core-medication.html\"/> (Medication)</th>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Medication-search-type\" title=\"IF the Medication Resource is used in a MedicationStatement or a MedicationRequest.   Allows discovery of existing US Core Medication resources using different search criteria.\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Medication-read\" title=\"IF the Medication Resource is used in a MedicationStatement or a MedicationRequest.  Allows retrieval of a specific US Core Medication by id\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Medication-vread\" title=\"Allows retrieval of a historical version of a US Core Medication instance\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Medication-history-instance\" title=\"Allows review of changes to US Core Medication instance over time\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/current/daf/daf-core-medicationstatement.html\"/> (MedicationStatement)</th>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#MedicationStatement-search-type\" title=\"Allows discovery of existing US Core medicationstatement resources using different search criteria\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#MedicationStatement-read\" title=\"Allows retrieval of a specific US Core medicationstatement by id\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#MedicationStatement-vread\" title=\"Allows retrieval of a historical version of a US Core medicationstatement instance\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#MedicationStatement-history-instance\" title=\"Allows review of changes to US Core medicationstatement instance over time\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/current/daf/daf-core-medicationorder.html\"/> (MedicationRequest)</th>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#MedicationRequest-search-type\" title=\"Allows discovery of existing US Core medicationorder resources using different search criteria\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#MedicationRequest-read\" title=\"Allows retrieval of a specific US Core medicationorder by id\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#MedicationRequest-vread\" title=\"Allows retrieval of a historical version of a US Core medicationorder instance\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#MedicationRequest-history-instance\" title=\"Allows review of changes to US Core medicationorder instance over time\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/current/daf/daf-core-smokingstatus.html\"/> (Observation)</th>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Observation-search-type\" title=\"Allows discovery of existing US Core smokingstatus resources using different search criteria\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Observation-read\" title=\"Allows retrieval of a specific US Core smokingstatus by id\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Observation-vread\" title=\"Allows retrieval of a historical version of a US Core smokingstatus instance\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Observation-history-instance\" title=\"Allows review of changes to US Core smokingstatus instance over time\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/current/daf/daf-core-vitalsigns.html\"/> (Observation)</th>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Observation-search-type\" title=\"Allows discovery of existing US Core vitalsigns resources using different search criteria\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Observation-read\" title=\"Allows retrieval of a specific US Core vitalsigns by id\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Observation-vread\" title=\"Allows retrieval of a historical version of a US Core vitalsigns instance\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Observation-history-instance\" title=\"Allows review of changes to US Core vitalsigns instance over time\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/current/daf/daf-core-procedure.html\"/> (Procedure)</th>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Procedure-search-type\" title=\"Allows discovery of existing US Core procedure resources using different search criteria\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Procedure-read\" title=\"Allows retrieval of a specific US Core procedure by id\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Procedure-vread\" title=\"Allows retrieval of a historical version of a US Core procedure instance\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Procedure-history-instance\" title=\"Allows review of changes to US Core procedure instance over time\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<p>\n\t\t\t\t<b>Operations:</b>\n\t\t\t\t<a href=\"http://hl7.org/fhir/OperationDefinition/patient-everything\" title=\"null\">patient-everything</a> SHOULD</p>\n\t\t\t<br/>\n\t\t\t<br/>\n\t\t\t<h3>Patient</h3>\n\t\t\t<p>Profile: <a href=\"http://hl7.org/fhir/current/daf/daf-core-patient.html\"/></p>\n\t\t\t<h4>Interactions</h4>\n\t\t\t<table class=\"list\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Name</th>\n\t\t\t\t\t\t<th>Conformance</th>\n\t\t\t\t\t\t<th>Description</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Patient-search-type\"> </a>\n\t\t\t\t\t\t\t<span>search-type</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows discovery of existing US Core patient resources using different search criteria</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Patient-read\"> </a>\n\t\t\t\t\t\t\t<span>read</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a specific US Core patients by id</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Patient-history-instance\"> </a>\n\t\t\t\t\t\t\t<span>history-instance</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows review of changes to US Core patient instance over time</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Patient-vread\"> </a>\n\t\t\t\t\t\t\t<span>vread</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a historical version of a US Core patient instance</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<br/>\n\t\t\t<br/>\n\t\t\t<h3>AllergyIntolerance</h3>\n\t\t\t<p>Profile: <a href=\"http://hl7.org/fhir/current/daf/daf-core-allergyintolerance.html\"/></p>\n\t\t\t<h4>Interactions</h4>\n\t\t\t<table class=\"list\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Name</th>\n\t\t\t\t\t\t<th>Conformance</th>\n\t\t\t\t\t\t<th>Description</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"AllergyIntolerance-search-type\"> </a>\n\t\t\t\t\t\t\t<span>search-type</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows discovery of existing US Core AllergyIntolerance resources using different search criteria</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"AllergyIntolerance-read\"> </a>\n\t\t\t\t\t\t\t<span>read</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a specific US Core AllergyIntolerance by id</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"AllergyIntolerance-history-instance\"> </a>\n\t\t\t\t\t\t\t<span>history-instance</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows review of changes to US Core AllergyIntolerance instance over time</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"AllergyIntolerance-vread\"> </a>\n\t\t\t\t\t\t\t<span>vread</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a historical version of a US Core AllergyIntolerance instance</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<br/>\n\t\t\t<br/>\n\t\t\t<h3>CarePlan</h3>\n\t\t\t<p>Profile: <a href=\"http://hl7.org/fhir/current/daf/daf-core-careplan.html\"/></p>\n\t\t\t<h4>Interactions</h4>\n\t\t\t<table class=\"list\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Name</th>\n\t\t\t\t\t\t<th>Conformance</th>\n\t\t\t\t\t\t<th>Description</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"CarePlan-search-type\"> </a>\n\t\t\t\t\t\t\t<span>search-type</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows discovery of existing US Core careplan resources using different search criteria</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"CarePlan-read\"> </a>\n\t\t\t\t\t\t\t<span>read</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a specific US Core careplan by id</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"CarePlan-history-instance\"> </a>\n\t\t\t\t\t\t\t<span>history-instance</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows review of changes to US Core careplan instance over time</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"CarePlan-vread\"> </a>\n\t\t\t\t\t\t\t<span>vread</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a historical version of a US Core careplan instance</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<br/>\n\t\t\t<br/>\n\t\t\t<h3>CarePlan</h3>\n\t\t\t<p>Profile: <a href=\"http://hl7.org/fhir/current/daf/daf-core-careteam.html\"/></p>\n\t\t\t<h4>Interactions</h4>\n\t\t\t<table class=\"list\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Name</th>\n\t\t\t\t\t\t<th>Conformance</th>\n\t\t\t\t\t\t<th>Description</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"CarePlan-search-type\"> </a>\n\t\t\t\t\t\t\t<span>search-type</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows discovery of existing US Core careteam resources using different search criteria</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"CarePlan-read\"> </a>\n\t\t\t\t\t\t\t<span>read</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a specific US Core careteam by id</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"CarePlan-history-instance\"> </a>\n\t\t\t\t\t\t\t<span>history-instance</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows review of changes to US Core careteam instance over time</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"CarePlan-vread\"> </a>\n\t\t\t\t\t\t\t<span>vread</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a historical version of a US Core careteam instance</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<br/>\n\t\t\t<br/>\n\t\t\t<h3>Condition</h3>\n\t\t\t<p>Profile: <a href=\"http://hl7.org/fhir/current/daf/daf-core-condition.html\"/></p>\n\t\t\t<h4>Interactions</h4>\n\t\t\t<table class=\"list\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Name</th>\n\t\t\t\t\t\t<th>Conformance</th>\n\t\t\t\t\t\t<th>Description</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Condition-search-type\"> </a>\n\t\t\t\t\t\t\t<span>search-type</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows discovery of existing US Core condition resources using different search criteria</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Condition-read\"> </a>\n\t\t\t\t\t\t\t<span>read</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a specific US Core condition by id</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Condition-history-instance\"> </a>\n\t\t\t\t\t\t\t<span>history-instance</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows review of changes to US Core condition instance over time</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Condition-vread\"> </a>\n\t\t\t\t\t\t\t<span>vread</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a historical version of a US Core condition instance</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<br/>\n\t\t\t<br/>\n\t\t\t<h3>Device</h3>\n\t\t\t<p>Profile: <a href=\"http://hl7.org/fhir/current/daf/daf-core-device.html\"/></p>\n\t\t\t<h4>Interactions</h4>\n\t\t\t<table class=\"list\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Name</th>\n\t\t\t\t\t\t<th>Conformance</th>\n\t\t\t\t\t\t<th>Description</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Device-search-type\"> </a>\n\t\t\t\t\t\t\t<span>search-type</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows discovery of existing US Core device resources using different search criteria</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Device-read\"> </a>\n\t\t\t\t\t\t\t<span>read</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a specific US Core device by id</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Device-history-instance\"> </a>\n\t\t\t\t\t\t\t<span>history-instance</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows review of changes to US Core device instance over time</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Device-vread\"> </a>\n\t\t\t\t\t\t\t<span>vread</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a historical version of a US Core device instance</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<br/>\n\t\t\t<br/>\n\t\t\t<h3>Goal</h3>\n\t\t\t<p>Profile: <a href=\"http://hl7.org/fhir/current/daf/daf-core-goal.html\"/></p>\n\t\t\t<h4>Interactions</h4>\n\t\t\t<table class=\"list\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Name</th>\n\t\t\t\t\t\t<th>Conformance</th>\n\t\t\t\t\t\t<th>Description</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Goal-search-type\"> </a>\n\t\t\t\t\t\t\t<span>search-type</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows discovery of existing US Core goal resources using different search criteria</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Goal-read\"> </a>\n\t\t\t\t\t\t\t<span>read</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a specific US Core goal by id</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Goal-history-instance\"> </a>\n\t\t\t\t\t\t\t<span>history-instance</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows review of changes to US Core goal instance over time</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Goal-vread\"> </a>\n\t\t\t\t\t\t\t<span>vread</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a historical version of a US Core goal instance</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<br/>\n\t\t\t<br/>\n\t\t\t<h3>Immunization</h3>\n\t\t\t<p>Profile: <a href=\"http://hl7.org/fhir/current/daf/daf-core-immunization.html\"/></p>\n\t\t\t<h4>Interactions</h4>\n\t\t\t<table class=\"list\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Name</th>\n\t\t\t\t\t\t<th>Conformance</th>\n\t\t\t\t\t\t<th>Description</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Immunization-search-type\"> </a>\n\t\t\t\t\t\t\t<span>search-type</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows discovery of existing US Core immunization resources using different search criteria</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Immunization-read\"> </a>\n\t\t\t\t\t\t\t<span>read</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a specific US Core immunization by id</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Immunization-history-instance\"> </a>\n\t\t\t\t\t\t\t<span>history-instance</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows review of changes to US Core immunization instance over time</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Immunization-vread\"> </a>\n\t\t\t\t\t\t\t<span>vread</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a historical version of a US Core immunization instance</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<br/>\n\t\t\t<br/>\n\t\t\t<h3>DiagnosticReport</h3>\n\t\t\t<p>Profile: <a href=\"http://hl7.org/fhir/current/daf/daf-core-diagnosticreport.html\"/></p>\n\t\t\t<h4>Interactions</h4>\n\t\t\t<table class=\"list\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Name</th>\n\t\t\t\t\t\t<th>Conformance</th>\n\t\t\t\t\t\t<th>Description</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"DiagnosticReport-search-type\"> </a>\n\t\t\t\t\t\t\t<span>search-type</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows discovery of existing US Core diagnosticreport resources using different search criteria</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"DiagnosticReport-read\"> </a>\n\t\t\t\t\t\t\t<span>read</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a specific US Core diagnosticreport by id</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"DiagnosticReport-history-instance\"> </a>\n\t\t\t\t\t\t\t<span>history-instance</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows review of changes to US Core diagnosticreport instance over time</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"DiagnosticReport-vread\"> </a>\n\t\t\t\t\t\t\t<span>vread</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a historical version of a US Core diagnosticreport instance</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<br/>\n\t\t\t<br/>\n\t\t\t<h3>Observation</h3>\n\t\t\t<p>Profile: <a href=\"http://hl7.org/fhir/current/daf/daf-core-resultobs.html\"/></p>\n\t\t\t<h4>Interactions</h4>\n\t\t\t<table class=\"list\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Name</th>\n\t\t\t\t\t\t<th>Conformance</th>\n\t\t\t\t\t\t<th>Description</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Observation-search-type\"> </a>\n\t\t\t\t\t\t\t<span>search-type</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows discovery of existing US Core resultobs resources using different search criteria</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Observation-read\"> </a>\n\t\t\t\t\t\t\t<span>read</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a specific US Core resultobs by id</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Observation-history-instance\"> </a>\n\t\t\t\t\t\t\t<span>history-instance</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows review of changes to US Core resultobs instance over time</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Observation-vread\"> </a>\n\t\t\t\t\t\t\t<span>vread</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a historical version of a US Core resultobs instance</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<br/>\n\t\t\t<br/>\n\t\t\t<h3>Medication</h3>\n\t\t\t<p>Profile: <a href=\"http://hl7.org/fhir/us/core/us-core-medication.html\"/></p>\n\t\t\t<p>The MedicationStatement and MedicationRequest resources can represent a medication, using either a code or refer to a <a href=\"Medication\">Medication</a> resource.  If the Medication Resource is used in a MedicationStatement or a MedicationRequest,  then the READ and SEARCH Criteria **SHALL** be supported.</p>\n\t\t\t<h4>Interactions</h4>\n\t\t\t<table class=\"list\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Name</th>\n\t\t\t\t\t\t<th>Conformance</th>\n\t\t\t\t\t\t<th>Description</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Medication-search-type\"> </a>\n\t\t\t\t\t\t\t<span>search-type</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>IF the Medication Resource is used in a MedicationStatement or a MedicationRequest.   Allows discovery of existing US Core Medication resources using different search criteria.</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Medication-read\"> </a>\n\t\t\t\t\t\t\t<span>read</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>IF the Medication Resource is used in a MedicationStatement or a MedicationRequest.  Allows retrieval of a specific US Core Medication by id</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Medication-history-instance\"> </a>\n\t\t\t\t\t\t\t<span>history-instance</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows review of changes to US Core Medication instance over time</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Medication-vread\"> </a>\n\t\t\t\t\t\t\t<span>vread</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a historical version of a US Core Medication instance</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<br/>\n\t\t\t<br/>\n\t\t\t<h3>MedicationStatement</h3>\n\t\t\t<p>Profile: <a href=\"http://hl7.org/fhir/current/daf/daf-core-medicationstatement.html\"/></p>\n\t\t\t<p>The MedicationStatement and MedicationRequest resources can represent a medication, using either a code or refer to a <a href=\"Medication\">Medication</a> resource.   *  When referencing a Medication resource,  the resource may be <a href=\"contained\">contained</a> or an external resource.   *  The server application can choose any one way or more than one method,  but if the an external reference to Medication is used, the server SHALL support the <a href=\"include\">include</a> parameter for searching this element.   *  The client application must support both methods.        <a href=\"include\">include</a>: http://hl7.org/fhir/2017Jan/search.html#include  <a href=\"contained\">contained</a>: http://hl7.org/fhir/2017Jan/references.html#contained  <a href=\"Medication\">Medication</a>:http://hl7.org/fhir/2017Jan/medication.html </p>\n\t\t\t<h4>Interactions</h4>\n\t\t\t<table class=\"list\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Name</th>\n\t\t\t\t\t\t<th>Conformance</th>\n\t\t\t\t\t\t<th>Description</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"MedicationStatement-search-type\"> </a>\n\t\t\t\t\t\t\t<span>search-type</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows discovery of existing US Core medicationstatement resources using different search criteria</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"MedicationStatement-read\"> </a>\n\t\t\t\t\t\t\t<span>read</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a specific US Core medicationstatement by id</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"MedicationStatement-history-instance\"> </a>\n\t\t\t\t\t\t\t<span>history-instance</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows review of changes to US Core medicationstatement instance over time</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"MedicationStatement-vread\"> </a>\n\t\t\t\t\t\t\t<span>vread</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a historical version of a US Core medicationstatement instance</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<br/>\n\t\t\t<br/>\n\t\t\t<h3>MedicationRequest</h3>\n\t\t\t<p>Profile: <a href=\"http://hl7.org/fhir/current/daf/daf-core-medicationorder.html\"/></p>\n\t\t\t<p>The MedicationStatement and MedicationRequest resources can represent a medication, using either a code or refer to a <a href=\"Medication\">Medication</a> resource.   *  When referencing a Medication resource,  the resource may be <a href=\"contained\">contained</a> or an external resource.   *  The server application can choose any one way or more than one method,  but if the an external reference to Medication is used, the server SHALL support the <a href=\"include\">include</a> parameter for searching this element.   *  The client application must support both methods.        <a href=\"include\">include</a>: http://hl7.org/fhir/2017Jan/search.html#include  <a href=\"contained\">contained</a>: http://hl7.org/fhir/2017Jan/references.html#contained  <a href=\"Medication\">Medication</a>:http://hl7.org/fhir/2017Jan/medication.html </p>\n\t\t\t<h4>Interactions</h4>\n\t\t\t<table class=\"list\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Name</th>\n\t\t\t\t\t\t<th>Conformance</th>\n\t\t\t\t\t\t<th>Description</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"MedicationRequest-search-type\"> </a>\n\t\t\t\t\t\t\t<span>search-type</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows discovery of existing US Core medicationorder resources using different search criteria</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"MedicationRequest-read\"> </a>\n\t\t\t\t\t\t\t<span>read</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a specific US Core medicationorder by id</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"MedicationRequest-history-instance\"> </a>\n\t\t\t\t\t\t\t<span>history-instance</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows review of changes to US Core medicationorder instance over time</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"MedicationRequest-vread\"> </a>\n\t\t\t\t\t\t\t<span>vread</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a historical version of a US Core medicationorder instance</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<br/>\n\t\t\t<br/>\n\t\t\t<h3>Observation</h3>\n\t\t\t<p>Profile: <a href=\"http://hl7.org/fhir/current/daf/daf-core-smokingstatus.html\"/></p>\n\t\t\t<h4>Interactions</h4>\n\t\t\t<table class=\"list\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Name</th>\n\t\t\t\t\t\t<th>Conformance</th>\n\t\t\t\t\t\t<th>Description</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Observation-search-type\"> </a>\n\t\t\t\t\t\t\t<span>search-type</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows discovery of existing US Core smokingstatus resources using different search criteria</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Observation-read\"> </a>\n\t\t\t\t\t\t\t<span>read</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a specific US Core smokingstatus by id</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Observation-history-instance\"> </a>\n\t\t\t\t\t\t\t<span>history-instance</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows review of changes to US Core smokingstatus instance over time</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Observation-vread\"> </a>\n\t\t\t\t\t\t\t<span>vread</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a historical version of a US Core smokingstatus instance</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<br/>\n\t\t\t<br/>\n\t\t\t<h3>Observation</h3>\n\t\t\t<p>Profile: <a href=\"http://hl7.org/fhir/current/daf/daf-core-vitalsigns.html\"/></p>\n\t\t\t<h4>Interactions</h4>\n\t\t\t<table class=\"list\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Name</th>\n\t\t\t\t\t\t<th>Conformance</th>\n\t\t\t\t\t\t<th>Description</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Observation-search-type\"> </a>\n\t\t\t\t\t\t\t<span>search-type</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows discovery of existing US Core vitalsigns resources using different search criteria</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Observation-read\"> </a>\n\t\t\t\t\t\t\t<span>read</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a specific US Core vitalsigns by id</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Observation-history-instance\"> </a>\n\t\t\t\t\t\t\t<span>history-instance</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows review of changes to US Core vitalsigns instance over time</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Observation-vread\"> </a>\n\t\t\t\t\t\t\t<span>vread</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a historical version of a US Core vitalsigns instance</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<br/>\n\t\t\t<br/>\n\t\t\t<h3>Procedure</h3>\n\t\t\t<p>Profile: <a href=\"http://hl7.org/fhir/current/daf/daf-core-procedure.html\"/></p>\n\t\t\t<h4>Interactions</h4>\n\t\t\t<table class=\"list\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Name</th>\n\t\t\t\t\t\t<th>Conformance</th>\n\t\t\t\t\t\t<th>Description</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Procedure-search-type\"> </a>\n\t\t\t\t\t\t\t<span>search-type</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows discovery of existing US Core procedure resources using different search criteria</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Procedure-read\"> </a>\n\t\t\t\t\t\t\t<span>read</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a specific US Core procedure by id</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Procedure-history-instance\"> </a>\n\t\t\t\t\t\t\t<span>history-instance</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows review of changes to US Core procedure instance over time</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Procedure-vread\"> </a>\n\t\t\t\t\t\t\t<span>vread</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a historical version of a US Core procedure instance</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t</div>"
+    "status": "additional",
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n\t\t\t<h3 id=\"conformance-requirements-for-the-us-core-server\">Conformance requirements for the US Core Server</h3>\n\t\t\t\n\t\t\t<p>\n\t\t\t\t<strong>Contents</strong>\n\t\t\t</p>\n\t\t\t<ul id=\"markdown-toc\">\n\t\t\t\t<li>\n\t\t\t\t\t<a href=\"#conformance-requirements-for-the-us-core-server\">Conformance requirements for the US Core Server</a>\n\t\t\t\t\t<ul>\n\t\t\t\t\t\t<li>\n\t\t\t\t\t\t\t<a href=\"#behavior\">Behavior</a>\n\t\t\t\t\t\t</li>\n\t\t\t\t\t\t<li>\n\t\t\t\t\t\t\t<a href=\"#resource-details\">Resource Details</a>\n\t\t\t\t\t\t\t<ul>\n\t\t\t\t\t\t\t\t<li>\n\t\t\t\t\t\t\t\t\t<a href=\"#patient\">1. Patient</a>\n\t\t\t\t\t\t\t\t</li>\n\t\t\t\t\t\t\t\t<li>\n\t\t\t\t\t\t\t\t\t<a href=\"#allergyintolerance\">2. AllergyIntolerance</a>\n\t\t\t\t\t\t\t\t</li>\n\t\t\t\t\t\t\t\t<li>\n\t\t\t\t\t\t\t\t\t<a href=\"#careplan\">3. CarePlan</a>\n\t\t\t\t\t\t\t\t</li>\n\t\t\t\t\t\t\t\t<li>\n\t\t\t\t\t\t\t\t\t<a href=\"#careteam\">4. CareTeam</a>\n\t\t\t\t\t\t\t\t</li>\n\t\t\t\t\t\t\t\t<li>\n\t\t\t\t\t\t\t\t\t<a href=\"#condition\">5. Condition</a>\n\t\t\t\t\t\t\t\t</li>\n\t\t\t\t\t\t\t\t<li>\n\t\t\t\t\t\t\t\t\t<a href=\"#device\">6. Device</a>\n\t\t\t\t\t\t\t\t</li>\n\t\t\t\t\t\t\t\t<li>\n\t\t\t\t\t\t\t\t\t<a href=\"#diagnosticreport\">7. DiagnosticReport</a>\n\t\t\t\t\t\t\t\t</li>\n\t\t\t\t\t\t\t\t<li>\n\t\t\t\t\t\t\t\t\t<a href=\"#goal\">8. Goal</a>\n\t\t\t\t\t\t\t\t</li>\n\t\t\t\t\t\t\t\t<li>\n\t\t\t\t\t\t\t\t\t<a href=\"#immunization\">9. Immunization</a>\n\t\t\t\t\t\t\t\t</li>\n\t\t\t\t\t\t\t\t<li>\n\t\t\t\t\t\t\t\t\t<a href=\"#location\">10. Location</a>\n\t\t\t\t\t\t\t\t</li>\n\t\t\t\t\t\t\t\t<li>\n\t\t\t\t\t\t\t\t\t<a href=\"#medication\">11. Medication</a>\n\t\t\t\t\t\t\t\t</li>\n\t\t\t\t\t\t\t\t<li>\n\t\t\t\t\t\t\t\t\t<a href=\"#medicationstatement\">12. MedicationStatement</a>\n\t\t\t\t\t\t\t\t</li>\n\t\t\t\t\t\t\t\t<li>\n\t\t\t\t\t\t\t\t\t<a href=\"#medicationrequest\">13. MedicationRequest</a>\n\t\t\t\t\t\t\t\t</li>\n\t\t\t\t\t\t\t\t<li>\n\t\t\t\t\t\t\t\t\t<a href=\"#observation\">14. Observation</a>\n\t\t\t\t\t\t\t\t</li>\n\t\t\t\t\t\t\t\t<li>\n\t\t\t\t\t\t\t\t\t<a href=\"#organization\">15. Organization</a>\n\t\t\t\t\t\t\t\t</li>\n\t\t\t\t\t\t\t\t<li>\n\t\t\t\t\t\t\t\t\t<a href=\"#practitioner\">16. Practitioner</a>\n\t\t\t\t\t\t\t\t</li>\n\t\t\t\t\t\t\t\t<li>\n\t\t\t\t\t\t\t\t\t<a href=\"#procedure\">17. Procedure</a>\n\t\t\t\t\t\t\t\t</li>\n\t\t\t\t\t\t\t</ul>\n\t\t\t\t\t\t</li>\n\t\t\t\t\t</ul>\n\t\t\t\t</li>\n\t\t\t</ul>\n\t\t\t\n\t\t\t<ul>\n\t\t\t\t<li>FHIR Version: 1.9.0</li>\n\t\t\t\t<li>Supported formats: xml, json</li>\n\t\t\t\t<li>Published: 2017-03-08</li>\n\t\t\t\t<li>Published by: Health Level Seven International US Realm Steering Committee</li>\n\t\t\t</ul>\n\t\t\t<p>The Section describes the expected capabilities of the  US-Core Client which is responsible for creating and initiating the queries for information about an individual patient. The complete list of FHIR profiles, RESTful operations, and search parameters supported by US Core Servers are defined in the <a href=\"#conformance-requirements-for-the-us-core-server\">Conformance requirements for the US-Core Server section</a>. US Core Clients have the option of choosing from this list to access necessary data based on their local use cases and other contextual requirements.</p>\n\t\t\t<h4 id=\"behavior\">Behavior</h4>\n\t\t\t<p>Description:</p>\n\t\t\t<p>The US Core Client <strong>SHOULD</strong>:</p>\n\t\t\t<ul>\n\t\t\t\t<li>Support fetching and querying of one or more US Core profile(s), using the supported RESTful interactions and search parameters declared in the US Core Server CapabilityStatement.</li>\n\t\t\t</ul>\n\t\t\t<p>security:</p>\n\t\t\t<p>The US Core Client <strong>SHALL</strong>:</p>\n\t\t\t<ul>\n\t\t\t\t<li>implement the <a href=\"security.html\">security requirements</a> documented in the US-Core IG.</li>\n\t\t\t</ul>\n\t\t\t<h4 id=\"resource-details\">Resource Details</h4>\n\t\t\t<h5 id=\"patient\">1. Patient</h5>\n\t\t\t<p>Supported Profiles:  <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-patient.html\">US Core Patient Profile</a>\n\t\t\t</p>\n\t\t\t<p>Search Criteria:</p>\n\t\t\t<ul>\n\t\t\t\t<li>\n\t\t\t\t\t<p>A client <strong>SHOULD</strong> be capable of connecting to a server and fetching a patient using:</p>\n\t\t\t\t\t<p>\n\t\t\t\t\t\t<code>GET [base]/Patient/[id]</code>.</p>\n\t\t\t\t</li>\n\t\t\t\t<li>\n\t\t\t\t\t<p>A client <strong>SHOULD</strong> be capable of connecting to a server and fetching a patient by identifier using</p>\n\t\t\t\t\t<p>\n\t\t\t\t\t\t<code>GET [base]/Patient?identifier=[system]|[code]</code>\n\t\t\t\t\t</p>\n\t\t\t\t</li>\n\t\t\t\t<li>\n\t\t\t\t\t<p>A client <strong>SHOULD</strong> be capable of connecting to a server and fetching a patient by supporting at a minimum the following search parameters when at least 2 are present. To limit overly broad search results, a client search with gender should include family and given name search parameters.:</p>\n\t\t\t\t\t<ul>\n\t\t\t\t\t\t<li>name</li>\n\t\t\t\t\t\t<li>gender</li>\n\t\t\t\t\t\t<li>\n\t\t\t\t\t\t\t<p>birthdate</p>\n\t\t\t\t\t\t\t<ul>\n\t\t\t\t\t\t\t\t<li>for example:</li>\n\t\t\t\t\t\t\t</ul>\n\t\t\t\t\t\t\t<p>\n\t\t\t\t\t\t\t\t<code>GET [base]/Patient?family=[name]&amp;?given=[name]&amp;gender=[gender]</code>\n\t\t\t\t\t\t\t</p>\n\t\t\t\t\t\t</li>\n\t\t\t\t\t</ul>\n\t\t\t\t</li>\n\t\t\t</ul>\n\t\t\t<h5 id=\"allergyintolerance\">2. AllergyIntolerance</h5>\n\t\t\t<p>Supported Profiles:  <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-allergyintolerance.html\">US Core AllergyIntolerance Profile</a>\n\t\t\t</p>\n\t\t\t<p>Search Criteria:</p>\n\t\t\t<ul>\n\t\t\t\t<li>\n\t\t\t\t\t<p>A client <strong>SHOULD</strong> be capable of connecting to a server and fetching all patient's allergies using:</p>\n\t\t\t\t\t<p>\n\t\t\t\t\t\t<code>Get [base]/AllergyIntolerance?patient=[id]</code>\n\t\t\t\t\t</p>\n\t\t\t\t</li>\n\t\t\t</ul>\n\t\t\t<h5 id=\"careplan\">3. CarePlan</h5>\n\t\t\t<p>Supported Profiles:  <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-careplan.html\">US Core CarePlan Profile</a>\n\t\t\t</p>\n\t\t\t<p>Search Criteria:</p>\n\t\t\t<ul>\n\t\t\t\t<li>\n\t\t\t\t\t<p>A client <strong>SHOULD</strong> be capable of connecting to a server and fetching all of a patient's Assessment and Plan of Treatment information using:</p>\n\t\t\t\t\t<p>\n\t\t\t\t\t\t<code>Get [base]/CarePlan?patient=[id]&amp;category=assess-plan</code>\n\t\t\t\t\t</p>\n\t\t\t\t</li>\n\t\t\t\t<li>\n\t\t\t\t\t<p>A client <strong>SHOULD</strong> be capable of connecting to a server and fetching a patient's Assessment and Plan of Treatment information over a specified time period using:</p>\n\t\t\t\t\t<p>\n\t\t\t\t\t\t<code>Get [base]/CarePlan?patient=[id]&amp;category=assess-plan&amp;date=[date]</code>\n\t\t\t\t\t</p>\n\t\t\t\t</li>\n\t\t\t\t<li>\n\t\t\t\t\t<p>A client <strong>SHOULD</strong> be capable of connecting to a server and fetching all of a patient's active Assessment and Plan of Treatment information using</p>\n\t\t\t\t\t<p>\n\t\t\t\t\t\t<code>Get [base]/CarePlan?patient=[id]&amp;category=assess-plan&amp;status=active</code>\n\t\t\t\t\t</p>\n\t\t\t\t</li>\n\t\t\t\t<li>\n\t\t\t\t\t<p>A client <strong>SHOULD</strong> be capable of connecting to a server and fetching a patient's active Assessment and Plan of Treatment information over a specified time period using</p>\n\t\t\t\t\t<p>\n\t\t\t\t\t\t<code>Get [base]/CarePlan?patient=[id]&amp;category=assess-plan&amp;status=active&amp;date=[date]</code>\n\t\t\t\t\t</p>\n\t\t\t\t</li>\n\t\t\t</ul>\n\t\t\t<h5 id=\"careteam\">4. CareTeam</h5>\n\t\t\t<p>Supported Profiles:  <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-careteam.html\">US Core CareTeam Profile</a>\n\t\t\t</p>\n\t\t\t<p>Search Criteria:</p>\n\t\t\t<ul>\n\t\t\t\t<li>\n\t\t\t\t\t<p>A client <strong>SHOULD</strong> be capable of connecting to a server and fetching  a patient's current care team members using:</p>\n\t\t\t\t\t<p>\n\t\t\t\t\t\t<code>Get [base]/CareTeam?patient=[id]&amp;status=active</code>\n\t\t\t\t\t</p>\n\t\t\t\t</li>\n\t\t\t</ul>\n\t\t\t<h5 id=\"condition\">5. Condition</h5>\n\t\t\t<p>Supported Profiles:  <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-Condition.html\">US Core Condition Profile</a>\n\t\t\t</p>\n\t\t\t<p>Search Criteria:</p>\n\t\t\t<ul>\n\t\t\t\t<li>\n\t\t\t\t\t<p>A client <strong>SHOULD</strong> be capable of fetching all problems and health concerns for a patient, including current as well as historical problems and health concerns using:</p>\n\t\t\t\t\t<p>\n\t\t\t\t\t\t<code>Get [base]/Condition?patient=[id]</code>\n\t\t\t\t\t</p>\n\t\t\t\t</li>\n\t\t\t\t<li>\n\t\t\t\t\t<p>A client <strong>SHOULD</strong> be capable of connecting to a server and fetching all of a patient's <em>active</em> problems and health concerns using:</p>\n\t\t\t\t\t<p>\n\t\t\t\t\t\t<code>Get [base]/Condition?patient=[id]&amp;clinicalstatus=active,recurrance,remission</code>\n\t\t\t\t\t</p>\n\t\t\t\t</li>\n\t\t\t\t<li>\n\t\t\t\t\t<p>A client <strong>SHOULD</strong> be capable of connecting to a server and fetching all of a patient's problems <em>or</em> all of patient's health concerns using:</p>\n\t\t\t\t\t<p>\n\t\t\t\t\t\t<code>Get [base]/Condition?patient=[id]&amp;category=[problem|health-concern]</code>\n\t\t\t\t\t</p>\n\t\t\t\t</li>\n\t\t\t</ul>\n\t\t\t<h5 id=\"device\">6. Device</h5>\n\t\t\t<p>Supported Profiles:  <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-device.html\">US Core Device Profile</a>\n\t\t\t</p>\n\t\t\t<p>Search Criteria:</p>\n\t\t\t<ul>\n\t\t\t\t<li>\n\t\t\t\t\t<p>A client <strong>SHOULD</strong> be capable of connecting to a server and fetching all Unique device identifier(s)(UDI) for a patient's implanted device(s):</p>\n\t\t\t\t\t<p>\n\t\t\t\t\t\t<code>Get [base]/Device?patient=[id]</code>\n\t\t\t\t\t</p>\n\t\t\t\t</li>\n\t\t\t</ul>\n\t\t\t<h5 id=\"diagnosticreport\">7. DiagnosticReport</h5>\n\t\t\t<p>Supported Profiles:  <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-diagnosticreport.html\">US Core DiagnosticReport Profile</a>\n\t\t\t</p>\n\t\t\t<p>Search Criteria:</p>\n\t\t\t<ul>\n\t\t\t\t<li>\n\t\t\t\t\t<p>A client <strong>SHOULD</strong> be capable of connecting to a server and fetching all of a patient's laboratory diagnostic reports queried by category using:</p>\n\t\t\t\t\t<p>\n\t\t\t\t\t\t<code>Get [base]/DiagnosticReport?patient=[id]&amp;category=LAB</code>\n\t\t\t\t\t</p>\n\t\t\t\t</li>\n\t\t\t\t<li>\n\t\t\t\t\t<p>A client <strong>SHOULD</strong> be capable of connecting to a server and fetching all of a patient's laboratory diagnostic reports queried by category code and date range using:</p>\n\t\t\t\t\t<p>\n\t\t\t\t\t\t<code>GET [base]/DiagnosticReport?patient=[id]&amp;category=LAB&amp;date=[date]{&amp;date=[date]}</code>\n\t\t\t\t\t</p>\n\t\t\t\t</li>\n\t\t\t\t<li>\n\t\t\t\t\t<p>A client <strong>SHOULD</strong> be capable of connecting to a server and fetching all of a patient's laboratory diagnostic reports queried by category and code using:</p>\n\t\t\t\t\t<p>\n\t\t\t\t\t\t<code>GET [base]/DiagnosticReport?patient=[id]&amp;category=LAB&amp;code=[LOINC]</code>\n\t\t\t\t\t</p>\n\t\t\t\t</li>\n\t\t\t\t<li>\n\t\t\t\t\t<p>A client <strong>SHOULD</strong> be capable of connecting to a server and fetching all of a patient's laboratory diagnostic reports queried by category and one or more codes and date range using:</p>\n\t\t\t\t\t<p>\n\t\t\t\t\t\t<code>GET [base]/DiagnosticReport?patient=[id]&amp;category=LAB&amp;code=[LOINC1{,LOINC2,LOINC3,…}]&amp;date=[date]{&amp;date=[date]}</code>\n\t\t\t\t\t</p>\n\t\t\t\t</li>\n\t\t\t</ul>\n\t\t\t<h5 id=\"goal\">8. Goal</h5>\n\t\t\t<p>Supported Profiles:  <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-goal.html\">US Core Goal Profile</a>\n\t\t\t</p>\n\t\t\t<p>Search Criteria:</p>\n\t\t\t<ul>\n\t\t\t\t<li>\n\t\t\t\t\t<p>A client <strong>SHOULD</strong> be capable of connecting to a server and fetching all of a patient's goals using:</p>\n\t\t\t\t\t<p>\n\t\t\t\t\t\t<code>Get [base]/Goal?patient=[id]</code>\n\t\t\t\t\t</p>\n\t\t\t\t</li>\n\t\t\t\t<li>\n\t\t\t\t\t<p>A client <strong>SHOULD</strong> be capable of connecting to a server and fetching all of all of a patient's goals over a specified time period using:</p>\n\t\t\t\t\t<p>\n\t\t\t\t\t\t<code>GET [base]/Goal?patient=[id]&amp;date=[date]{&amp;date=[date]}</code>\n\t\t\t\t\t</p>\n\t\t\t\t</li>\n\t\t\t</ul>\n\t\t\t<h5 id=\"immunization\">9. Immunization</h5>\n\t\t\t<p>Supported Profiles:  <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-immunization.html\">US Core Immunization Profile</a>\n\t\t\t</p>\n\t\t\t<p>Search Criteria:</p>\n\t\t\t<ul>\n\t\t\t\t<li>\n\t\t\t\t\t<p>A client <strong>SHOULD</strong> be capable of connecting to a server and fetching all immunizations for a patient using:</p>\n\t\t\t\t\t<p>\n\t\t\t\t\t\t<code>Get [base]/Immunization?patient=[id]</code>\n\t\t\t\t\t</p>\n\t\t\t\t</li>\n\t\t\t</ul>\n\t\t\t<h5 id=\"location\">10. Location</h5>\n\t\t\t<p>Supported Profiles:  <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-location.html\">US Core Location Profile</a>\n\t\t\t</p>\n\t\t\t<p>Search Criteria:</p>\n\t\t\t<ul>\n\t\t\t\t<li>\n\t\t\t\t\t<p>A client <strong>SHOULD</strong> be capable of connecting to a server and fetching a location by name using:</p>\n\t\t\t\t\t<p>\n\t\t\t\t\t\t<code>Get [base]/Location?name=[string]</code>\n\t\t\t\t\t</p>\n\t\t\t\t</li>\n\t\t\t\t<li>\n\t\t\t\t\t<p>A client <strong>SHOULD</strong> be capable of connecting to a server and fetching a location by address using:</p>\n\t\t\t\t\t<p>\n\t\t\t\t\t\t<code>GET [base]/Location?address=[string]</code>\n\t\t\t\t\t</p>\n\t\t\t\t</li>\n\t\t\t</ul>\n\t\t\t<h5 id=\"medication\">11. Medication</h5>\n\t\t\t<p>Supported Profiles:  <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-medication.html\">US Core Medication Profile</a>\n\t\t\t</p>\n\t\t\t<p>The MedicationStatement and MedicationRequest resources can represent a medication, using an external reference to a Medication resource. If an external Medication Resource is used in a MedicationStatement or a MedicationRequest, then the READ and SEARCH Criteria SHOULD be supported.</p>\n\t\t\t<h5 id=\"medicationstatement\">12. MedicationStatement</h5>\n\t\t\t<p>Supported Profiles:  <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-medicationstatement.html\">US Core MedicationStatement Profile</a>\n\t\t\t</p>\n\t\t\t<p>Search Criteria:</p>\n\t\t\t<p>The MedicationStatement resources can represent a medication using either a code or refer to the Medication resource.  When referencing a Medication resource, the resource may be <a href=\"http://hl7.org/fhir/2017Jan/references.html#contained\">contained</a> or an external resource. IF, an external reference to Medication is used, the server <strong>SHALL</strong> support the <a href=\"http://hl7.org/fhir/2017Jan/references.html#include\">\n\t\t\t\t\t<code>_include</code>\n\t\t\t\t</a> parameter for searching this element. The client application <strong>SHALL</strong> support all methods.</p>\n\t\t\t<p>A client <strong>SHOULD</strong> be capable of connecting to a server and fetching all medications for a patient using both:</p>\n\t\t\t<p>\n\t\t\t\t<code>GET /MedicationStatement?patient=[id]</code>\n\t\t\t</p>\n\t\t\t<p>and</p>\n\t\t\t<p>\n\t\t\t\t<code>GET /MedicationStatement?patient=[id]&amp;_include=MedicationStatement:medication</code>\n\t\t\t</p>\n\t\t\t<h5 id=\"medicationrequest\">13. MedicationRequest</h5>\n\t\t\t<p>Supported Profiles:  <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-medicationrequest.html\">US Core MedicationRequest Profile</a>\n\t\t\t</p>\n\t\t\t<p>Search Criteria:</p>\n\t\t\t<p>The MedicationRequest resources can represent a medication using either a code or refer to the Medication resource.  When referencing a Medication resource, the resource may be <a href=\"http://hl7.org/fhir/2017Jan/references.html#contained\">contained</a> or an external resource. If, an external reference to Medication is used, the server <strong>SHALL</strong> support the <a href=\"http://hl7.org/fhir/2017Jan/references.html#include\">\n\t\t\t\t\t<code>_include</code>\n\t\t\t\t</a> parameter for searching this element. The client application <strong>SHALL</strong> support all methods.</p>\n\t\t\t<p>A client <strong>SHOULD</strong> be capable of connecting to a server and fetching all medications for a patient using both:</p>\n\t\t\t<p>\n\t\t\t\t<code>GET /MedicationRequest?patient=[id]</code>\n\t\t\t</p>\n\t\t\t<p>and</p>\n\t\t\t<p>\n\t\t\t\t<code>GET /MedicationRequest?patient=[id]&amp;_include=MedicationRequest:medication</code>\n\t\t\t</p>\n\t\t\t<h5 id=\"observation\">14. Observation</h5>\n\t\t\t<p>Supported Profiles:\n1. <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-observationresults.html\">US Core Result Observation Profile</a>\n\t\t\t</p>\n\t\t\t<p>Search Criteria:</p>\n\t\t\t<ul>\n\t\t\t\t<li>\n\t\t\t\t\t<p>A client <strong>SHOULD</strong> be capable of connecting to a server and fetching all of a patient's laboratory results \n\nqueried by category using:</p>\n\t\t\t\t\t<p>\n\t\t\t\t\t\t<code>GET [base]/Observation?patient=[id]&amp;category=laboratory</code>\n\t\t\t\t\t</p>\n\t\t\t\t</li>\n\t\t\t\t<li>\n\t\t\t\t\t<p>A client <strong>SHOULD</strong> be capable of connecting to a server and fetching all of a patient's laboratory results queried by category code and date range using:</p>\n\t\t\t\t\t<p>\n\t\t\t\t\t\t<code>GET [base]/Observation?patient=[id]&amp;category=laboratory&amp;date=[date]{&amp;date=[date]}</code>\n\t\t\t\t\t</p>\n\t\t\t\t</li>\n\t\t\t\t<li>\n\t\t\t\t\t<p>A client <strong>SHOULD</strong> be capable of connecting to a server and fetching all of a patient's laboratory results queried by category and code using:</p>\n\t\t\t\t\t<p>\n\t\t\t\t\t\t<code>GET [base]/Observation?patient=[id]&amp;category=laboratory&amp;code=[LOINC]</code>\n\t\t\t\t\t</p>\n\t\t\t\t</li>\n\t\t\t\t<li>\n\t\t\t\t\t<p>A client <strong>SHOULD</strong> be capable of connecting to a server and fetching all of a patient's laboratory results queried by category and one or more codes and date range using:</p>\n\t\t\t\t\t<p>\n\t\t\t\t\t\t<code>GET [base]/Observation?patient=[id]&amp;category=laboratory&amp;code=[LOINC1{,LOINC2,LOINC3,...}]&amp;date=[date]{&amp;date=[date]}</code>\n\t\t\t\t\t</p>\n\t\t\t\t</li>\n\t\t\t</ul>\n\t\t\t<ol>\n\t\t\t\t<li>\n\t\t\t\t\t<a href=\"http://hl7.org/fhir/STU3/vitalsigns.html\">Vital Signs Profile</a>\n\t\t\t\t</li>\n\t\t\t</ol>\n\t\t\t<p>Search Criteria</p>\n\t\t\t<ul>\n\t\t\t\t<li>\n\t\t\t\t\t<p>A client <strong>SHOULD</strong> be capable of connecting to a server and fetching all of a patient's vital signs that it supports using:</p>\n\t\t\t\t\t<p>\n\t\t\t\t\t\t<code>GET [base]/Observation?patient=[id]&amp;category=vital-signs</code>\n\t\t\t\t\t</p>\n\t\t\t\t</li>\n\t\t\t\t<li>\n\t\t\t\t\t<p>A client <strong>SHOULD</strong> be capable of connecting to a server and fetching all of a patient's vital signs queried by date range using:</p>\n\t\t\t\t\t<p>\n\t\t\t\t\t\t<code>GET [base]/Observation?patient=[id]&amp;category=vital-signs&amp;date=[date]{&amp;date=[date]}</code>\n\t\t\t\t\t</p>\n\t\t\t\t</li>\n\t\t\t\t<li>\n\t\t\t\t\t<p>A client <strong>SHOULD</strong> be capable of connecting to a server and fetching any of a patient's vital signs queried by one or more of the codes listed below using:</p>\n\t\t\t\t\t<p>\n\t\t\t\t\t\t<code>GET [base]/Observation?patient=[id]&amp;code[vital sign LOINC{,LOINC2,LOINC3,…}]</code>\n\t\t\t\t\t</p>\n\t\t\t\t</li>\n\t\t\t\t<li>\n\t\t\t\t\t<p>A client <strong>SHOULD</strong> be capable of connecting to a server and fetching any of a patient's vital signs queried by one or more of the codes listed below and date range using:</p>\n\t\t\t\t\t<p>\n\t\t\t\t\t\t<code>GET [base]/Observation?patient=[id]&amp;code=[LOINC{,LOINC2…}]vital-signs&amp;date=[date]{&amp;date=[date]}</code>\n\t\t\t\t\t</p>\n\t\t\t\t</li>\n\t\t\t</ul>\n\t\t\t<ol>\n\t\t\t\t<li>\n\t\t\t\t\t<a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-smokingstatus.html\">US Core Smoking Status Observation Profile</a>\n\t\t\t\t</li>\n\t\t\t</ol>\n\t\t\t<p>Search Criteria:</p>\n\t\t\t<ul>\n\t\t\t\t<li>\n\t\t\t\t\t<p>A client <strong>SHOULD</strong> be capable of connecting to a server and fetching a patient's smoking status using:</p>\n\t\t\t\t\t<p>\n\t\t\t\t\t\t<code>GET [base]/Observation?patient=[id]&amp;code=72166-2</code>\n\t\t\t\t\t</p>\n\t\t\t\t</li>\n\t\t\t</ul>\n\t\t\t<h5 id=\"organization\">15. Organization</h5>\n\t\t\t<p>Supported Profiles:  <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-organization.html\">US Core Organization Profile</a>\n\t\t\t</p>\n\t\t\t<p>Search Criteria:</p>\n\t\t\t<ul>\n\t\t\t\t<li>\n\t\t\t\t\t<p>A client <strong>SHOULD</strong> be capable of connecting to a server and fetching an organization by identifier using:</p>\n\t\t\t\t\t<table>\n\t\t\t\t\t\t<tbody>\n\t\t\t\t\t\t\t<tr>\n\t\t\t\t\t\t\t\t<td>`GET [base]/Organization?identifier=[system]</td>\n\t\t\t\t\t\t\t\t<td>[code]'</td>\n\t\t\t\t\t\t\t</tr>\n\t\t\t\t\t\t</tbody>\n\t\t\t\t\t</table>\n\t\t\t\t</li>\n\t\t\t\t<li>\n\t\t\t\t\t<p>A client <strong>SHOULD</strong> be capable of connecting to a server and fetching an organization by name using:</p>\n\t\t\t\t\t<p>\n\t\t\t\t\t\t<code>GET [base]/Organization?name=[string]</code>\n\t\t\t\t\t</p>\n\t\t\t\t</li>\n\t\t\t\t<li>\n\t\t\t\t\t<p>A client <strong>SHOULD</strong> be capable of connecting to a server and fetching an organization by address using:</p>\n\t\t\t\t\t<p>\n\t\t\t\t\t\t<code>GET [base]/Organization?address=[string]</code>\n\t\t\t\t\t</p>\n\t\t\t\t</li>\n\t\t\t</ul>\n\t\t\t<h5 id=\"practitioner\">16. Practitioner</h5>\n\t\t\t<p>Supported Profiles:  <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-practitioner.html\">US Core Practitioner Profile</a>\n\t\t\t</p>\n\t\t\t<p>Search Criteria:</p>\n\t\t\t<ul>\n\t\t\t\t<li>\n\t\t\t\t\t<p>A client <strong>SHOULD</strong> be capable of connecting to a server and fetching a practitioner by identifier using:</p>\n\t\t\t\t\t<p>\n\t\t\t\t\t\t<code>GET [base]/Practitioner?identifier=[system]|[code]</code>\n\t\t\t\t\t</p>\n\t\t\t\t</li>\n\t\t\t\t<li>\n\t\t\t\t\t<p>A client <strong>SHOULD</strong> be capable of connecting to a server and fetching a practitioner by name using:</p>\n\t\t\t\t\t<p>\n\t\t\t\t\t\t<code>GET [base]/Practitioner?family=[string]&amp;given=[string]</code>\n\t\t\t\t\t</p>\n\t\t\t\t</li>\n\t\t\t</ul>\n\t\t\t<h5 id=\"procedure\">17. Procedure</h5>\n\t\t\t<p>Supported Profiles:  <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-procedure.html\">US Core Procedure Profile</a>\n\t\t\t</p>\n\t\t\t<p>Search Criteria:</p>\n\t\t\t<ul>\n\t\t\t\t<li>\n\t\t\t\t\t<p>A client <strong>SHOULD</strong> be capable of connecting to a server and fetching a patient's procedures using:</p>\n\t\t\t\t\t<p>\n\t\t\t\t\t\t<code>GET/Procedure?patient=[id]</code>\n\t\t\t\t\t</p>\n\t\t\t\t</li>\n\t\t\t\t<li>\n\t\t\t\t\t<p>A client <strong>SHOULD</strong> be capable of connecting to a server and fetching all of a patient's procedures over a specified time period using:</p>\n\t\t\t\t\t<p>\n\t\t\t\t\t\t<code>GET /Procedure?patient=[id]&amp;date=[date]{&amp;date=[date]}</code>\n\t\t\t\t\t</p>\n\t\t\t\t</li>\n\t\t\t</ul>\n\t\t\t<p/>\n\t\t</div>"
   },
-  "name": "US Core Requestor",
+  "url": "http://hl7.org/fhir/us/core/CapabilityStatement/client",
+  "version": "1.0.0",
+  "name": "US Core Client",
   "status": "draft",
-  "date": "2015-04-02",
-  "publisher": "U.S. Office of the National Coordinator (ONC)",
+  "date": "2017-03-20",
+  "publisher": "HL7 US Realm Steering Committee",
   "contact": [
     {
       "telecom": [
         {
           "system": "other",
-          "value": "http://www.healthit.gov/"
+          "value": "http://www.hl7.org/SpecialCommittees/usrealm/index.cfm"
         }
       ]
     }
   ],
-  "description": "This profile defines the expected capabilities of the US Core Requestor actor when conforming to the US Core IG.",
+  "description": "This profile defines the expected capabilities of the US Core Client conforming to the US Core IG.",
   "kind": "requirements",
   "fhirVersion": "1.8.0",
   "acceptUnknown": "extensions",
@@ -27,19 +29,204 @@
     "xml",
     "json"
   ],
+  "profile": [
+    {
+      "extension": [
+        {
+          "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-profile-link",
+          "valueCode": "AllergyIntolerance"
+        }
+      ],
+      "reference": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance",
+      "display": "US Core AllergyIntolerance Profile"
+    },
+    {
+      "extension": [
+        {
+          "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-profile-link",
+          "valueCode": "CarePlan"
+        }
+      ],
+      "reference": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-careplan",
+      "display": "US Core CarePlan Profile"
+    },
+    {
+      "extension": [
+        {
+          "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-profile-link",
+          "valueCode": "CareTeam"
+        }
+      ],
+      "reference": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-careteam",
+      "display": "US Core CareTeam Profile"
+    },
+    {
+      "extension": [
+        {
+          "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-profile-link",
+          "valueCode": "Condition"
+        }
+      ],
+      "reference": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition",
+      "display": "US Core Condition Profile"
+    },
+    {
+      "extension": [
+        {
+          "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-profile-link",
+          "valueCode": "Device"
+        }
+      ],
+      "reference": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-device",
+      "display": "US Core Device Profile"
+    },
+    {
+      "extension": [
+        {
+          "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-profile-link",
+          "valueCode": "Goal"
+        }
+      ],
+      "reference": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-goal",
+      "display": "US Core Goal Profile"
+    },
+    {
+      "extension": [
+        {
+          "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-profile-link",
+          "valueCode": "Immunization"
+        }
+      ],
+      "reference": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization",
+      "display": "US Core Immunization Profile"
+    },
+    {
+      "extension": [
+        {
+          "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-profile-link",
+          "valueCode": "DiagnosticReport"
+        }
+      ],
+      "reference": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport",
+      "display": "US Core DiagnosticReport Profile"
+    },
+    {
+      "extension": [
+        {
+          "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-profile-link",
+          "valueCode": "Observation"
+        }
+      ],
+      "reference": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observationresults",
+      "display": "US Core Result Observation Profile"
+    },
+    {
+      "extension": [
+        {
+          "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-profile-link",
+          "valueCode": "Location"
+        }
+      ],
+      "reference": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-location",
+      "display": "US Core Location Profile"
+    },
+    {
+      "extension": [
+        {
+          "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-profile-link",
+          "valueCode": "Medication"
+        }
+      ],
+      "reference": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication",
+      "display": "US Core Medication Profile"
+    },
+    {
+      "extension": [
+        {
+          "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-profile-link",
+          "valueCode": "MedicationRequest"
+        }
+      ],
+      "reference": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationrequest",
+      "display": "US Core MedicationRequest Profile"
+    },
+    {
+      "extension": [
+        {
+          "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-profile-link",
+          "valueCode": "MedicationStatement"
+        }
+      ],
+      "reference": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationstatement",
+      "display": "US Core MedicationStatement Profile"
+    },
+    {
+      "extension": [
+        {
+          "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-profile-link",
+          "valueCode": "Observation"
+        }
+      ],
+      "reference": "http://hl7.org/fhir/StructureDefinition/vitalsigns",
+      "display": "Vital Signs Profile"
+    },
+    {
+      "extension": [
+        {
+          "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-profile-link",
+          "valueCode": "Observation"
+        }
+      ],
+      "reference": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-smokingstatus",
+      "display": "US Core Smoking Status Observation Profile"
+    },
+    {
+      "extension": [
+        {
+          "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-profile-link",
+          "valueCode": "Organization"
+        }
+      ],
+      "reference": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization",
+      "display": "US Core Organization Profile"
+    },
+    {
+      "extension": [
+        {
+          "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-profile-link",
+          "valueCode": "Patient"
+        }
+      ],
+      "reference": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient",
+      "display": "US Core Patient Profile"
+    },
+    {
+      "extension": [
+        {
+          "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-profile-link",
+          "valueCode": "Practitioner"
+        }
+      ],
+      "reference": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner",
+      "display": "US Core Practitioner Profile"
+    },
+    {
+      "extension": [
+        {
+          "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-profile-link",
+          "valueCode": "Procedure"
+        }
+      ],
+      "reference": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure",
+      "display": "US Core Procedure Profile"
+    }
+  ],
   "rest": [
     {
       "mode": "client",
-      "documentation": "The US Core Requestor SHOULD support querying of one or more FHIR resources using appropriate US Core profile(s), RESTful operations defined for the profile and Search parameters identified for the profile.",
-      "security": {
-        "description": "US Core Requestors SHALL implement applicable security requirements documented in the US Core IG."
-      },
       "resource": [
         {
           "type": "Patient",
-          "profile": {
-            "reference": "http://hl7.org/fhir/current/daf/daf-core-patient.html"
-          },
           "interaction": [
             {
               "extension": [
@@ -85,9 +272,6 @@
         },
         {
           "type": "AllergyIntolerance",
-          "profile": {
-            "reference": "http://hl7.org/fhir/current/daf/daf-core-allergyintolerance.html"
-          },
           "interaction": [
             {
               "extension": [
@@ -133,9 +317,6 @@
         },
         {
           "type": "CarePlan",
-          "profile": {
-            "reference": "http://hl7.org/fhir/current/daf/daf-core-careplan.html"
-          },
           "interaction": [
             {
               "extension": [
@@ -180,10 +361,7 @@
           ]
         },
         {
-          "type": "CarePlan",
-          "profile": {
-            "reference": "http://hl7.org/fhir/current/daf/daf-core-careteam.html"
-          },
+          "type": "CareTeam",
           "interaction": [
             {
               "extension": [
@@ -229,9 +407,6 @@
         },
         {
           "type": "Condition",
-          "profile": {
-            "reference": "http://hl7.org/fhir/current/daf/daf-core-condition.html"
-          },
           "interaction": [
             {
               "extension": [
@@ -277,9 +452,6 @@
         },
         {
           "type": "Device",
-          "profile": {
-            "reference": "http://hl7.org/fhir/current/daf/daf-core-device.html"
-          },
           "interaction": [
             {
               "extension": [
@@ -325,9 +497,6 @@
         },
         {
           "type": "Goal",
-          "profile": {
-            "reference": "http://hl7.org/fhir/current/daf/daf-core-goal.html"
-          },
           "interaction": [
             {
               "extension": [
@@ -373,9 +542,6 @@
         },
         {
           "type": "Immunization",
-          "profile": {
-            "reference": "http://hl7.org/fhir/current/daf/daf-core-immunization.html"
-          },
           "interaction": [
             {
               "extension": [
@@ -421,9 +587,6 @@
         },
         {
           "type": "DiagnosticReport",
-          "profile": {
-            "reference": "http://hl7.org/fhir/current/daf/daf-core-diagnosticreport.html"
-          },
           "interaction": [
             {
               "extension": [
@@ -469,9 +632,6 @@
         },
         {
           "type": "Observation",
-          "profile": {
-            "reference": "http://hl7.org/fhir/current/daf/daf-core-resultobs.html"
-          },
           "interaction": [
             {
               "extension": [
@@ -515,12 +675,53 @@
             }
           ]
         },
+        {
+          "type": "Location",
+          "interaction": [
+            {
+              "extension": [
+                {
+                  "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
+                  "valueCode": "SHOULD"
+                }
+              ],
+              "code": "search-type",
+              "documentation": "Allows discovery of existing US Core location resources using different search criteria."
+            },
+            {
+              "extension": [
+                {
+                  "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
+                  "valueCode": "SHOULD"
+                }
+              ],
+              "code": "read",
+              "documentation": "Allows retrieval of a historical version of a US Core location instance"
+            },
+            {
+              "extension": [
+                {
+                  "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
+                  "valueCode": "SHOULD"
+                }
+              ],
+              "code": "history-instance",
+              "documentation": "Allows review of changes to US Core Medication instance over time"
+            },
+            {
+              "extension": [
+                {
+                  "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
+                  "valueCode": "SHOULD"
+                }
+              ],
+              "code": "vread",
+              "documentation": "Allows retrieval of a historical version of a US Core Medication instance"
+            }
+          ]
+        },
         {
           "type": "Medication",
-          "profile": {
-            "reference": "http://hl7.org/fhir/us/core/us-core-medication.html"
-          },
-          "documentation": "The MedicationStatement and MedicationRequest resources can represent a medication, using either a code or refer to a [Medication] resource.  If the Medication Resource is used in a MedicationStatement or a MedicationRequest,  then the READ and SEARCH Criteria **SHALL** be supported.",
           "interaction": [
             {
               "extension": [
@@ -566,10 +767,6 @@
         },
         {
           "type": "MedicationStatement",
-          "profile": {
-            "reference": "http://hl7.org/fhir/current/daf/daf-core-medicationstatement.html"
-          },
-          "documentation": "The MedicationStatement and MedicationRequest resources can represent a medication, using either a code or refer to a [Medication] resource.   *  When referencing a Medication resource,  the resource may be [contained] or an external resource.   *  The server application can choose any one way or more than one method,  but if the an external reference to Medication is used, the server SHALL support the [include] parameter for searching this element.   *  The client application must support both methods.        [include]: http://hl7.org/fhir/2017Jan/search.html#include  [contained]: http://hl7.org/fhir/2017Jan/references.html#contained  [Medication]:http://hl7.org/fhir/2017Jan/medication.html ",
           "interaction": [
             {
               "extension": [
@@ -615,10 +812,6 @@
         },
         {
           "type": "MedicationRequest",
-          "profile": {
-            "reference": "http://hl7.org/fhir/current/daf/daf-core-medicationorder.html"
-          },
-          "documentation": "The MedicationStatement and MedicationRequest resources can represent a medication, using either a code or refer to a [Medication] resource.   *  When referencing a Medication resource,  the resource may be [contained] or an external resource.   *  The server application can choose any one way or more than one method,  but if the an external reference to Medication is used, the server SHALL support the [include] parameter for searching this element.   *  The client application must support both methods.        [include]: http://hl7.org/fhir/2017Jan/search.html#include  [contained]: http://hl7.org/fhir/2017Jan/references.html#contained  [Medication]:http://hl7.org/fhir/2017Jan/medication.html ",
           "interaction": [
             {
               "extension": [
@@ -663,10 +856,7 @@
           ]
         },
         {
-          "type": "Observation",
-          "profile": {
-            "reference": "http://hl7.org/fhir/current/daf/daf-core-smokingstatus.html"
-          },
+          "type": "Organization",
           "interaction": [
             {
               "extension": [
@@ -676,7 +866,7 @@
                 }
               ],
               "code": "search-type",
-              "documentation": "Allows discovery of existing US Core smokingstatus resources using different search criteria"
+              "documentation": "Allows discovery of existing US Core organization resources using different search criteria"
             },
             {
               "extension": [
@@ -686,7 +876,7 @@
                 }
               ],
               "code": "read",
-              "documentation": "Allows retrieval of a specific US Core smokingstatus by id"
+              "documentation": "Allows retrieval of a specific US Core organization by id"
             },
             {
               "extension": [
@@ -696,7 +886,7 @@
                 }
               ],
               "code": "history-instance",
-              "documentation": "Allows review of changes to US Core smokingstatus instance over time"
+              "documentation": "Allows review of changes to US Core organization instance over time"
             },
             {
               "extension": [
@@ -706,15 +896,12 @@
                 }
               ],
               "code": "vread",
-              "documentation": "Allows retrieval of a historical version of a US Core smokingstatus instance"
+              "documentation": "Allows retrieval of a historical version of a US Core organization instance"
             }
           ]
         },
         {
-          "type": "Observation",
-          "profile": {
-            "reference": "http://hl7.org/fhir/current/daf/daf-core-vitalsigns.html"
-          },
+          "type": "Practitioner",
           "interaction": [
             {
               "extension": [
@@ -724,7 +911,7 @@
                 }
               ],
               "code": "search-type",
-              "documentation": "Allows discovery of existing US Core vitalsigns resources using different search criteria"
+              "documentation": "Allows discovery of existing US Core practitioner resources using different search criteria"
             },
             {
               "extension": [
@@ -734,7 +921,7 @@
                 }
               ],
               "code": "read",
-              "documentation": "Allows retrieval of a specific US Core vitalsigns by id"
+              "documentation": "Allows retrieval of a specific US Core practitioner by id"
             },
             {
               "extension": [
@@ -744,7 +931,7 @@
                 }
               ],
               "code": "history-instance",
-              "documentation": "Allows review of changes to US Core vitalsigns instance over time"
+              "documentation": "Allows review of changes to US Core practitioner instance over time"
             },
             {
               "extension": [
@@ -754,15 +941,12 @@
                 }
               ],
               "code": "vread",
-              "documentation": "Allows retrieval of a historical version of a US Core vitalsigns instance"
+              "documentation": "Afllows retrieval of a historical version of a US Core practitioner instance"
             }
           ]
         },
         {
           "type": "Procedure",
-          "profile": {
-            "reference": "http://hl7.org/fhir/current/daf/daf-core-procedure.html"
-          },
           "interaction": [
             {
               "extension": [
@@ -806,21 +990,7 @@
             }
           ]
         }
-      ],
-      "operation": [
-        {
-          "extension": [
-            {
-              "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
-              "valueCode": "SHOULD"
-            }
-          ],
-          "name": "patient-everything",
-          "definition": {
-            "reference": "http://hl7.org/fhir/OperationDefinition/patient-everything"
-          }
-        }
       ]
     }
   ]
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/CapabilityStatement-server.json b/lib/resources/us_core/CapabilityStatement-server.json
index 8c2f781..a4518a0 100755
--- a/lib/resources/us_core/CapabilityStatement-server.json
+++ b/lib/resources/us_core/CapabilityStatement-server.json
@@ -2,26 +2,28 @@
   "resourceType": "CapabilityStatement",
   "id": "server",
   "text": {
-    "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n\t\t\t<h2>US Core  Server</h2>\n\t\t\t<p>(Requirements Definition)</p>\n\t\t\t<p>Published: 2016-08-10 (draft)</p>\n\t\t\t<p>Published by: <b>U.S. Office of the National Coordinator (ONC)</b>\n\t\t\t</p>\n\t\t\t<p>This profile defines the expected capabilities of the US Core  Server actor when conforming to the US-Core IG  The statement includes the complete list of actual profiles, RESTful operations, search parameters supported by US Core Servers. US Core Requesters have the option of choosing from this list to access necessary data based on their local use cases and other contextual requirements.</p>\n\t\t\t<h2>General</h2>\n\t\t\t<table>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>FHIR Version:</th>\n\t\t\t\t\t\t<td>1.8.0</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Accepts elements from future versions:</th>\n\t\t\t\t\t\t<td>extensions</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Supported formats:</th>\n\t\t\t\t\t\t<td>xml, json</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Supported profiles:</th>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>\n\t\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-allergyintolerance.html\">US CORE ALLERGYINTOLERANCE</a>\n\t\t\t\t\t\t\t</p>\n\t\t\t\t\t\t\t<p>\n\t\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-careplan.html\">US CORE CAREPLAN</a>\n\t\t\t\t\t\t\t</p>\n\t\t\t\t\t\t\t<p>\n\t\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-careteam.html\">US CORE CARETEAM</a>\n\t\t\t\t\t\t\t</p>\n\t\t\t\t\t\t\t<p>\n\t\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-condition.html\">US CORE CONDITION</a>\n\t\t\t\t\t\t\t</p>\n\t\t\t\t\t\t\t<p>\n\t\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-device.html\">US CORE DEVICE</a>\n\t\t\t\t\t\t\t</p>\n\t\t\t\t\t\t\t<p>\n\t\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-goal.html\">US CORE GOAL</a>\n\t\t\t\t\t\t\t</p>\n\t\t\t\t\t\t\t<p>\n\t\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-immunization.html\">US CORE IMMUNIZATION</a>\n\t\t\t\t\t\t\t</p>\n\t\t\t\t\t\t\t<p>\n\t\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-diagnosticreport.html\">US CORE DIAGNOSTICREPORT</a>\n\t\t\t\t\t\t\t</p>\n\t\t\t\t\t\t\t<p>\n\t\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-observationresults.html\">US CORE OBSERVATIONRESULTS</a>\n\t\t\t\t\t\t\t</p>\n\t\t\t\t\t\t\t<p>\n\t\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-location.html\">US CORE LOCATION</a>\n\t\t\t\t\t\t\t</p>\n\t\t\t\t\t\t\t<p>\n\t\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-medication.html\">US CORE MEDICATION</a>\n\t\t\t\t\t\t\t</p>\n\t\t\t\t\t\t\t<p>\n\t\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-medicationrequest.html\">US CORE MEDICATIONREQUEST</a>\n\t\t\t\t\t\t\t</p>\n\t\t\t\t\t\t\t<p>\n\t\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-vitalsigns.html\">US CORE VITALSIGNS</a>\n\t\t\t\t\t\t\t</p>\n\t\t\t\t\t\t\t<p>\n\t\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-patient.html\">US CORE PATIENT</a>\n\t\t\t\t\t\t\t</p>\n\t\t\t\t\t\t\t<p>\n\t\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-pract.html\">US CORE PRACT</a>\n\t\t\t\t\t\t\t</p>\n\t\t\t\t\t\t\t<p>\n\t\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-procedure.html\">US CORE PROCEDURE</a>\n\t\t\t\t\t\t\t</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<h2>REST  behavior</h2>\n\t\t\t<p>\n\t\t\t\t<h4>The US Core  Server SHALL:</h4>     1.Support the US Core Patient resource profile.      2.Support at least one additional resource profile from the list of US Core Profiles      2. Implement REST behavior according to the FHIR specification      3.  Support json resource formats for all US Core interactions.      4. Identify the US Core profile(s) supported as part of the FHIR <a href=\"http://hl7.org/fhir/2017Jan/resource-definitions.html#Meta.profile\">Meta profile attribute</a> for each instance.     5.  Declare a CapabilityStatement identifying the list of profiles, operations, search parameter supported.                <h4>The US Core  Server SHOULD:</h4>     1. Support xml resource formats for all US Core interactions.  </p>\n\t\t\t<p>\n\t\t\t\t<b>Security:</b>\n\t\t\t</p>\n\t\t\t<p>US Core  Servers <b>SHALL</b> implement the <a href=\"security.html\">security requirements</a>  documented in the US-Core IG.</p>\n\t\t\t<h3>Profile summary</h3>\n\t\t\t<table class=\"grid\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Profile (Resource)</th>\n\t\t\t\t\t\t<th>Search</th>\n\t\t\t\t\t\t<th>Read</th>\n\t\t\t\t\t\t<th>Read Version</th>\n\t\t\t\t\t\t<th>Instance History</th>\n\t\t\t\t\t\t<th>Resource History</th>\n\t\t\t\t\t\t<th>Create</th>\n\t\t\t\t\t\t<th>Update</th>\n\t\t\t\t\t\t<th>Delete</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-patient.html\">US CORE PATIENT</a> (Patient)</th>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Patient-search-type\" title=\"Allows discovery of existing US Core patient resources using different search criteria\">SHALL</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Patient-read\" title=\"Allows retrieval of a specific US Core patients by id\">SHALL</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Patient-vread\" title=\"Allows retrieval of a historical version of a US Core patient instance\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Patient-history-instance\" title=\"Allows review of changes to US Core patient instance over time\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-allergyintolerance.html\">US CORE ALLERGYINTOLERANCE</a> (AllergyIntolerance)</th>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#AllergyIntolerance-search-type\" title=\"Allows discovery of existing US Core AllergyIntolerance resources using different search criteria\">SHALL</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#AllergyIntolerance-read\" title=\"Allows retrieval of a specific US Core AllergyIntolerance by id\">SHALL</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#AllergyIntolerance-vread\" title=\"Allows retrieval of a historical version of a US Core AllergyIntolerance instance\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#AllergyIntolerance-history-instance\" title=\"Allows review of changes to US Core AllergyIntolerance instance over time\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-careplan.html\">US CORE CAREPLAN</a> (CarePlan)</th>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#CarePlan-search-type\" title=\"Allows discovery of existing US Core careplan resources using different search criteria\">SHALL</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#CarePlan-read\" title=\"Allows retrieval of a specific US Core careplan by id\">SHALL</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#CarePlan-vread\" title=\"Allows retrieval of a historical version of a US Core careplan instance\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#CarePlan-history-instance\" title=\"Allows review of changes to US Core careplan instance over time\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-careteam.html\">US CORE CARETEAM</a> (CareTeam)</th>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#CareTeam-search-type\" title=\"Allows discovery of existing US Core careteam resources using different search criteria\">SHALL</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#CareTeam-read\" title=\"Allows retrieval of a specific US Core careteam by id\">SHALL</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#CareTeam-vread\" title=\"Allows retrieval of a historical version of a US Core careteam instance\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#CareTeam-history-instance\" title=\"Allows review of changes to US Core careteam instance over time\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-condition.html\">US CORE CONDITION</a> (Condition)</th>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Condition-search-type\" title=\"Allows discovery of existing US Core condition resources using different search criteria\">SHALL</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Condition-read\" title=\"Allows retrieval of a specific US Core condition by id\">SHALL</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Condition-vread\" title=\"Allows retrieval of a historical version of a US Core condition instance\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Condition-history-instance\" title=\"Allows review of changes to US Core condition instance over time\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-device.html\">US CORE DEVICE</a> (Device)</th>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Device-search-type\" title=\"Allows discovery of existing US Core device resources using different search criteria\">SHALL</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Device-read\" title=\"Allows retrieval of a specific US Core device by id\">SHALL</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Device-vread\" title=\"Allows retrieval of a historical version of a US Core device instance\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Device-history-instance\" title=\"Allows review of changes to US Core device instance over time\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-Goal.html\">US CORE GOAL</a> (Goal)</th>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Goal-search-type\" title=\"Allows discovery of existing US Core Goal resources using different search criteria\">SHALL</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Goal-read\" title=\"Allows retrieval of a specific US Core Goal by id\">SHALL</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Goal-vread\" title=\"Allows retrieval of a historical version of a US Core Goal instance\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Goal-history-instance\" title=\"Allows review of changes to US Core Goal instance over time\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-immunization.html\">US CORE IMMUNIZATION</a> (Immunization)</th>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Immunization-search-type\" title=\"Allows discovery of existing US Core immunization resources using different search criteria\">SHALL</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Immunization-read\" title=\"Allows retrieval of a specific US Core immunization by id\">SHALL</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Immunization-vread\" title=\"Allows retrieval of a historical version of a US Core immunization instance\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Immunization-history-instance\" title=\"Allows review of changes to US Core immunization instance over time\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-diagnosticreport.html\">US CORE DIAGNOSTICREPORT</a> (DiagnosticReport)</th>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#DiagnosticReport-search-type\" title=\"Allows discovery of existing US Core diagnosticreport resources using different search criteria\">SHALL</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#DiagnosticReport-read\" title=\"Allows retrieval of a specific US Core diagnosticreport by id\">SHALL</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#DiagnosticReport-vread\" title=\"Allows retrieval of a historical version of a US Core diagnosticreport instance\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#DiagnosticReport-history-instance\" title=\"Allows review of changes to US Core diagnosticreport instance over time\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-observationresults.html\">US CORE OBSERVATIONRESULTS</a> (Observation)</th>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Observation-search-type\" title=\"Allows discovery of existing US Core observation results resources using different search criteria\">SHALL</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Observation-read\" title=\"Allows retrieval of a specific US Core observation results by id\">SHALL</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Observation-vread\" title=\"Allows retrieval of a historical version of a US Core observation results instance\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Observation-history-instance\" title=\"Allows review of changes to US Core observation results instance over time\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-medication.html\">US CORE MEDICATION</a> (Medication)</th>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Medication-search-type\" title=\"IF the Medication Resource is used in a MedicationStatement or a MedicationRequest.   Allows discovery of existing US Core Medication resources using different search criteria.\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Medication-read\" title=\"IF the Medication Resource is used in a MedicationStatement or a MedicationRequest.  Allows retrieval of a specific US Core Medication by id\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Medication-vread\" title=\"Allows retrieval of a historical version of a US Core Medication instance\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Medication-history-instance\" title=\"Allows review of changes to US Core Medication instance over time\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-medicationstatement.html\">US CORE MEDICATIONSTATEMENT</a> (MedicationStatement)</th>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#MedicationStatement-search-type\" title=\"Allows discovery of existing US Core medicationstatement resources using different search criteria\">SHALL</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#MedicationStatement-read\" title=\"Allows retrieval of a specific US Core medicationstatement by id\">SHALL</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#MedicationStatement-vread\" title=\"Allows retrieval of a historical version of a US Core medicationstatement instance\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#MedicationStatement-history-instance\" title=\"Allows review of changes to US Core medicationstatement instance over time\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-medicationrequest.html\">US CORE MEDICATIONREQUEST</a> (MedicationRequest)</th>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#MedicationRequest-search-type\" title=\"Allows discovery of existing US Core medicationrequest resources using different search criteria\">SHALL</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#MedicationRequest-read\" title=\"Allows retrieval of a specific US Core medicationrequest by id\">SHALL</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#MedicationRequest-vread\" title=\"Allows retrieval of a historical version of a US Core medicationrequest instance\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#MedicationRequest-history-instance\" title=\"Allows review of changes to US Core medicationrequest instance over time\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-smokingstatus.html\">US CORE SMOKINGSTATUS</a> (Observation)</th>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Observation-search-type\" title=\"Allows discovery of existing US Core smokingstatus resources using different search criteria\">SHALL</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Observation-read\" title=\"Allows retrieval of a specific US Core smokingstatus by id\">SHALL</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Observation-vread\" title=\"Allows retrieval of a historical version of a US Core smokingstatus instance\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Observation-history-instance\" title=\"Allows review of changes to US Core smokingstatus instance over time\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-vitalsigns.html\">US CORE VITALSIGNS</a> (Observation)</th>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Observation-search-type\" title=\"Allows discovery of existing US Core vitalsigns resources using different search criteria\">SHALL</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Observation-read\" title=\"Allows retrieval of a specific US Core vitalsigns by id\">SHALL</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Observation-vread\" title=\"Allows retrieval of a historical version of a US Core vitalsigns instance\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Observation-history-instance\" title=\"Allows review of changes to US Core vitalsigns instance over time\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-procedure.html\">US CORE PROCEDURE</a> (Procedure)</th>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Procedure-search-type\" title=\"Allows discovery of existing US Core procedure resources using different search criteria\">SHALL</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Procedure-read\" title=\"Allows retrieval of a specific US Core procedure by id\">SHALL</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Procedure-vread\" title=\"Allows retrieval of a historical version of a US Core procedure instance\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<a href=\"#Procedure-history-instance\" title=\"Allows review of changes to US Core procedure instance over time\">SHOULD</a>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<br/>\n\t\t\t<br/>\n\t\t\t<h3>Patient</h3>\n\t\t\t<p>Profile: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-patient.html\">US CORE PATIENT</a>\n\t\t\t</p>\n\t\t\t<h4>Interactions</h4>\n\t\t\t<table class=\"list\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Name</th>\n\t\t\t\t\t\t<th>Conformance</th>\n\t\t\t\t\t\t<th>Description</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Patient-search-type\"> </a>\n\t\t\t\t\t\t\t<span>search-type</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows discovery of existing US Core patient resources using different search criteria</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Patient-read\"> </a>\n\t\t\t\t\t\t\t<span>read</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a specific US Core patients by id</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Patient-history-instance\"> </a>\n\t\t\t\t\t\t\t<span>history-instance</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows review of changes to US Core patient instance over time</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Patient-vread\"> </a>\n\t\t\t\t\t\t\t<span>vread</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a historical version of a US Core patient instance</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<h4>Search</h4>\n\t\t\t<table class=\"list\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Parameter</th>\n\t\t\t\t\t\t<th>Conformance</th>\n\t\t\t\t\t\t<th>Type</th>\n\t\t\t\t\t\t<th>Definition &amp; Chaining</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>name</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>string</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>todo</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>family</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>string</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>given</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>string</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>identifier</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>token</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>gender</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>token</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>birthdate</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>date</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<br/>\n\t\t\t<br/>\n\t\t\t<h3>AllergyIntolerance</h3>\n\t\t\t<p>Profile: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-allergyintolerance.html\">US CORE ALLERGYINTOLERANCE</a>\n\t\t\t</p>\n\t\t\t<h4>Interactions</h4>\n\t\t\t<table class=\"list\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Name</th>\n\t\t\t\t\t\t<th>Conformance</th>\n\t\t\t\t\t\t<th>Description</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"AllergyIntolerance-search-type\"> </a>\n\t\t\t\t\t\t\t<span>search-type</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows discovery of existing US Core AllergyIntolerance resources using different search criteria</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"AllergyIntolerance-read\"> </a>\n\t\t\t\t\t\t\t<span>read</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a specific US Core AllergyIntolerance by id</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"AllergyIntolerance-history-instance\"> </a>\n\t\t\t\t\t\t\t<span>history-instance</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows review of changes to US Core AllergyIntolerance instance over time</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"AllergyIntolerance-vread\"> </a>\n\t\t\t\t\t\t\t<span>vread</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a historical version of a US Core AllergyIntolerance instance</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<h4>Search</h4>\n\t\t\t<table class=\"list\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Parameter</th>\n\t\t\t\t\t\t<th>Conformance</th>\n\t\t\t\t\t\t<th>Type</th>\n\t\t\t\t\t\t<th>Definition &amp; Chaining</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>patient</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>reference</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<br/>\n\t\t\t<br/>\n\t\t\t<h3>CarePlan</h3>\n\t\t\t<p>Profile: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-careplan.html\">US CORE CAREPLAN</a>\n\t\t\t</p>\n\t\t\t<h4>Interactions</h4>\n\t\t\t<table class=\"list\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Name</th>\n\t\t\t\t\t\t<th>Conformance</th>\n\t\t\t\t\t\t<th>Description</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"CarePlan-search-type\"> </a>\n\t\t\t\t\t\t\t<span>search-type</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows discovery of existing US Core careplan resources using different search criteria</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"CarePlan-read\"> </a>\n\t\t\t\t\t\t\t<span>read</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a specific US Core careplan by id</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"CarePlan-history-instance\"> </a>\n\t\t\t\t\t\t\t<span>history-instance</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows review of changes to US Core careplan instance over time</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"CarePlan-vread\"> </a>\n\t\t\t\t\t\t\t<span>vread</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a historical version of a US Core careplan instance</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<h4>Search</h4>\n\t\t\t<table class=\"list\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Parameter</th>\n\t\t\t\t\t\t<th>Conformance</th>\n\t\t\t\t\t\t<th>Type</th>\n\t\t\t\t\t\t<th>Definition &amp; Chaining</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>patient</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>reference</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>category</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>token</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>status</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>token</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>date</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>date</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>The server SHALL support the <a href=\"http://hl7.org/fhir/2017Jan/search.html#prefix\">date search modifiers</a> 'ge','le','eq' for this profile</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<br/>\n\t\t\t<br/>\n\t\t\t<h3>CareTeam</h3>\n\t\t\t<p>Profile: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-careteam.html\">US CORE CARETEAM</a>\n\t\t\t</p>\n\t\t\t<h4>Interactions</h4>\n\t\t\t<table class=\"list\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Name</th>\n\t\t\t\t\t\t<th>Conformance</th>\n\t\t\t\t\t\t<th>Description</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"CareTeam-search-type\"> </a>\n\t\t\t\t\t\t\t<span>search-type</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows discovery of existing US Core careteam resources using different search criteria</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"CareTeam-read\"> </a>\n\t\t\t\t\t\t\t<span>read</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a specific US Core careteam by id</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"CareTeam-history-instance\"> </a>\n\t\t\t\t\t\t\t<span>history-instance</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows review of changes to US Core careteam instance over time</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"CareTeam-vread\"> </a>\n\t\t\t\t\t\t\t<span>vread</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a historical version of a US Core careteam instance</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<h4>Search</h4>\n\t\t\t<table class=\"list\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Parameter</th>\n\t\t\t\t\t\t<th>Conformance</th>\n\t\t\t\t\t\t<th>Type</th>\n\t\t\t\t\t\t<th>Definition &amp; Chaining</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>patient</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>reference</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>status</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>token</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<br/>\n\t\t\t<br/>\n\t\t\t<h3>Condition</h3>\n\t\t\t<p>Profile: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-condition.html\">US CORE CONDITION</a>\n\t\t\t</p>\n\t\t\t<h4>Interactions</h4>\n\t\t\t<table class=\"list\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Name</th>\n\t\t\t\t\t\t<th>Conformance</th>\n\t\t\t\t\t\t<th>Description</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Condition-search-type\"> </a>\n\t\t\t\t\t\t\t<span>search-type</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows discovery of existing US Core condition resources using different search criteria</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Condition-read\"> </a>\n\t\t\t\t\t\t\t<span>read</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a specific US Core condition by id</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Condition-history-instance\"> </a>\n\t\t\t\t\t\t\t<span>history-instance</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows review of changes to US Core condition instance over time</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Condition-vread\"> </a>\n\t\t\t\t\t\t\t<span>vread</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a historical version of a US Core condition instance</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<h4>Search</h4>\n\t\t\t<table class=\"list\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Parameter</th>\n\t\t\t\t\t\t<th>Conformance</th>\n\t\t\t\t\t\t<th>Type</th>\n\t\t\t\t\t\t<th>Definition &amp; Chaining</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>patient</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>reference</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>category</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>token</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>clinicalstatus</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>token</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<br/>\n\t\t\t<br/>\n\t\t\t<h3>Device</h3>\n\t\t\t<p>Profile: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-device.html\">US CORE DEVICE</a>\n\t\t\t</p>\n\t\t\t<h4>Interactions</h4>\n\t\t\t<table class=\"list\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Name</th>\n\t\t\t\t\t\t<th>Conformance</th>\n\t\t\t\t\t\t<th>Description</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Device-search-type\"> </a>\n\t\t\t\t\t\t\t<span>search-type</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows discovery of existing US Core device resources using different search criteria</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Device-read\"> </a>\n\t\t\t\t\t\t\t<span>read</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a specific US Core device by id</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Device-history-instance\"> </a>\n\t\t\t\t\t\t\t<span>history-instance</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows review of changes to US Core device instance over time</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Device-vread\"> </a>\n\t\t\t\t\t\t\t<span>vread</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a historical version of a US Core device instance</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<h4>Search</h4>\n\t\t\t<table class=\"list\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Parameter</th>\n\t\t\t\t\t\t<th>Conformance</th>\n\t\t\t\t\t\t<th>Type</th>\n\t\t\t\t\t\t<th>Definition &amp; Chaining</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>patient</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>reference</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<br/>\n\t\t\t<br/>\n\t\t\t<h3>Goal</h3>\n\t\t\t<p>Profile: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-Goal.html\">US CORE GOAL</a>\n\t\t\t</p>\n\t\t\t<h4>Interactions</h4>\n\t\t\t<table class=\"list\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Name</th>\n\t\t\t\t\t\t<th>Conformance</th>\n\t\t\t\t\t\t<th>Description</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Goal-search-type\"> </a>\n\t\t\t\t\t\t\t<span>search-type</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows discovery of existing US Core Goal resources using different search criteria</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Goal-read\"> </a>\n\t\t\t\t\t\t\t<span>read</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a specific US Core Goal by id</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Goal-history-instance\"> </a>\n\t\t\t\t\t\t\t<span>history-instance</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows review of changes to US Core Goal instance over time</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Goal-vread\"> </a>\n\t\t\t\t\t\t\t<span>vread</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a historical version of a US Core Goal instance</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<h4>Search</h4>\n\t\t\t<table class=\"list\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Parameter</th>\n\t\t\t\t\t\t<th>Conformance</th>\n\t\t\t\t\t\t<th>Type</th>\n\t\t\t\t\t\t<th>Definition &amp; Chaining</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>patient</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>reference</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>date</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>date</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>The server SHALL support the <a href=\"http://hl7.org/fhir/2017Jan/search.html#prefix\">date search modifiers</a> 'ge','le','eq' for this profile</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<br/>\n\t\t\t<br/>\n\t\t\t<h3>Immunization</h3>\n\t\t\t<p>Profile: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-immunization.html\">US CORE IMMUNIZATION</a>\n\t\t\t</p>\n\t\t\t<h4>Interactions</h4>\n\t\t\t<table class=\"list\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Name</th>\n\t\t\t\t\t\t<th>Conformance</th>\n\t\t\t\t\t\t<th>Description</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Immunization-search-type\"> </a>\n\t\t\t\t\t\t\t<span>search-type</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows discovery of existing US Core immunization resources using different search criteria</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Immunization-read\"> </a>\n\t\t\t\t\t\t\t<span>read</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a specific US Core immunization by id</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Immunization-history-instance\"> </a>\n\t\t\t\t\t\t\t<span>history-instance</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows review of changes to US Core immunization instance over time</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Immunization-vread\"> </a>\n\t\t\t\t\t\t\t<span>vread</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a historical version of a US Core immunization instance</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<h4>Search</h4>\n\t\t\t<table class=\"list\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Parameter</th>\n\t\t\t\t\t\t<th>Conformance</th>\n\t\t\t\t\t\t<th>Type</th>\n\t\t\t\t\t\t<th>Definition &amp; Chaining</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>patient</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>reference</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<br/>\n\t\t\t<br/>\n\t\t\t<h3>DiagnosticReport</h3>\n\t\t\t<p>Profile: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-diagnosticreport.html\">US CORE DIAGNOSTICREPORT</a>\n\t\t\t</p>\n\t\t\t<h4>Interactions</h4>\n\t\t\t<table class=\"list\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Name</th>\n\t\t\t\t\t\t<th>Conformance</th>\n\t\t\t\t\t\t<th>Description</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"DiagnosticReport-search-type\"> </a>\n\t\t\t\t\t\t\t<span>search-type</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows discovery of existing US Core diagnosticreport resources using different search criteria</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"DiagnosticReport-read\"> </a>\n\t\t\t\t\t\t\t<span>read</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a specific US Core diagnosticreport by id</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"DiagnosticReport-history-instance\"> </a>\n\t\t\t\t\t\t\t<span>history-instance</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows review of changes to US Core diagnosticreport instance over time</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"DiagnosticReport-vread\"> </a>\n\t\t\t\t\t\t\t<span>vread</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a historical version of a US Core diagnosticreport instance</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<h4>Search</h4>\n\t\t\t<table class=\"list\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Parameter</th>\n\t\t\t\t\t\t<th>Conformance</th>\n\t\t\t\t\t\t<th>Type</th>\n\t\t\t\t\t\t<th>Definition &amp; Chaining</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>patient</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>reference</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>category</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>token</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>code</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>token</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>date</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>date</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>The server SHALL support the <a href=\"http://hl7.org/fhir/2017Jan/search.html#prefix\">date search modifiers</a> 'ge','le','eq' for this profile</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<br/>\n\t\t\t<br/>\n\t\t\t<h3>Observation</h3>\n\t\t\t<p>Profile: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-observationresults.html\">US CORE OBSERVATIONRESULTS</a>\n\t\t\t</p>\n\t\t\t<h4>Interactions</h4>\n\t\t\t<table class=\"list\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Name</th>\n\t\t\t\t\t\t<th>Conformance</th>\n\t\t\t\t\t\t<th>Description</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Observation-search-type\"> </a>\n\t\t\t\t\t\t\t<span>search-type</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows discovery of existing US Core observation results resources using different search criteria</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Observation-read\"> </a>\n\t\t\t\t\t\t\t<span>read</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a specific US Core observation results by id</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Observation-history-instance\"> </a>\n\t\t\t\t\t\t\t<span>history-instance</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows review of changes to US Core observation results instance over time</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Observation-vread\"> </a>\n\t\t\t\t\t\t\t<span>vread</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a historical version of a US Core observation results instance</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<h4>Search</h4>\n\t\t\t<table class=\"list\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Parameter</th>\n\t\t\t\t\t\t<th>Conformance</th>\n\t\t\t\t\t\t<th>Type</th>\n\t\t\t\t\t\t<th>Definition &amp; Chaining</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>patient</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>reference</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>category</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>token</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>code</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>token</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>date</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>date</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>The server SHALL support the <a href=\"http://hl7.org/fhir/2017Jan/search.html#prefix\">date search modifiers</a> 'ge','le','eq' for this profile</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<br/>\n\t\t\t<br/>\n\t\t\t<h3>Medication</h3>\n\t\t\t<p>Profile: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-medication.html\">US CORE MEDICATION</a>\n\t\t\t</p>\n\t\t\t<p>The MedicationStatement and MedicationRequest resources can represent a medication, using either a code or refer to a Medication resource.  If the Medication Resource is used in a MedicationStatement or a MedicationRequest,  then the READ and SEARCH Criteria  <b>SHALL</b> be supported.</p>\n\t\t\t<h4>Interactions</h4>\n\t\t\t<table class=\"list\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Name</th>\n\t\t\t\t\t\t<th>Conformance</th>\n\t\t\t\t\t\t<th>Description</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Medication-search-type\"> </a>\n\t\t\t\t\t\t\t<span>search-type</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>IF the Medication Resource is used in a MedicationStatement or a MedicationRequest.   Allows discovery of existing US Core Medication resources using different search criteria.</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Medication-read\"> </a>\n\t\t\t\t\t\t\t<span>read</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>IF the Medication Resource is used in a MedicationStatement or a MedicationRequest.  Allows retrieval of a specific US Core Medication by id</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Medication-history-instance\"> </a>\n\t\t\t\t\t\t\t<span>history-instance</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows review of changes to US Core Medication instance over time</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Medication-vread\"> </a>\n\t\t\t\t\t\t\t<span>vread</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a historical version of a US Core Medication instance</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<br/>\n\t\t\t<br/>\n\t\t\t<h3>MedicationStatement</h3>\n\t\t\t<p>Profile: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-medicationstatement.html\">US CORE MEDICATIONSTATEMENT</a>\n\t\t\t</p>\n\t\t\t<p>    The MedicationStatement and MedicationRequest resources can represent a medication, using either a code or refer to a Medication resource.    When referencing a Medication resource,  the resource may be <a href=\"http://hl7.org/fhir/2017Jan/references.html#contained\">contained</a> or an external resource.   The server application can choose any one way or more than one method,  but if the an external reference to Medication is used, the server SHALL support the <a href=\"http://hl7.org/fhir/2017Jan/search.html#include\">include</a> parameter for searching this element.   The client application must support both methods.</p>\n\t\t\t<h4>Interactions</h4>\n\t\t\t<table class=\"list\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Name</th>\n\t\t\t\t\t\t<th>Conformance</th>\n\t\t\t\t\t\t<th>Description</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"MedicationStatement-search-type\"> </a>\n\t\t\t\t\t\t\t<span>search-type</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows discovery of existing US Core medicationstatement resources using different search criteria</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"MedicationStatement-read\"> </a>\n\t\t\t\t\t\t\t<span>read</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a specific US Core medicationstatement by id</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"MedicationStatement-history-instance\"> </a>\n\t\t\t\t\t\t\t<span>history-instance</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows review of changes to US Core medicationstatement instance over time</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"MedicationStatement-vread\"> </a>\n\t\t\t\t\t\t\t<span>vread</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a historical version of a US Core medicationstatement instance</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<h4>Search</h4>\n\t\t\t<p>Supported Includes: MedicationStatement.medicationReference</p>\n\t\t\t<table class=\"list\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Parameter</th>\n\t\t\t\t\t\t<th>Conformance</th>\n\t\t\t\t\t\t<th>Type</th>\n\t\t\t\t\t\t<th>Definition &amp; Chaining</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>patient</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>reference</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<br/>\n\t\t\t<br/>\n\t\t\t<h3>MedicationRequest</h3>\n\t\t\t<p>Profile: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-medicationrequest.html\">US CORE MEDICATIONREQUEST</a>\n\t\t\t</p>\n\t\t\t<p>    The MedicationStatement and MedicationRequest resources can represent a medication, using either a code or refer to a Medication resource.    When referencing a Medication resource,  the resource may be <a href=\"http://hl7.org/fhir/2017Jan/references.html#contained\">contained</a> or an external resource.   The server application can choose any one way or more than one method,  but if the an external reference to Medication is used, the server SHALL support the <a href=\"http://hl7.org/fhir/2017Jan/search.html#include\">include</a> parameter for searching this element.   The client application must support both methods.</p>\n\t\t\t<h4>Interactions</h4>\n\t\t\t<table class=\"list\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Name</th>\n\t\t\t\t\t\t<th>Conformance</th>\n\t\t\t\t\t\t<th>Description</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"MedicationRequest-search-type\"> </a>\n\t\t\t\t\t\t\t<span>search-type</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows discovery of existing US Core medicationrequest resources using different search criteria</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"MedicationRequest-read\"> </a>\n\t\t\t\t\t\t\t<span>read</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a specific US Core medicationrequest by id</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"MedicationRequest-history-instance\"> </a>\n\t\t\t\t\t\t\t<span>history-instance</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows review of changes to US Core medicationrequest instance over time</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"MedicationRequest-vread\"> </a>\n\t\t\t\t\t\t\t<span>vread</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a historical version of a US Core medicationrequest instance</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<h4>Search</h4>\n\t\t\t<p>Supported Includes: MedicationRequest.medicationReference</p>\n\t\t\t<table class=\"list\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Parameter</th>\n\t\t\t\t\t\t<th>Conformance</th>\n\t\t\t\t\t\t<th>Type</th>\n\t\t\t\t\t\t<th>Definition &amp; Chaining</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>patient</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>reference</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<br/>\n\t\t\t<br/>\n\t\t\t<h3>Observation</h3>\n\t\t\t<p>Profile: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-smokingstatus.html\">US CORE SMOKINGSTATUS</a>\n\t\t\t</p>\n\t\t\t<h4>Interactions</h4>\n\t\t\t<table class=\"list\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Name</th>\n\t\t\t\t\t\t<th>Conformance</th>\n\t\t\t\t\t\t<th>Description</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Observation-search-type\"> </a>\n\t\t\t\t\t\t\t<span>search-type</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows discovery of existing US Core smokingstatus resources using different search criteria</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Observation-read\"> </a>\n\t\t\t\t\t\t\t<span>read</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a specific US Core smokingstatus by id</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Observation-history-instance\"> </a>\n\t\t\t\t\t\t\t<span>history-instance</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows review of changes to US Core smokingstatus instance over time</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Observation-vread\"> </a>\n\t\t\t\t\t\t\t<span>vread</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a historical version of a US Core smokingstatus instance</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<h4>Search</h4>\n\t\t\t<table class=\"list\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Parameter</th>\n\t\t\t\t\t\t<th>Conformance</th>\n\t\t\t\t\t\t<th>Type</th>\n\t\t\t\t\t\t<th>Definition &amp; Chaining</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>patient</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>reference</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>code</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>token</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<br/>\n\t\t\t<br/>\n\t\t\t<h3>Observation</h3>\n\t\t\t<p>Profile: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-vitalsigns.html\">US CORE VITALSIGNS</a>\n\t\t\t</p>\n\t\t\t<h4>Interactions</h4>\n\t\t\t<table class=\"list\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Name</th>\n\t\t\t\t\t\t<th>Conformance</th>\n\t\t\t\t\t\t<th>Description</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Observation-search-type\"> </a>\n\t\t\t\t\t\t\t<span>search-type</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows discovery of existing US Core vitalsigns resources using different search criteria</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Observation-read\"> </a>\n\t\t\t\t\t\t\t<span>read</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a specific US Core vitalsigns by id</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Observation-history-instance\"> </a>\n\t\t\t\t\t\t\t<span>history-instance</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows review of changes to US Core vitalsigns instance over time</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Observation-vread\"> </a>\n\t\t\t\t\t\t\t<span>vread</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a historical version of a US Core vitalsigns instance</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<h4>Search</h4>\n\t\t\t<table class=\"list\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Parameter</th>\n\t\t\t\t\t\t<th>Conformance</th>\n\t\t\t\t\t\t<th>Type</th>\n\t\t\t\t\t\t<th>Definition &amp; Chaining</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>patient</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>reference</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>category</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>token</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>code</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>token</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>date</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>date</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>The server SHALL support the <a href=\"http://hl7.org/fhir/2017Jan/search.html#prefix\">date search modifiers</a> 'ge','le','eq' for this profile</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<br/>\n\t\t\t<br/>\n\t\t\t<h3>Procedure</h3>\n\t\t\t<p>Profile: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-procedure.html\">US CORE PROCEDURE</a>\n\t\t\t</p>\n\t\t\t<h4>Interactions</h4>\n\t\t\t<table class=\"list\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Name</th>\n\t\t\t\t\t\t<th>Conformance</th>\n\t\t\t\t\t\t<th>Description</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Procedure-search-type\"> </a>\n\t\t\t\t\t\t\t<span>search-type</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows discovery of existing US Core procedure resources using different search criteria</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Procedure-read\"> </a>\n\t\t\t\t\t\t\t<span>read</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a specific US Core procedure by id</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Procedure-history-instance\"> </a>\n\t\t\t\t\t\t\t<span>history-instance</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows review of changes to US Core procedure instance over time</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>\n\t\t\t\t\t\t\t<a name=\"Procedure-vread\"> </a>\n\t\t\t\t\t\t\t<span>vread</span>\n\t\t\t\t\t\t</th>\n\t\t\t\t\t\t<td>SHOULD</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>Allows retrieval of a historical version of a US Core procedure instance</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t\t<h4>Search</h4>\n\t\t\t<table class=\"list\">\n\t\t\t\t<thead>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>Parameter</th>\n\t\t\t\t\t\t<th>Conformance</th>\n\t\t\t\t\t\t<th>Type</th>\n\t\t\t\t\t\t<th>Definition &amp; Chaining</th>\n\t\t\t\t\t</tr>\n\t\t\t\t</thead>\n\t\t\t\t<tbody>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>patient</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>reference</td>\n\t\t\t\t\t\t<td/>\n\t\t\t\t\t</tr>\n\t\t\t\t\t<tr>\n\t\t\t\t\t\t<th>date</th>\n\t\t\t\t\t\t<td>SHALL</td>\n\t\t\t\t\t\t<td>date</td>\n\t\t\t\t\t\t<td>\n\t\t\t\t\t\t\t<p>The server SHALL support the <a href=\"http://hl7.org/fhir/2017Jan/search.html#prefix\">date search modifiers</a> 'ge','le','eq' for this profile</p>\n\t\t\t\t\t\t</td>\n\t\t\t\t\t</tr>\n\t\t\t\t</tbody>\n\t\t\t</table>\n\t\t</div>"
+    "status": "additional",
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<ul><li>FHIR Version: 1.9.0</li><li>Supported formats: xml, json</li><li>Published: 2017-03-08</li><li>Published by: Health Level Seven International US Realm Steering Committee</li></ul><p>The Section describes the expected capabilities of the US Core Server actor which is responsible for providing responses to the queries submitted by the US Core Requestors. The complete list of FHIR profiles, RESTful operations, and search parameters supported by US Core Servers are defined. Systems implementing this capability statement should meet the ONC 2015 Common Clinical Data Set (CCDS) access requirement for Patient Selection 170.315(g)(7) and Application Access - Data Category Request 170.315(g)(8).  US Core Clients have the option of choosing from this list to access necessary data based on their local use cases and other contextual requirements.</p><h4 id=\"behavior\">Behavior</h4><p>Description: The US Core Server <strong>SHALL</strong>:</p><ul><li>Support the US Core Patient resource profile.</li><li>Support at least one additional resource profile from the list of US Core Profiles.</li><li>Implement the RESTful behavior according to the FHIR specification.</li><li>Return the following response classes:\n    <ul><li>(Status 200): successful operation</li><li>(Status 400): invalid parameter</li><li>(Status 401/4xx): unauthorized request</li><li>(Status 403): insufficient scope</li><li>(Status 404): unknown resource</li><li>(Status 410): deleted resource.</li></ul></li><li>Support <em>json</em> resource formats for all US Core interactions.</li><li>Declare a CapabilityStatement identifying the list of profiles, operations, search parameter supported.</li></ul><p>The US Core Server <strong>SHOULD</strong>:</p><ul><li>Support <em>xml</em> resource formats for all US Core interactions.</li><li>Identify the US Core profiles supported as part of the FHIR <code class=\"highlighter-rouge\">meta.profile</code> attribute for each instance.</li></ul><h4 id=\"security\">Security:</h4><p>US Core Servers <strong>SHALL</strong>:</p><ul><li>Implement the <a href=\"security.html\">security requirements</a> documented in the this IG.</li><li>A server has ensured that every API request includes a valid Authorization token, supplied via: <code class=\"highlighter-rouge\">Authorization: Bearer {server-specific-token-here}</code></li><li>A server has rejected any unauthorized requests by returning an <code class=\"highlighter-rouge\">HTTP 401</code> Unauthorized response code.</li></ul><h4 id=\"profile-interaction-summary\">Profile Interaction Summary:</h4><ul><li>All servers <strong>SHALL</strong> make available the <a href=\"http://hl7.org/fhir/STU3/http.html#read\">read</a> and <a href=\"http://hl7.org/fhir/STU3/http.html#search\">search</a> interactions for the Profiles the server chooses to support.</li><li>All servers <strong>SHOULD</strong> make available the <a href=\"http://hl7.org/fhir/STU3/http.html#vread\">vread</a> and <a href=\"http://hl7.org/fhir/STU3/http.html#history\">history-instance</a> interactions for the Profiles the server chooses to support.</li></ul><p><strong>Summary of US Core search criteria</strong></p><p>Specific server search capabilities are described in detail in each of the resource sections below.</p><table class=\"grid\"><thead><tr><th>Resource Type</th><th>Supported Profiles</th><th>Supported Searches</th><th>Supported Includes</th></tr></thead><tbody><tr><td><a href=\"#patient\">Patient</a></td><td>US Core Patient Profile</td><td>name , family , given , identifier , gender , birthdate , name + gender , name + birthdate , family + gender , given + gender</td><td/></tr><tr><td><a href=\"#allergyintolerance\">AllergyIntolerance</a></td><td>US Core AllergyIntolerance Profile</td><td>patient</td><td/></tr><tr><td><a href=\"#careplan\">CarePlan</a></td><td>US Core CarePlan Profile</td><td>patient , category , status , date, patient + category , patient + category + date , patient + category + status , patient + category + status + date</td><td/></tr><tr><td><a href=\"#careteam\">CareTeam</a></td><td>US Core CareTeam Profile</td><td>patient , status, patient + status</td><td/></tr><tr><td><a href=\"#condition\">Condition</a></td><td>US Core Condition Profile</td><td>patient , category , clinicalstatus, patient + clinicalstatus , patient + category</td><td/></tr><tr><td><a href=\"#device\">Device</a></td><td>US Core Device Profile</td><td>patient</td><td/></tr><tr><td><a href=\"#diagnosticreport\">DiagnosticReport</a></td><td>US Core DiagnosticReport Profile</td><td>patient , category , code , date, patient + category , patient + category + date , patient + category + code, patient + category + code + date</td><td/></tr><tr><td><a href=\"#goal\">Goal</a></td><td>US Core Goal Profile</td><td>patient , date, patient + date</td><td/></tr><tr><td><a href=\"#immunization\">Immunization</a></td><td>US Core Immunization Profile</td><td>patient</td><td/></tr><tr><td><a href=\"#location\">Location</a></td><td>US Core Location Profile</td><td>name , address</td><td/></tr><tr><td><a href=\"#medication\">Medication</a></td><td>US Core Medication Profile</td><td/><td/></tr><tr><td><a href=\"#medicationstatement\">MedicationStatement</a></td><td>US Core MedicationStatement Profile</td><td>patient</td><td>MedicationStatement.medication</td></tr><tr><td><a href=\"#medicationrequest\">MedicationRequest</a></td><td>US Core MedicationRequest Profile</td><td>patient</td><td>MedicationRequest.medication</td></tr><tr><td><a href=\"#observation\">Observation</a></td><td>US Core Result Observation Profile, Vital Signs Profile, US Core Smoking Status Observation Profile</td><td>patient , category , code , date, patient + category , patient + category + date , patient + category + code, patient + category + code + date</td><td/></tr><tr><td><a href=\"#organization\">Organization</a></td><td>US Core Organization Profile</td><td>identifier , name , address</td><td/></tr><tr><td><a href=\"#practitioner\">Practitioner</a></td><td>US Core Practitioner Profile</td><td>identifier , name</td><td/></tr><tr><td><a href=\"#procedure\">Procedure</a></td><td>US Core Procedure Profile</td><td>patient , date , patient + date</td><td/></tr></tbody></table><h4 id=\"resource--details\" class=\"no_toc\">Resource  Details:</h4><h5 id=\"patient\" class=\"no_toc\">1. Patient</h5><p>Supported Profiles:  <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-patient.html\">US Core Patient Profile</a></p><p>Search Criteria:</p><ul><li><p>A server <strong>SHALL</strong> be capable of returning a patient using:</p><p><code class=\"highlighter-rouge\">GET [base]/Patient/[id]</code>.</p></li><li><p>A server <strong>SHALL</strong> be capable of returning a patient by identifier using\n<code class=\"highlighter-rouge\">GET [base]/Patient?identifier=[system]|[code]</code></p></li><li><p>A server <strong>SHALL</strong> be capbable of returning a patient by supporting at a minimum the following search parameters when at least 2 are present:</p><ul><li>name</li><li>gender</li><li><p>birthdate</p><ul><li>for example:</li></ul><p><code class=\"highlighter-rouge\">GET [base]/Patient?name=[name]&amp;gender=[gender]</code></p></li></ul></li></ul><p>Search Parameters:</p><table class=\"grid\"><thead><tr><th>Conformance</th><th>Parameter</th><th>Type</th></tr></thead><tbody><tr><td>SHALL</td><td>name</td><td>string</td></tr><tr><td>SHALL</td><td>identifier</td><td>token</td></tr><tr><td>SHALL</td><td>family +gender</td><td>string  + token</td></tr><tr><td>SHALL</td><td>given +gender</td><td>string  + token</td></tr><tr><td>SHALL</td><td>name+gender</td><td>string  + token</td></tr><tr><td>SHALL</td><td>name+birthdate</td><td>string + date</td></tr></tbody></table><h5 id=\"allergyintolerance\" class=\"no_toc\">2. AllergyIntolerance</h5><p>Supported Profiles:  <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-allergyintolerance.html\">US Core AllergyIntolerance Profile</a></p><p>Search Criteria:</p><ul><li><p>A server <strong>SHALL</strong> be capable of returning all patient's allergies using:</p><p><code class=\"highlighter-rouge\">Get [base]/AllergyIntolerance?patient=[id]</code></p></li></ul><p>Search Parameters:</p><table class=\"grid\"><thead><tr><th>Conformance</th><th>Parameter</th><th>Type</th></tr></thead><tbody><tr><td>SHALL</td><td>patient</td><td>reference</td></tr></tbody></table><h5 id=\"careplan\" class=\"no_toc\">3. CarePlan</h5><p>Supported Profiles:  <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-careplan.html\">US Core CarePlan Profile</a></p><p>Search Criteria:</p><ul><li><p>A server <strong>SHALL</strong> be capable of returning all of a patient's Assessment and Plan of Treatment information using:</p><p><code class=\"highlighter-rouge\">Get [base]/CarePlan?patient=[id]&amp;category=assess-plan</code></p></li><li><p>A server <strong>SHALL</strong> be capable of returning a patient's Assessment and Plan of Treatment information over a specified time period using:</p><p><code class=\"highlighter-rouge\">Get [base]/CarePlan?patient=[id]&amp;category=assess-plan&amp;date=[date]</code></p></li><li><p>A server <strong>SHOULD</strong> be capable returning all of a patient's active Assessment and Plan of Treatment information using</p><p><code class=\"highlighter-rouge\">Get [base]/CarePlan?patient=[id]&amp;category=assess-plan&amp;status=active</code></p></li><li><p>A server <strong>SHOULD</strong> be capable returning a patient's active Assessment and Plan of Treatment information over a specified time period using</p><p><code class=\"highlighter-rouge\">Get [base]/CarePlan?patient=[id]&amp;category=assess-plan&amp;status=active&amp;date=[date]</code></p></li></ul><p>Search Parameters:</p><table class=\"grid\"><thead><tr><th>Conformance</th><th>Parameter</th><th>Type</th><th>Modifiers</th></tr></thead><tbody><tr><td>SHALL</td><td>patient + category</td><td>reference + token</td><td/></tr><tr><td>SHALL</td><td>patient + category + date</td><td>reference + token + date</td><td>date modifiers'ge','le','gt','lt'</td></tr><tr><td>SHOULD</td><td>patient + category + status</td><td>reference + token</td><td/></tr><tr><td>SHOULD</td><td>patient + category + date + status</td><td>reference + token + date</td><td>date modifiers'ge','le','gt','lt'</td></tr></tbody></table><h5 id=\"careteam\" class=\"no_toc\">4. CareTeam</h5><p>Supported Profiles:  <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-careteam.html\">US Core CareTeam Profile</a></p><p>Search Criteria:</p><ul><li><p>A server <strong>SHALL</strong> be capable of returning  a patient's current care team members using:</p><p><code class=\"highlighter-rouge\">Get [base]/CareTeam?patient=[id]&amp;status=active</code></p></li></ul><p>Search Parameters:</p><table class=\"grid\"><thead><tr><th>Conformance</th><th>Parameter</th><th>Type</th></tr></thead><tbody><tr><td>SHALL</td><td>patient + status</td><td>reference + token</td></tr></tbody></table><h5 id=\"condition\" class=\"no_toc\">5. Condition</h5><p>Supported Profiles:  <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-Condition.html\">US Core Condition Profile</a></p><p>Search Criteria:</p><ul><li><p>A server <strong>SHALL</strong> be capable of returning a patient's conditions list using:</p><p><code class=\"highlighter-rouge\">Get [base]/Condition?patient=[id]</code></p></li><li><p>A server <strong>SHOULD</strong> be capable returning all of a patient's active problems and health concerns using:</p><p><code class=\"highlighter-rouge\">Get [base]/Condition?patient=[id]&amp;clinicalstatus=active,recurrance,remission</code></p></li><li><p>A server <strong>SHOULD</strong> be capable returning all of a patient's problems or all of patient's health concerns using:</p><p><code class=\"highlighter-rouge\">Get [base]/Condition?patient=[id]&amp;category=[problem|health-concern]</code></p></li></ul><p>Search Parameters:</p><table class=\"grid\"><thead><tr><th>Conformance</th><th>Parameter</th><th>Type</th></tr></thead><tbody><tr><td>SHALL</td><td>patient</td><td>reference</td></tr><tr><td>SHOULD</td><td>patient + category</td><td>reference + token</td></tr><tr><td>SHOULD</td><td>patient + clinicalstatus</td><td>reference + token</td></tr></tbody></table><h5 id=\"device\" class=\"no_toc\">6. Device</h5><p>Supported Profiles:  <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-device.html\">US Core Device Profile</a></p><p>Search Criteria:</p><ul><li><p>A server <strong>SHALL</strong> be capable of returning all Unique device identifier(s)(UDI) for a patient's implanted device(s):</p><p><code class=\"highlighter-rouge\">Get [base]/Device?patient=[id]</code></p></li></ul><p>Search Parameters:</p><table class=\"grid\"><thead><tr><th>Conformance</th><th>Parameter</th><th>Type</th></tr></thead><tbody><tr><td>SHALL</td><td>patient</td><td>reference</td></tr></tbody></table><h5 id=\"diagnosticreport\" class=\"no_toc\">7. DiagnosticReport</h5><p>Supported Profiles:  <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-diagnosticreport.html\">US Core DiagnosticReport Profile</a></p><p>Search Criteria:</p><ul><li><p>A server <strong>SHALL</strong> be capable of returning all of a patient's laboratory diagnostic reports queried by category using:</p><p><code class=\"highlighter-rouge\">Get [base]/DiagnosticReport?patient=[id]&amp;category=LAB</code></p></li><li><p>A server <strong>SHALL</strong> be capable of returning all of a patient's laboratory diagnostic reports queried by category code and date range using:</p><p><code class=\"highlighter-rouge\">GET [base]/DiagnosticReport?patient=[id]&amp;category=LAB&amp;date=[date]{&amp;date=[date]}</code></p></li><li><p>A server <strong>SHALL</strong> be capable of returning all of a patient's laboratory diagnostic reports queried by category and code using:</p><p><code class=\"highlighter-rouge\">GET [base]/DiagnosticReport?patient=[id]&amp;category=LAB&amp;code=[LOINC]</code></p></li><li><p>A server <strong>SHOULD</strong> be capable of returning all of a patient's laboratory diagnostic reports queried by category and one or more codes and date range using:</p><p><code class=\"highlighter-rouge\">GET [base]/DiagnosticReport?patient=[id]&amp;category=LAB&amp;code=[LOINC1{,LOINC2,LOINC3,…}]&amp;date=[date]{&amp;date=[date]}</code></p></li></ul><p>Search Parameters:</p><table class=\"grid\"><thead><tr><th>Conformance</th><th>Parameter</th><th>Type</th><th>Modifiers</th></tr></thead><tbody><tr><td>SHALL</td><td>patient + category</td><td>reference + token</td><td/></tr><tr><td>SHALL</td><td>patient + category + code</td><td>reference + token</td><td/></tr><tr><td>SHALL</td><td>patient + category + date</td><td>reference + token + date</td><td>date modifiers'ge','le','gt','lt'</td></tr><tr><td>SHOULD</td><td>patient + category + code + date</td><td>reference + token + date</td><td>date modifiers'ge','le','gt','lt'</td></tr></tbody></table><h5 id=\"goal\" class=\"no_toc\">8. Goal</h5><p>Supported Profiles:  <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-goal.html\">US Core Goal Profile</a></p><p>Search Criteria:</p><ul><li><p>A server <strong>SHALL</strong> be capable of returning all of a patient's goals using:</p><p><code class=\"highlighter-rouge\">Get [base]/Goal?patient=[id]</code></p></li><li><p>A server <strong>SHALL</strong> be capable of returning all of all of a patient's goals over a specified time period using:</p><p><code class=\"highlighter-rouge\">GET [base]/Goal?patient=[id]&amp;date=[date]{&amp;date=[date]}</code></p></li></ul><p>Search Parameters:</p><table class=\"grid\"><thead><tr><th>Conformance</th><th>Parameter</th><th>Type</th><th>Modifiers</th></tr></thead><tbody><tr><td>SHALL</td><td>patient</td><td>reference</td><td/></tr><tr><td>SHALL</td><td>patient + date</td><td>reference + date</td><td>date modifiers'ge','le','gt','lt'</td></tr></tbody></table><h5 id=\"immunization\" class=\"no_toc\">9. Immunization</h5><p>Supported Profiles:  <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-immunization.html\">US Core Immunization Profile</a></p><p>Search Criteria:</p><ul><li><p>A server <strong>SHALL</strong> be capable of returning all patient's allergies using:</p><p><code class=\"highlighter-rouge\">Get [base]/Immunization?patient=[id]</code></p></li></ul><p>Search Parameters:</p><table class=\"grid\"><thead><tr><th>Conformance</th><th>Parameter</th><th>Type</th></tr></thead><tbody><tr><td>SHALL</td><td>patient</td><td>reference</td></tr></tbody></table><h5 id=\"location\" class=\"no_toc\">10. Location</h5><p>Supported Profiles:  <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-location.html\">US Core Location Profile</a></p><p>Search Criteria:</p><ul><li><p>A server <strong>SHALL</strong> be capable of returning a location by name using:</p><p><code class=\"highlighter-rouge\">Get [base]/Location?name=[string]</code></p></li><li><p>A server <strong>SHALL</strong> be capable of returning a location by address using:</p><p><code class=\"highlighter-rouge\">GET [base]/Location?address=[string]</code></p></li></ul><p>Search Parameters:</p><table class=\"grid\"><thead><tr><th>Conformance</th><th>Parameter</th><th>Type</th></tr></thead><tbody><tr><td>SHALL</td><td>name</td><td>string</td></tr><tr><td>SHALL</td><td>address</td><td>string</td></tr></tbody></table><h5 id=\"medication\" class=\"no_toc\">11. Medication</h5><p>Supported Profiles:  <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-medication.html\">US Core Medication Profile</a></p><p>The MedicationStatement and MedicationRequest resources can represent a medication, using an external reference to a Medication resource. If an external Medication Resource is used in a MedicationStatement or a MedicationRequest, then the READ and SEARCH Criteria SHALL be supported.</p><h5 id=\"medicationstatement\" class=\"no_toc\">12. MedicationStatement</h5><p>Supported Profiles:  <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-medicationstatement.html\">US Core MedicationStatement Profile</a></p><p>Search Criteria:</p><p>The MedicationStatement resources can represent a medication using either a code or refer to the Medication resource.  When referencing a Medication resource, the resource may be <a href=\"http://hl7.org/fhir/2017Jan/references.html#contained\">contained</a> or an external resource. The server application <strong>MAY</strong> choose any one way or more than one method, but <em>if</em> an external reference to Medication is used, the server <strong>SHALL</strong> support the <a href=\"http://hl7.org/fhir/2017Jan/references.html#include\"><code class=\"highlighter-rouge\">_include</code></a> parameter for searching this element. The client application must support all methods.</p><p>A server <strong>SHALL</strong> be capable of returning all medications for a patient using one of or both:</p><p><code class=\"highlighter-rouge\">GET /MedicationStatement?patient=[id]</code></p><p><code class=\"highlighter-rouge\">GET /MedicationStatement?patient=[id]&amp;_include=MedicationStatement:medication</code></p><p>Search Parameters:</p><table class=\"grid\"><thead><tr><th>Conformance</th><th>Parameter</th><th>Type</th><th>_include(see documentation)</th></tr></thead><tbody><tr><td><strong>SHALL</strong></td><td>patient</td><td>reference</td><td>MedicationStatement:medication</td></tr></tbody></table><h5 id=\"medicationrequest\" class=\"no_toc\">13. MedicationRequest</h5><p>Supported Profiles:  <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-medicationrequest.html\">US Core MedicationRequest Profile</a></p><p>Search Criteria:</p><p>The MedicationRequest resources can represent a medication using either a code or refer to the Medication resource.  When referencing a Medication resource, the resource may be <a href=\"http://hl7.org/fhir/2017Jan/references.html#contained\">contained</a> or an external resource. The server application <strong>MAY</strong> choose any one way or more than one method, but <em>if</em> an external reference to Medication is used, the server <strong>SHALL</strong> support the <a href=\"http://hl7.org/fhir/2017Jan/references.html#include\"><code class=\"highlighter-rouge\">_include</code></a> parameter for searching this element. The client application must support all methods.</p><p>A server <strong>SHALL</strong> be capable of returning all medications for a patient using one of or both:</p><p><code class=\"highlighter-rouge\">GET /MedicationRequest?patient=[id]</code></p><p><code class=\"highlighter-rouge\">GET /MedicationRequest?patient=[id]&amp;_include=MedicationRequest:medication</code></p><p>Search Parameters:</p><table class=\"grid\"><thead><tr><th>Conformance</th><th>Parameter</th><th>Type</th><th>_include(see documentation)</th></tr></thead><tbody><tr><td><strong>SHALL</strong></td><td>patient</td><td>reference</td><td>MedicationRequest:medication</td></tr></tbody></table><h5 id=\"observation\" class=\"no_toc\">14. Observation</h5><p>Supported Profiles:\n1. <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-observationresults.html\">US Core Result Observation Profile</a></p><p>Search Criteria:</p><ul><li><p>A server <strong>SHALL</strong> be capable of  returning all of a patient's laboratory results queried by category using:</p><p><code class=\"highlighter-rouge\">GET [base]/Observation?patient=[id]&amp;category=laboratory</code></p></li><li><p>A server <strong>SHALL</strong> be capable of  returning all of a patient's laboratory results queried by category code and date range using:</p><p><code class=\"highlighter-rouge\">GET [base]/Observation?patient=[id]&amp;category=laboratory&amp;date=[date]{&amp;date=[date]}</code></p></li><li><p>A server <strong>SHALL</strong> be capable of  returning all of a patient's laboratory results queried by category and code using:</p><p><code class=\"highlighter-rouge\">GET [base]/Observation?patient=[id]&amp;category=laboratory&amp;code=[LOINC]</code></p></li><li><p>A server <strong>SHOULD</strong> be capable of returning all of a patient's laboratory results queried by category and one or more codes and date range using:</p><p><code class=\"highlighter-rouge\">GET [base]/Observation?patient=[id]&amp;category=laboratory&amp;code=[LOINC1{,LOINC2,LOINC3,...}]&amp;date=[date]{&amp;date=[date]}</code></p></li></ul><ol><li><a href=\"http://hl7.org/fhir/STU3/vitalsigns.html\">Vital Signs Profile</a></li></ol><p>Search Criteria</p><ul><li><p>A server <strong>SHALL</strong> be capable of  returning all of a patient's vital signs that it supports using:</p><p><code class=\"highlighter-rouge\">GET [base]/Observation?patient=[id]&amp;category=vital-signs</code></p></li><li><p>A server <strong>SHALL</strong> be capable of  returning all of a patient's vital signs queried by date range using:</p><p><code class=\"highlighter-rouge\">GET [base]/Observation?patient=[id]&amp;category=vital-signs&amp;date=[date]{&amp;date=[date]}</code></p></li><li><p>A server <strong>SHALL</strong> be capable of  returning any of a patient's vital signs queried by one or more of the codes listed below using:</p><p><code class=\"highlighter-rouge\">GET [base]/Observation?patient=[id]&amp;code[vital sign LOINC{,LOINC2,LOINC3,…}]</code></p></li><li><p>A server <strong>SHOULD</strong> be capable of returning any of a patient's vital signs queried by one or more of the codes listed below and date range using:</p><p><code class=\"highlighter-rouge\">GET [base]/Observation?patient=[id]&amp;code=[LOINC{,LOINC2…}]vital-signs&amp;date=[date]{&amp;date=[date]}</code></p></li></ul><ol><li><a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-smokingstatus.html\">US Core Smoking Status Observation Profile</a></li></ol><p>Search Criteria:</p><ul><li><p>A server <strong>SHALL</strong> be capable of  returning a patient's smoking status using:</p><p><code class=\"highlighter-rouge\">GET [base]/Observation?patient=[id]&amp;code=72166-2</code></p></li></ul><p>Search Parameters:</p><table class=\"grid\"><thead><tr><th>Conformance</th><th>Parameter</th><th>Type</th><th>Modifiers</th></tr></thead><tbody><tr><td>SHALL</td><td>patient + category</td><td>reference + token</td><td/></tr><tr><td>SHALL</td><td>patient + category + code</td><td>reference + token</td><td/></tr><tr><td>SHALL</td><td>patient + category + date</td><td>reference + token + date</td><td>date modifiers'ge','le','gt','lt'</td></tr><tr><td>SHOULD</td><td>patient + category + code + date</td><td>reference + token + date</td><td>date modifiers'ge','le','gt','lt'</td></tr></tbody></table><h5 id=\"organization\" class=\"no_toc\">15. Organization</h5><p>Supported Profiles:  <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-organization.html\">US Core Organization Profile</a></p><p>Search Criteria:</p><ul><li><p>A server <strong>SHALL</strong> be capable of  returning an organization by identifier using:</p><table><tbody><tr><td>`GET [base]/Organization?identifier=[system]</td><td>[code]'</td></tr></tbody></table></li><li><p>A server <strong>SHALL</strong> be capable of  returning an organization by name using:</p><p><code class=\"highlighter-rouge\">GET [base]/Organization?name=[string]</code></p></li><li><p>A server <strong>SHALL</strong> be capable of  returning an organization by address using:</p><p><code class=\"highlighter-rouge\">GET [base]/Organization?address=[string]</code></p></li></ul><p>Search Parameters:</p><table class=\"grid\"><thead><tr><th>Conformance</th><th>Parameter</th><th>Type</th></tr></thead><tbody><tr><td>SHALL</td><td>identifier</td><td>token</td></tr><tr><td>SHALL</td><td>name</td><td>string</td></tr><tr><td>SHALL</td><td>address</td><td>string</td></tr></tbody></table><h5 id=\"practitioner\" class=\"no_toc\">16. Practitioner</h5><p>Supported Profiles:  <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-practitioner.html\">US Core Practitioner Profile</a></p><p>Search Criteria:</p><ul><li><p>A server <strong>SHALL</strong> be capable of  returning a practitioner by identifier using:</p><p><code class=\"highlighter-rouge\">GET [base]/Practitioner?identifier=[system]|[code]</code></p></li><li><p>A server <strong>SHALL</strong> be capable of  returning a practitioner by name using:</p><p><code class=\"highlighter-rouge\">GET [base]/Practitioner?family=[string]&amp;given=[string]</code></p></li></ul><p>Search Parameters:</p><table class=\"grid\"><thead><tr><th>Conformance</th><th>Parameter</th><th>Type</th></tr></thead><tbody><tr><td>SHALL</td><td>identifier</td><td>token</td></tr><tr><td>SHALL</td><td>name</td><td>string</td></tr></tbody></table><h5 id=\"procedure\" class=\"no_toc\">17. Procedure</h5><p>Supported Profiles:  <a href=\"http://hl7.org/fhir/us/core/StructureDefinition-us-core-procedure.html\">US Core Procedure Profile</a></p><p>Search Criteria:</p><ul><li><p>A server <strong>SHALL</strong> be capable of  returning a patient's procedures using:\n<code class=\"highlighter-rouge\">GET/Procedure?patient=[id]</code></p></li><li><p>A server <strong>SHALL</strong> be capable of  returning all of a patient's procedures over a specified time period using:</p><p><code class=\"highlighter-rouge\">GET /Procedure?patient=[id]&amp;date=[date]{&amp;date=[date]}</code></p></li></ul><p>Search Parameters:</p><table class=\"grid\"><thead><tr><th>Conformance</th><th>Parameter</th><th>Type</th><th>Modifiers</th></tr></thead><tbody><tr><td>SHALL</td><td>patient</td><td>reference</td><td/></tr><tr><td>SHALL</td><td>patient + date</td><td>reference + date</td><td>date modifiers'ge','le','gt','lt'</td></tr></tbody></table>\n</div>"
   },
+  "url": "http://hl7.org/fhir/us/core/CapabilityStatement/server",
+  "version": "1.0.0",
   "name": "US Core  Server",
   "status": "draft",
-  "date": "2016-08-10",
-  "publisher": "U.S. Office of the National Coordinator (ONC)",
+  "date": "2017-03-20",
+  "publisher": "HL7 US Realm Steering Committee",
   "contact": [
     {
       "telecom": [
         {
           "system": "other",
-          "value": "http://www.healthit.gov/"
+          "value": "http://www.hl7.org/SpecialCommittees/usrealm/index.cfm"
         }
       ]
     }
   ],
-  "description": "This profile defines the expected capabilities of the US Core  Server actor when conforming to the US-Core IG  The statement includes the complete list of actual profiles, RESTful operations, search parameters supported by US Core Servers. US Core Requesters have the option of choosing from this list to access necessary data based on their local use cases and other contextual requirements.",
+  "description": "This profile defines the expected capabilities of the US Core Server conforming to the US Core IG.",
   "kind": "requirements",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "1.9.0",
   "acceptUnknown": "extensions",
   "format": [
     "xml",
@@ -29,66 +31,203 @@
   ],
   "profile": [
     {
-      "reference": "http://hl7.org/fhir/us/core/StructureDefinition-us-core-allergyintolerance.html"
+      "extension": [
+        {
+          "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-profile-link",
+          "valueCode": "AllergyIntolerance"
+        }
+      ],
+      "reference": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance",
+      "display": "US Core AllergyIntolerance Profile"
     },
     {
-      "reference": "http://hl7.org/fhir/us/core/StructureDefinition-us-core-careplan.html"
+      "extension": [
+        {
+          "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-profile-link",
+          "valueCode": "CarePlan"
+        }
+      ],
+      "reference": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-careplan",
+      "display": "US Core CarePlan Profile"
     },
     {
-      "reference": "http://hl7.org/fhir/us/core/StructureDefinition-us-core-careteam.html"
+      "extension": [
+        {
+          "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-profile-link",
+          "valueCode": "CareTeam"
+        }
+      ],
+      "reference": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-careteam",
+      "display": "US Core CareTeam Profile"
     },
     {
-      "reference": "http://hl7.org/fhir/us/core/StructureDefinition-us-core-condition.html"
+      "extension": [
+        {
+          "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-profile-link",
+          "valueCode": "Condition"
+        }
+      ],
+      "reference": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition",
+      "display": "US Core Condition Profile"
     },
     {
-      "reference": "http://hl7.org/fhir/us/core/StructureDefinition-us-core-device.html"
+      "extension": [
+        {
+          "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-profile-link",
+          "valueCode": "Device"
+        }
+      ],
+      "reference": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-device",
+      "display": "US Core Device Profile"
     },
     {
-      "reference": "http://hl7.org/fhir/us/core/StructureDefinition-us-core-goal.html"
+      "extension": [
+        {
+          "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-profile-link",
+          "valueCode": "Goal"
+        }
+      ],
+      "reference": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-goal",
+      "display": "US Core Goal Profile"
     },
     {
-      "reference": "http://hl7.org/fhir/us/core/StructureDefinition-us-core-immunization.html"
+      "extension": [
+        {
+          "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-profile-link",
+          "valueCode": "Immunization"
+        }
+      ],
+      "reference": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization",
+      "display": "US Core Immunization Profile"
     },
     {
-      "reference": "http://hl7.org/fhir/us/core/StructureDefinition-us-core-diagnosticreport.html"
+      "extension": [
+        {
+          "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-profile-link",
+          "valueCode": "DiagnosticReport"
+        }
+      ],
+      "reference": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport",
+      "display": "US Core DiagnosticReport Profile"
     },
     {
-      "reference": "http://hl7.org/fhir/us/core/StructureDefinition-us-core-observationresults.html"
+      "extension": [
+        {
+          "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-profile-link",
+          "valueCode": "Observation"
+        }
+      ],
+      "reference": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observationresults",
+      "display": "US Core Result Observation Profile"
     },
     {
-      "reference": "http://hl7.org/fhir/us/core/StructureDefinition-us-core-location.html"
+      "extension": [
+        {
+          "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-profile-link",
+          "valueCode": "Location"
+        }
+      ],
+      "reference": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-location",
+      "display": "US Core Location Profile"
     },
     {
-      "reference": "http://hl7.org/fhir/us/core/StructureDefinition-us-core-medication.html"
+      "extension": [
+        {
+          "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-profile-link",
+          "valueCode": "Medication"
+        }
+      ],
+      "reference": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication",
+      "display": "US Core Medication Profile"
     },
     {
-      "reference": "http://hl7.org/fhir/us/core/StructureDefinition-us-core-medicationrequest.html"
+      "extension": [
+        {
+          "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-profile-link",
+          "valueCode": "MedicationRequest"
+        }
+      ],
+      "reference": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationrequest",
+      "display": "US Core MedicationRequest Profile"
     },
     {
-      "reference": "http://hl7.org/fhir/us/core/StructureDefinition-us-core-vitalsigns.html"
+      "extension": [
+        {
+          "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-profile-link",
+          "valueCode": "MedicationStatement"
+        }
+      ],
+      "reference": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationstatement",
+      "display": "US Core MedicationStatement Profile"
     },
     {
-      "reference": "http://hl7.org/fhir/us/core/StructureDefinition-us-core-patient.html"
+      "extension": [
+        {
+          "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-profile-link",
+          "valueCode": "Observation"
+        }
+      ],
+      "reference": "http://hl7.org/fhir/StructureDefinition/vitalsigns",
+      "display": "Vital Signs Profile"
     },
     {
-      "reference": "http://hl7.org/fhir/us/core/StructureDefinition-us-core-pract.html"
+      "extension": [
+        {
+          "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-profile-link",
+          "valueCode": "Observation"
+        }
+      ],
+      "reference": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-smokingstatus",
+      "display": "US Core Smoking Status Observation Profile"
+    },
+    {
+      "extension": [
+        {
+          "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-profile-link",
+          "valueCode": "Organization"
+        }
+      ],
+      "reference": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization",
+      "display": "US Core Organization Profile"
+    },
+    {
+      "extension": [
+        {
+          "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-profile-link",
+          "valueCode": "Patient"
+        }
+      ],
+      "reference": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient",
+      "display": "US Core Patient Profile"
     },
     {
-      "reference": "http://hl7.org/fhir/us/core/StructureDefinition-us-core-procedure.html"
+      "extension": [
+        {
+          "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-profile-link",
+          "valueCode": "Practitioner"
+        }
+      ],
+      "reference": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner",
+      "display": "US Core Practitioner Profile"
+    },
+    {
+      "extension": [
+        {
+          "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-profile-link",
+          "valueCode": "Procedure"
+        }
+      ],
+      "reference": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure",
+      "display": "US Core Procedure Profile"
     }
   ],
   "rest": [
     {
       "mode": "server",
-      "documentation": "==The US Core  Server SHALL:==     1.Support the US Core Patient resource profile.      2.Support at least one additional resource profile from the list of US Core Profiles      2. Implement REST behavior according to the FHIR specification      3.  Support json resource formats for all US Core interactions.      4. Identify the US Core profile(s) supported as part of the FHIR [http://hl7.org/fhir/2017Jan/resource-definitions.html#Meta.profile Meta profile attribute] for each instance.     5.  Declare a CapabilityStatement identifying the list of profiles, operations, search parameter supported.                ==The US Core  Server SHOULD:==     1. Support xml resource formats for all US Core interactions.  ",
-      "security": {
-        "description": "US Core  Servers '''SHALL''' implement the [security.html security requirements]  documented in the US-Core IG."
-      },
       "resource": [
         {
           "extension": [
             {
-              "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-search-parameter-combination",
               "extension": [
                 {
                   "url": "required",
@@ -98,13 +237,50 @@
                   "url": "required",
                   "valueString": "gender"
                 }
-              ]
+              ],
+              "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-search-parameter-combination"
+            },
+            {
+              "extension": [
+                {
+                  "url": "required",
+                  "valueString": "name"
+                },
+                {
+                  "url": "required",
+                  "valueString": "birthdate"
+                }
+              ],
+              "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-search-parameter-combination"
+            },
+            {
+              "extension": [
+                {
+                  "url": "required",
+                  "valueString": "family"
+                },
+                {
+                  "url": "required",
+                  "valueString": "gender"
+                }
+              ],
+              "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-search-parameter-combination"
+            },
+            {
+              "extension": [
+                {
+                  "url": "required",
+                  "valueString": "given"
+                },
+                {
+                  "url": "required",
+                  "valueString": "gender"
+                }
+              ],
+              "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-search-parameter-combination"
             }
           ],
           "type": "Patient",
-          "profile": {
-            "reference": "http://hl7.org/fhir/us/core/StructureDefinition-us-core-patient.html"
-          },
           "interaction": [
             {
               "extension": [
@@ -157,8 +333,7 @@
               ],
               "name": "name",
               "definition": "http://hl7.org/fhir/SearchParameter/Patient-name",
-              "type": "string",
-              "documentation": "todo"
+              "type": "string"
             },
             {
               "extension": [
@@ -219,9 +394,6 @@
         },
         {
           "type": "AllergyIntolerance",
-          "profile": {
-            "reference": "http://hl7.org/fhir/us/core/StructureDefinition-us-core-allergyintolerance.html"
-          },
           "interaction": [
             {
               "extension": [
@@ -279,10 +451,77 @@
           ]
         },
         {
+          "extension": [
+            {
+              "extension": [
+                {
+                  "url": "required",
+                  "valueString": "patient"
+                },
+                {
+                  "url": "required",
+                  "valueString": "category"
+                }
+              ],
+              "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-search-parameter-combination"
+            },
+            {
+              "extension": [
+                {
+                  "url": "required",
+                  "valueString": "patient"
+                },
+                {
+                  "url": "required",
+                  "valueString": "category"
+                },
+                {
+                  "url": "required",
+                  "valueString": "date"
+                }
+              ],
+              "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-search-parameter-combination"
+            },
+            {
+              "extension": [
+                {
+                  "url": "required",
+                  "valueString": "patient"
+                },
+                {
+                  "url": "required",
+                  "valueString": "category"
+                },
+                {
+                  "url": "required",
+                  "valueString": "status"
+                }
+              ],
+              "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-search-parameter-combination"
+            },
+            {
+              "extension": [
+                {
+                  "url": "required",
+                  "valueString": "patient"
+                },
+                {
+                  "url": "required",
+                  "valueString": "category"
+                },
+                {
+                  "url": "required",
+                  "valueString": "status"
+                },
+                {
+                  "url": "required",
+                  "valueString": "date"
+                }
+              ],
+              "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-search-parameter-combination"
+            }
+          ],
           "type": "CarePlan",
-          "profile": {
-            "reference": "http://hl7.org/fhir/us/core/StructureDefinition-us-core-careplan.html"
-          },
           "interaction": [
             {
               "extension": [
@@ -369,15 +608,27 @@
               "name": "date",
               "definition": "http://hl7.org/fhir/SearchParameter/CarePlan-Date",
               "type": "date",
-              "documentation": "The server SHALL support the [http://hl7.org/fhir/2017Jan/search.html#prefix date search modifiers] 'ge','le','eq' for this profile"
+              "documentation": "The server SHALL support the date search modifiers 'ge','le','gt', and 'lt'"
             }
           ]
         },
         {
+          "extension": [
+            {
+              "extension": [
+                {
+                  "url": "required",
+                  "valueString": "patient"
+                },
+                {
+                  "url": "required",
+                  "valueString": "status"
+                }
+              ],
+              "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-search-parameter-combination"
+            }
+          ],
           "type": "CareTeam",
-          "profile": {
-            "reference": "http://hl7.org/fhir/us/core/StructureDefinition-us-core-careteam.html"
-          },
           "interaction": [
             {
               "extension": [
@@ -446,10 +697,35 @@
           ]
         },
         {
+          "extension": [
+            {
+              "extension": [
+                {
+                  "url": "required",
+                  "valueString": "patient"
+                },
+                {
+                  "url": "required",
+                  "valueString": "clinicalstatus"
+                }
+              ],
+              "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-search-parameter-combination"
+            },
+            {
+              "extension": [
+                {
+                  "url": "required",
+                  "valueString": "patient"
+                },
+                {
+                  "url": "required",
+                  "valueString": "category"
+                }
+              ],
+              "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-search-parameter-combination"
+            }
+          ],
           "type": "Condition",
-          "profile": {
-            "reference": "http://hl7.org/fhir/us/core/StructureDefinition-us-core-condition.html"
-          },
           "interaction": [
             {
               "extension": [
@@ -508,7 +784,7 @@
               "extension": [
                 {
                   "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
-                  "valueCode": "SHALL"
+                  "valueCode": "SHOULD"
                 }
               ],
               "name": "category",
@@ -519,7 +795,7 @@
               "extension": [
                 {
                   "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
-                  "valueCode": "SHALL"
+                  "valueCode": "SHOULD"
                 }
               ],
               "name": "clinicalstatus",
@@ -530,9 +806,6 @@
         },
         {
           "type": "Device",
-          "profile": {
-            "reference": "http://hl7.org/fhir/us/core/StructureDefinition-us-core-device.html"
-          },
           "interaction": [
             {
               "extension": [
@@ -590,10 +863,22 @@
           ]
         },
         {
+          "extension": [
+            {
+              "extension": [
+                {
+                  "url": "required",
+                  "valueString": "patient"
+                },
+                {
+                  "url": "required",
+                  "valueString": "date"
+                }
+              ],
+              "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-search-parameter-combination"
+            }
+          ],
           "type": "Goal",
-          "profile": {
-            "reference": "http://hl7.org/fhir/us/core/StructureDefinition-us-core-Goal.html"
-          },
           "interaction": [
             {
               "extension": [
@@ -658,15 +943,12 @@
               "name": "date",
               "definition": "http://hl7.org/fhir/SearchParameter/Goal-Date",
               "type": "date",
-              "documentation": "The server SHALL support the [http://hl7.org/fhir/2017Jan/search.html#prefix date search modifiers] 'ge','le','eq' for this profile"
+              "documentation": "The server SHALL support the date search modifiers 'ge','le','gt', and 'lt'"
             }
           ]
         },
         {
           "type": "Immunization",
-          "profile": {
-            "reference": "http://hl7.org/fhir/us/core/StructureDefinition-us-core-immunization.html"
-          },
           "interaction": [
             {
               "extension": [
@@ -724,10 +1006,77 @@
           ]
         },
         {
+          "extension": [
+            {
+              "extension": [
+                {
+                  "url": "required",
+                  "valueString": "patient"
+                },
+                {
+                  "url": "required",
+                  "valueString": "category"
+                }
+              ],
+              "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-search-parameter-combination"
+            },
+            {
+              "extension": [
+                {
+                  "url": "required",
+                  "valueString": "patient"
+                },
+                {
+                  "url": "required",
+                  "valueString": "category"
+                },
+                {
+                  "url": "required",
+                  "valueString": "date"
+                }
+              ],
+              "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-search-parameter-combination"
+            },
+            {
+              "extension": [
+                {
+                  "url": "required",
+                  "valueString": "patient"
+                },
+                {
+                  "url": "required",
+                  "valueString": "category"
+                },
+                {
+                  "url": "required",
+                  "valueString": "code"
+                }
+              ],
+              "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-search-parameter-combination"
+            },
+            {
+              "extension": [
+                {
+                  "url": "required",
+                  "valueString": "patient"
+                },
+                {
+                  "url": "required",
+                  "valueString": "category"
+                },
+                {
+                  "url": "required",
+                  "valueString": "code"
+                },
+                {
+                  "url": "required",
+                  "valueString": "date"
+                }
+              ],
+              "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-search-parameter-combination"
+            }
+          ],
           "type": "DiagnosticReport",
-          "profile": {
-            "reference": "http://hl7.org/fhir/us/core/StructureDefinition-us-core-diagnosticreport.html"
-          },
           "interaction": [
             {
               "extension": [
@@ -814,16 +1163,81 @@
               "name": "date",
               "definition": "http://hl7.org/fhir/SearchParameter/DiagnosticReport-Date",
               "type": "date",
-              "documentation": "The server SHALL support the [http://hl7.org/fhir/2017Jan/search.html#prefix date search modifiers] 'ge','le','eq' for this profile"
+              "documentation": "The server SHALL support the date search modifiers 'ge','le','gt', and 'lt'"
+            }
+          ]
+        },
+        {
+          "type": "Location",
+          "interaction": [
+            {
+              "extension": [
+                {
+                  "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
+                  "valueCode": "SHALL"
+                }
+              ],
+              "code": "search-type",
+              "documentation": "Allows discovery of existing US Core location resources using different search criteria."
+            },
+            {
+              "extension": [
+                {
+                  "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
+                  "valueCode": "SHALL"
+                }
+              ],
+              "code": "read",
+              "documentation": "Allows retrieval of a historical version of a US Core location instance"
+            },
+            {
+              "extension": [
+                {
+                  "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
+                  "valueCode": "SHOULD"
+                }
+              ],
+              "code": "history-instance",
+              "documentation": "Allows review of changes to US Core Medication instance over time"
+            },
+            {
+              "extension": [
+                {
+                  "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
+                  "valueCode": "SHOULD"
+                }
+              ],
+              "code": "vread",
+              "documentation": "Allows retrieval of a historical version of a US Core Medication instance"
+            }
+          ],
+          "searchParam": [
+            {
+              "extension": [
+                {
+                  "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
+                  "valueCode": "SHALL"
+                }
+              ],
+              "name": "name",
+              "definition": "http://hl7.org/fhir/SearchParameter/Location-Name",
+              "type": "string"
+            },
+            {
+              "extension": [
+                {
+                  "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
+                  "valueCode": "SHALL"
+                }
+              ],
+              "name": "address",
+              "definition": "http://hl7.org/fhir/SearchParameter/Location-Address",
+              "type": "string"
             }
           ]
         },
         {
           "type": "Medication",
-          "profile": {
-            "reference": "http://hl7.org/fhir/us/core/StructureDefinition-us-core-medication.html"
-          },
-          "documentation": "The MedicationStatement and MedicationRequest resources can represent a medication, using either a code or refer to a Medication resource.  If the Medication Resource is used in a MedicationStatement or a MedicationRequest,  then the READ and SEARCH Criteria  '''SHALL''' be supported.",
           "interaction": [
             {
               "extension": [
@@ -869,10 +1283,6 @@
         },
         {
           "type": "MedicationStatement",
-          "profile": {
-            "reference": "http://hl7.org/fhir/us/core/StructureDefinition-us-core-medicationstatement.html"
-          },
-          "documentation": "    The MedicationStatement and MedicationRequest resources can represent a medication, using either a code or refer to a Medication resource.    When referencing a Medication resource,  the resource may be [http://hl7.org/fhir/2017Jan/references.html#contained contained] or an external resource.   The server application can choose any one way or more than one method,  but if the an external reference to Medication is used, the server SHALL support the [http://hl7.org/fhir/2017Jan/search.html#include include] parameter for searching this element.   The client application must support both methods.",
           "interaction": [
             {
               "extension": [
@@ -944,10 +1354,6 @@
         },
         {
           "type": "MedicationRequest",
-          "profile": {
-            "reference": "http://hl7.org/fhir/us/core/StructureDefinition-us-core-medicationrequest.html"
-          },
-          "documentation": "    The MedicationStatement and MedicationRequest resources can represent a medication, using either a code or refer to a Medication resource.    When referencing a Medication resource,  the resource may be [http://hl7.org/fhir/2017Jan/references.html#contained contained] or an external resource.   The server application can choose any one way or more than one method,  but if the an external reference to Medication is used, the server SHALL support the [http://hl7.org/fhir/2017Jan/search.html#include include] parameter for searching this element.   The client application must support both methods.",
           "interaction": [
             {
               "extension": [
@@ -1018,10 +1424,77 @@
           ]
         },
         {
+          "extension": [
+            {
+              "extension": [
+                {
+                  "url": "required",
+                  "valueString": "patient"
+                },
+                {
+                  "url": "required",
+                  "valueString": "category"
+                }
+              ],
+              "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-search-parameter-combination"
+            },
+            {
+              "extension": [
+                {
+                  "url": "required",
+                  "valueString": "patient"
+                },
+                {
+                  "url": "required",
+                  "valueString": "category"
+                },
+                {
+                  "url": "required",
+                  "valueString": "date"
+                }
+              ],
+              "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-search-parameter-combination"
+            },
+            {
+              "extension": [
+                {
+                  "url": "required",
+                  "valueString": "patient"
+                },
+                {
+                  "url": "required",
+                  "valueString": "category"
+                },
+                {
+                  "url": "required",
+                  "valueString": "code"
+                }
+              ],
+              "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-search-parameter-combination"
+            },
+            {
+              "extension": [
+                {
+                  "url": "required",
+                  "valueString": "patient"
+                },
+                {
+                  "url": "required",
+                  "valueString": "category"
+                },
+                {
+                  "url": "required",
+                  "valueString": "code"
+                },
+                {
+                  "url": "required",
+                  "valueString": "date"
+                }
+              ],
+              "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-search-parameter-combination"
+            }
+          ],
           "type": "Observation",
-          "profile": {
-            "reference": "http://hl7.org/fhir/us/core/StructureDefinition-us-core-smokingstatus.html"
-          },
           "interaction": [
             {
               "extension": [
@@ -1031,7 +1504,7 @@
                 }
               ],
               "code": "search-type",
-              "documentation": "Allows discovery of existing US Core smokingstatus resources using different search criteria"
+              "documentation": "Allows discovery of existing US Core results observation, smokingstatus, and vitals signs observation using different search criteria"
             },
             {
               "extension": [
@@ -1041,7 +1514,7 @@
                 }
               ],
               "code": "read",
-              "documentation": "Allows retrieval of a specific US Core smokingstatus by id"
+              "documentation": "Allows retrieval of a specific US Core results observation, smokingstatus, and vitals signs observation by id"
             },
             {
               "extension": [
@@ -1051,7 +1524,7 @@
                 }
               ],
               "code": "history-instance",
-              "documentation": "Allows review of changes to US Core smokingstatus instance over time"
+              "documentation": "Allows review of changes to US Core results observation, smokingstatus, and vitals signs observation over time"
             },
             {
               "extension": [
@@ -1061,7 +1534,7 @@
                 }
               ],
               "code": "vread",
-              "documentation": "Allows retrieval of a historical version of a US Core smokingstatus instance"
+              "documentation": "Allows retrieval of a historical version of a US Core results observation, smokingstatus, and vitals signs observation instance"
             }
           ],
           "searchParam": [
@@ -1076,6 +1549,17 @@
               "definition": "http://hl7.org/fhir/SearchParameter/Observation-Patient",
               "type": "reference"
             },
+            {
+              "extension": [
+                {
+                  "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
+                  "valueCode": "SHALL"
+                }
+              ],
+              "name": "category",
+              "definition": "http://hl7.org/fhir/SearchParameter/Organization-Category",
+              "type": "token"
+            },
             {
               "extension": [
                 {
@@ -1084,16 +1568,25 @@
                 }
               ],
               "name": "code",
-              "definition": "http://hl7.org/fhir/SearchParameter/Observation-Code",
+              "definition": "http://hl7.org/fhir/SearchParameter/Organization-Code",
               "type": "token"
+            },
+            {
+              "extension": [
+                {
+                  "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
+                  "valueCode": "SHALL"
+                }
+              ],
+              "name": "date",
+              "definition": "http://hl7.org/fhir/SearchParameter/Organization-Date",
+              "type": "date",
+              "documentation": "The server SHALL support the date search modifiers 'ge','le','gt', and 'lt'"
             }
           ]
         },
         {
-          "type": "Observation",
-          "profile": {
-            "reference": "http://hl7.org/fhir/us/core/StructureDefinition-us-core-vitalsigns.html"
-          },
+          "type": "Organization",
           "interaction": [
             {
               "extension": [
@@ -1103,7 +1596,7 @@
                 }
               ],
               "code": "search-type",
-              "documentation": "Allows discovery of existing US Core vitalsigns resources using different search criteria"
+              "documentation": "Allows discovery of existing US Core organization resources using different search criteria"
             },
             {
               "extension": [
@@ -1113,7 +1606,7 @@
                 }
               ],
               "code": "read",
-              "documentation": "Allows retrieval of a specific US Core vitalsigns by id"
+              "documentation": "Allows retrieval of a specific US Core organization by id"
             },
             {
               "extension": [
@@ -1123,7 +1616,7 @@
                 }
               ],
               "code": "history-instance",
-              "documentation": "Allows review of changes to US Core vitalsigns instance over time"
+              "documentation": "Allows review of changes to US Core organization instance over time"
             },
             {
               "extension": [
@@ -1133,7 +1626,7 @@
                 }
               ],
               "code": "vread",
-              "documentation": "Allows retrieval of a historical version of a US Core vitalsigns instance"
+              "documentation": "Allows retrieval of a historical version of a US Core organization instance"
             }
           ],
           "searchParam": [
@@ -1144,9 +1637,9 @@
                   "valueCode": "SHALL"
                 }
               ],
-              "name": "patient",
-              "definition": "http://hl7.org/fhir/SearchParameter/Observation-Patient",
-              "type": "reference"
+              "name": "identifier",
+              "definition": "http://hl7.org/fhir/SearchParameter/Organization-Identifier",
+              "type": "token"
             },
             {
               "extension": [
@@ -1155,9 +1648,9 @@
                   "valueCode": "SHALL"
                 }
               ],
-              "name": "category",
-              "definition": "http://hl7.org/fhir/SearchParameter/Observation-Category",
-              "type": "token"
+              "name": "name",
+              "definition": "http://hl7.org/fhir/SearchParameter/Organization-Name",
+              "type": "string"
             },
             {
               "extension": [
@@ -1166,8 +1659,66 @@
                   "valueCode": "SHALL"
                 }
               ],
-              "name": "code",
-              "definition": "http://hl7.org/fhir/SearchParameter/Observation-Code",
+              "name": "address",
+              "definition": "http://hl7.org/fhir/SearchParameter/Organization-Address",
+              "type": "string"
+            }
+          ]
+        },
+        {
+          "type": "Practitioner",
+          "interaction": [
+            {
+              "extension": [
+                {
+                  "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
+                  "valueCode": "SHALL"
+                }
+              ],
+              "code": "search-type",
+              "documentation": "Allows discovery of existing US Core practitioner resources using different search criteria"
+            },
+            {
+              "extension": [
+                {
+                  "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
+                  "valueCode": "SHALL"
+                }
+              ],
+              "code": "read",
+              "documentation": "Allows retrieval of a specific US Core practitioner by id"
+            },
+            {
+              "extension": [
+                {
+                  "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
+                  "valueCode": "SHOULD"
+                }
+              ],
+              "code": "history-instance",
+              "documentation": "Allows review of changes to US Core practitioner instance over time"
+            },
+            {
+              "extension": [
+                {
+                  "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
+                  "valueCode": "SHOULD"
+                }
+              ],
+              "code": "vread",
+              "documentation": "Allows retrieval of a historical version of a US Core practitioner instance"
+            }
+          ],
+          "searchParam": [
+            {
+              "extension": [
+                {
+                  "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
+                  "valueCode": "SHALL"
+                }
+              ],
+              "name": "identifier",
+              "definition": "http://hl7.org/fhir/SearchParameter/Practitioner-Identifier",
               "type": "token"
             },
             {
@@ -1177,18 +1728,29 @@
                   "valueCode": "SHALL"
                 }
               ],
-              "name": "date",
-              "definition": "http://hl7.org/fhir/SearchParameter/Observation-Date",
-              "type": "date",
-              "documentation": "The server SHALL support the [http://hl7.org/fhir/2017Jan/search.html#prefix date search modifiers] 'ge','le','eq' for this profile"
+              "name": "name",
+              "definition": "http://hl7.org/fhir/SearchParameter/Practitioner-Name",
+              "type": "string"
             }
           ]
         },
         {
+          "extension": [
+            {
+              "extension": [
+                {
+                  "url": "required",
+                  "valueString": "patient"
+                },
+                {
+                  "url": "required",
+                  "valueString": "date"
+                }
+              ],
+              "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-search-parameter-combination"
+            }
+          ],
           "type": "Procedure",
-          "profile": {
-            "reference": "http://hl7.org/fhir/us/core/StructureDefinition-us-core-procedure.html"
-          },
           "interaction": [
             {
               "extension": [
@@ -1253,11 +1815,11 @@
               "name": "date",
               "definition": "http://hl7.org/fhir/SearchParameter/Procedure-Date",
               "type": "date",
-              "documentation": "The server SHALL support the [http://hl7.org/fhir/2017Jan/search.html#prefix date search modifiers] 'ge','le','eq' for this profile"
+              "documentation": "The server SHALL support the date search modifiers 'ge','le','gt', and 'lt'"
             }
           ]
         }
       ]
     }
   ]
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/CodeSystem-careplan-category.json b/lib/resources/us_core/CodeSystem-careplan-category.json
index d95b34b..83e49fb 100755
--- a/lib/resources/us_core/CodeSystem-careplan-category.json
+++ b/lib/resources/us_core/CodeSystem-careplan-category.json
@@ -3,27 +3,23 @@
   "id": "careplan-category",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>US Core CarePlan Category Extension Codes</h2><div><p>Set of codes that are needed for implementation of the US-Core profiles. These codes are used as extensions to the FHIR and US Core value sets.</p>\n</div><p>This code system http://hl7.org/fhir/us/core/CodeSystem/careplan-category defines the following codes:</p><table class=\"codes\"><tr><td><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td>careteam<a name=\"careplan-category-careteam\"> </a></td><td>Care Team</td><td>Careplan for identifying all the people and /or organizations who plan to participate in the coordination of delivery of care.</td></tr><tr><td>assess-plan<a name=\"careplan-category-assess-plan\"> </a></td><td>Assessment and Plan of Treatment</td><td>The clinical conclusions and assumptions that guide the patient's treatment and the clinical activities formulated for a patient.</td></tr></table></div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>US Core CarePlan Category Extension Codes</h2><div><p>Set of codes that are needed for implementation of the US-Core profiles. These codes are used as extensions to the FHIR and US Core value sets.</p>\n</div><p>This code system http://hl7.org/fhir/us/core/CodeSystem/careplan-category defines the following codes:</p><table class=\"codes\"><tr><td><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td>assess-plan<a name=\"careplan-category-assess-plan\"> </a></td><td>Assessment and Plan of Treatment</td><td>The clinical conclusions and assumptions that guide the patient's treatment and the clinical activities formulated for a patient.</td></tr></table></div>"
   },
   "url": "http://hl7.org/fhir/us/core/CodeSystem/careplan-category",
+  "version": "1.0.0",
   "name": "US Core CarePlan Category Extension Codes",
   "status": "draft",
-  "publisher": "HL7 (FHIR Project)",
-  "date": "2016-12-06T22:13:05+11:00",
+  "date": "2017-03-21T11:28:08+11:00",
+  "publisher": "HL7 US Realm Steering Committee",
   "description": "Set of codes that are needed for implementation of the US-Core profiles. These codes are used as extensions to the FHIR and US Core value sets.\n",
   "caseSensitive": true,
   "valueSet": "http://hl7.org/fhir/us/core/ValueSet/careplan-category",
   "content": "complete",
   "concept": [
-    {
-      "code": "careteam",
-      "display": "Care Team",
-      "definition": "Careplan for identifying all the people and /or organizations who plan to participate in the coordination of delivery of care."
-    },
     {
       "code": "assess-plan",
       "display": "Assessment and Plan of Treatment",
       "definition": "The clinical conclusions and assumptions that guide the patient's treatment and the clinical activities formulated for a patient."
     }
   ]
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/CodeSystem-careteam-status.json b/lib/resources/us_core/CodeSystem-careteam-status.json
deleted file mode 100755
index f3ceff2..0000000
--- a/lib/resources/us_core/CodeSystem-careteam-status.json
+++ /dev/null
@@ -1,39 +0,0 @@
-{
-  "resourceType": "CodeSystem",
-  "id": "careteam-status",
-  "text": {
-    "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>US Core CareTeam Status Codes</h2><div><p>Indicates whether the team is current , represents future intentions or is now a historical record.</p>\n</div><p>This code system http://hl7.org/fhir/us/core/CodeSystem/careteam-status defines the following codes:</p><table class=\"codes\"><tr><td><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td>draft<a name=\"careteam-status-draft\"> </a></td><td>Pending</td><td>The care team is in development or awaiting formation</td></tr><tr><td>active<a name=\"careteam-status-active\"> </a></td><td>Active</td><td>The care team is current and actively involved in patient care.</td></tr><tr><td>completed<a name=\"careteam-status-completed\"> </a></td><td>Completed</td><td>The care team is no longer current and actively involved in patient care.</td></tr><tr><td>cancelled<a name=\"careteam-status-cancelled\"> </a></td><td>Cancelled</td><td>The care team has been dispanded (though it may have been replaced by a new care team).</td></tr></table></div>"
-  },
-  "url": "http://hl7.org/fhir/us/core/CodeSystem/careteam-status",
-  "name": "US Core CareTeam Status Codes",
-  "status": "draft",
-  "publisher": "HL7 (FHIR Project)",
-  "date": "2016-12-06T22:13:05+11:00",
-  "description": "Indicates whether the team is current , represents future intentions or is now a historical record.",
-  "caseSensitive": true,
-  "valueSet": "http://hl7.org/fhir/us/core/ValueSet/careteam-status",
-  "content": "complete",
-  "concept": [
-    {
-      "code": "draft",
-      "display": "Pending",
-      "definition": "The care team is in development or awaiting formation"
-    },
-    {
-      "code": "active",
-      "display": "Active",
-      "definition": "The care team is current and actively involved in patient care."
-    },
-    {
-      "code": "completed",
-      "display": "Completed",
-      "definition": "The care team is no longer current and actively involved in patient care."
-    },
-    {
-      "code": "cancelled",
-      "display": "Cancelled",
-      "definition": "The care team has been dispanded (though it may have been replaced by a new care team)."
-    }
-  ]
-}
\ No newline at end of file
diff --git a/lib/resources/us_core/CodeSystem-cdcrec.json b/lib/resources/us_core/CodeSystem-cdcrec.json
new file mode 100755
index 0000000..14e4819
--- /dev/null
+++ b/lib/resources/us_core/CodeSystem-cdcrec.json
@@ -0,0 +1,4883 @@
+{
+  "resourceType": "CodeSystem",
+  "id": "cdcrec",
+  "text": {
+    "status": "generated",
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>Race &amp; Ethnicity - CDC</h2><div><p>The U.S. Centers for Disease Control and Prevention (CDC) has prepared a code set for use in coding race and ethnicity data. This code set is based on current federal standards for classifying data on race and ethnicity, specifically the minimum race and ethnicity categories defined by the U.S. Office of Management and Budget (OMB) and a more detailed set of race and ethnicity categories maintained by the U.S. Bureau of the Census (BC). The main purpose of the code set is to facilitate use of federal standards for classifying data on race and ethnicity when these data are exchanged, stored, retrieved, or analyzed in electronic form. At the same time, the code set can be applied to paper-based record systems to the extent that these systems are used to collect, maintain, and report data on race and ethnicity in accordance with current federal standards. Source: <a href=\"https://www.cdc.gov/phin/resources/vocabulary/documents/cdc-race--ethnicity-background-and-purpose.pdf\">Race and Ethnicity Code Set Version 1.0</a></p>\n</div><p>This code system urn:oid:2.16.840.1.113883.6.238 defines the following codes:</p><table class=\"codes\"><tr><td><b>Lvl</b></td><td><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td>1</td><td>1000-9<a name=\"cdcrec-1000-9\"> </a></td><td>Race</td><td>Race</td></tr><tr><td>2</td><td>  1002-5<a name=\"cdcrec-1002-5\"> </a></td><td>American Indian or Alaska Native</td><td>American Indian or Alaska Native</td></tr><tr><td>3</td><td>    1004-1<a name=\"cdcrec-1004-1\"> </a></td><td>American Indian</td><td>American Indian</td></tr><tr><td>3</td><td>    1735-0<a name=\"cdcrec-1735-0\"> </a></td><td>Alaska Native</td><td>Alaska Native</td></tr><tr><td>3</td><td>    1006-6<a name=\"cdcrec-1006-6\"> </a></td><td>Abenaki</td><td>Abenaki</td></tr><tr><td>3</td><td>    1008-2<a name=\"cdcrec-1008-2\"> </a></td><td>Algonquian</td><td>Algonquian</td></tr><tr><td>3</td><td>    1010-8<a name=\"cdcrec-1010-8\"> </a></td><td>Apache</td><td>Apache</td></tr><tr><td>3</td><td>    1021-5<a name=\"cdcrec-1021-5\"> </a></td><td>Arapaho</td><td>Arapaho</td></tr><tr><td>3</td><td>    1026-4<a name=\"cdcrec-1026-4\"> </a></td><td>Arikara</td><td>Arikara</td></tr><tr><td>3</td><td>    1028-0<a name=\"cdcrec-1028-0\"> </a></td><td>Assiniboine</td><td>Assiniboine</td></tr><tr><td>3</td><td>    1030-6<a name=\"cdcrec-1030-6\"> </a></td><td>Assiniboine Sioux</td><td>Assiniboine Sioux</td></tr><tr><td>3</td><td>    1033-0<a name=\"cdcrec-1033-0\"> </a></td><td>Bannock</td><td>Bannock</td></tr><tr><td>3</td><td>    1035-5<a name=\"cdcrec-1035-5\"> </a></td><td>Blackfeet</td><td>Blackfeet</td></tr><tr><td>3</td><td>    1037-1<a name=\"cdcrec-1037-1\"> </a></td><td>Brotherton</td><td>Brotherton</td></tr><tr><td>3</td><td>    1039-7<a name=\"cdcrec-1039-7\"> </a></td><td>Burt Lake Band</td><td>Burt Lake Band</td></tr><tr><td>3</td><td>    1041-3<a name=\"cdcrec-1041-3\"> </a></td><td>Caddo</td><td>Caddo</td></tr><tr><td>3</td><td>    1044-7<a name=\"cdcrec-1044-7\"> </a></td><td>Cahuilla</td><td>Cahuilla</td></tr><tr><td>3</td><td>    1053-8<a name=\"cdcrec-1053-8\"> </a></td><td>California Tribes</td><td>California Tribes</td></tr><tr><td>3</td><td>    1068-6<a name=\"cdcrec-1068-6\"> </a></td><td>Canadian and Latin American Indian</td><td>Canadian and Latin American Indian</td></tr><tr><td>3</td><td>    1076-9<a name=\"cdcrec-1076-9\"> </a></td><td>Catawba</td><td>Catawba</td></tr><tr><td>3</td><td>    1078-5<a name=\"cdcrec-1078-5\"> </a></td><td>Cayuse</td><td>Cayuse</td></tr><tr><td>3</td><td>    1080-1<a name=\"cdcrec-1080-1\"> </a></td><td>Chehalis</td><td>Chehalis</td></tr><tr><td>3</td><td>    1082-7<a name=\"cdcrec-1082-7\"> </a></td><td>Chemakuan</td><td>Chemakuan</td></tr><tr><td>3</td><td>    1086-8<a name=\"cdcrec-1086-8\"> </a></td><td>Chemehuevi</td><td>Chemehuevi</td></tr><tr><td>3</td><td>    1088-4<a name=\"cdcrec-1088-4\"> </a></td><td>Cherokee</td><td>Cherokee</td></tr><tr><td>3</td><td>    1100-7<a name=\"cdcrec-1100-7\"> </a></td><td>Cherokee Shawnee</td><td>Cherokee Shawnee</td></tr><tr><td>3</td><td>    1102-3<a name=\"cdcrec-1102-3\"> </a></td><td>Cheyenne</td><td>Cheyenne</td></tr><tr><td>3</td><td>    1106-4<a name=\"cdcrec-1106-4\"> </a></td><td>Cheyenne-Arapaho</td><td>Cheyenne-Arapaho</td></tr><tr><td>3</td><td>    1108-0<a name=\"cdcrec-1108-0\"> </a></td><td>Chickahominy</td><td>Chickahominy</td></tr><tr><td>3</td><td>    1112-2<a name=\"cdcrec-1112-2\"> </a></td><td>Chickasaw</td><td>Chickasaw</td></tr><tr><td>3</td><td>    1114-8<a name=\"cdcrec-1114-8\"> </a></td><td>Chinook</td><td>Chinook</td></tr><tr><td>3</td><td>    1123-9<a name=\"cdcrec-1123-9\"> </a></td><td>Chippewa</td><td>Chippewa</td></tr><tr><td>3</td><td>    1150-2<a name=\"cdcrec-1150-2\"> </a></td><td>Chippewa Cree</td><td>Chippewa Cree</td></tr><tr><td>3</td><td>    1153-6<a name=\"cdcrec-1153-6\"> </a></td><td>Chitimacha</td><td>Chitimacha</td></tr><tr><td>3</td><td>    1155-1<a name=\"cdcrec-1155-1\"> </a></td><td>Choctaw</td><td>Choctaw</td></tr><tr><td>3</td><td>    1162-7<a name=\"cdcrec-1162-7\"> </a></td><td>Chumash</td><td>Chumash</td></tr><tr><td>3</td><td>    1165-0<a name=\"cdcrec-1165-0\"> </a></td><td>Clear Lake</td><td>Clear Lake</td></tr><tr><td>3</td><td>    1167-6<a name=\"cdcrec-1167-6\"> </a></td><td>Coeur D'Alene</td><td>Coeur D'Alene</td></tr><tr><td>3</td><td>    1169-2<a name=\"cdcrec-1169-2\"> </a></td><td>Coharie</td><td>Coharie</td></tr><tr><td>3</td><td>    1171-8<a name=\"cdcrec-1171-8\"> </a></td><td>Colorado River</td><td>Colorado River</td></tr><tr><td>3</td><td>    1173-4<a name=\"cdcrec-1173-4\"> </a></td><td>Colville</td><td>Colville</td></tr><tr><td>3</td><td>    1175-9<a name=\"cdcrec-1175-9\"> </a></td><td>Comanche</td><td>Comanche</td></tr><tr><td>3</td><td>    1178-3<a name=\"cdcrec-1178-3\"> </a></td><td>Coos, Lower Umpqua, Siuslaw</td><td>Coos, Lower Umpqua, Siuslaw</td></tr><tr><td>3</td><td>    1180-9<a name=\"cdcrec-1180-9\"> </a></td><td>Coos</td><td>Coos</td></tr><tr><td>3</td><td>    1182-5<a name=\"cdcrec-1182-5\"> </a></td><td>Coquilles</td><td>Coquilles</td></tr><tr><td>3</td><td>    1184-1<a name=\"cdcrec-1184-1\"> </a></td><td>Costanoan</td><td>Costanoan</td></tr><tr><td>3</td><td>    1186-6<a name=\"cdcrec-1186-6\"> </a></td><td>Coushatta</td><td>Coushatta</td></tr><tr><td>3</td><td>    1189-0<a name=\"cdcrec-1189-0\"> </a></td><td>Cowlitz</td><td>Cowlitz</td></tr><tr><td>3</td><td>    1191-6<a name=\"cdcrec-1191-6\"> </a></td><td>Cree</td><td>Cree</td></tr><tr><td>3</td><td>    1193-2<a name=\"cdcrec-1193-2\"> </a></td><td>Creek</td><td>Creek</td></tr><tr><td>3</td><td>    1207-0<a name=\"cdcrec-1207-0\"> </a></td><td>Croatan</td><td>Croatan</td></tr><tr><td>3</td><td>    1209-6<a name=\"cdcrec-1209-6\"> </a></td><td>Crow</td><td>Crow</td></tr><tr><td>3</td><td>    1211-2<a name=\"cdcrec-1211-2\"> </a></td><td>Cupeno</td><td>Cupeno</td></tr><tr><td>3</td><td>    1214-6<a name=\"cdcrec-1214-6\"> </a></td><td>Delaware</td><td>Delaware</td></tr><tr><td>3</td><td>    1222-9<a name=\"cdcrec-1222-9\"> </a></td><td>Diegueno</td><td>Diegueno</td></tr><tr><td>3</td><td>    1233-6<a name=\"cdcrec-1233-6\"> </a></td><td>Eastern Tribes</td><td>Eastern Tribes</td></tr><tr><td>3</td><td>    1250-0<a name=\"cdcrec-1250-0\"> </a></td><td>Esselen</td><td>Esselen</td></tr><tr><td>3</td><td>    1252-6<a name=\"cdcrec-1252-6\"> </a></td><td>Fort Belknap</td><td>Fort Belknap</td></tr><tr><td>3</td><td>    1254-2<a name=\"cdcrec-1254-2\"> </a></td><td>Fort Berthold</td><td>Fort Berthold</td></tr><tr><td>3</td><td>    1256-7<a name=\"cdcrec-1256-7\"> </a></td><td>Fort Mcdowell</td><td>Fort Mcdowell</td></tr><tr><td>3</td><td>    1258-3<a name=\"cdcrec-1258-3\"> </a></td><td>Fort Hall</td><td>Fort Hall</td></tr><tr><td>3</td><td>    1260-9<a name=\"cdcrec-1260-9\"> </a></td><td>Gabrieleno</td><td>Gabrieleno</td></tr><tr><td>3</td><td>    1262-5<a name=\"cdcrec-1262-5\"> </a></td><td>Grand Ronde</td><td>Grand Ronde</td></tr><tr><td>3</td><td>    1264-1<a name=\"cdcrec-1264-1\"> </a></td><td>Gros Ventres</td><td>Gros Ventres</td></tr><tr><td>3</td><td>    1267-4<a name=\"cdcrec-1267-4\"> </a></td><td>Haliwa</td><td>Haliwa</td></tr><tr><td>3</td><td>    1269-0<a name=\"cdcrec-1269-0\"> </a></td><td>Hidatsa</td><td>Hidatsa</td></tr><tr><td>3</td><td>    1271-6<a name=\"cdcrec-1271-6\"> </a></td><td>Hoopa</td><td>Hoopa</td></tr><tr><td>3</td><td>    1275-7<a name=\"cdcrec-1275-7\"> </a></td><td>Hoopa Extension</td><td>Hoopa Extension</td></tr><tr><td>3</td><td>    1277-3<a name=\"cdcrec-1277-3\"> </a></td><td>Houma</td><td>Houma</td></tr><tr><td>3</td><td>    1279-9<a name=\"cdcrec-1279-9\"> </a></td><td>Inaja-Cosmit</td><td>Inaja-Cosmit</td></tr><tr><td>3</td><td>    1281-5<a name=\"cdcrec-1281-5\"> </a></td><td>Iowa</td><td>Iowa</td></tr><tr><td>3</td><td>    1285-6<a name=\"cdcrec-1285-6\"> </a></td><td>Iroquois</td><td>Iroquois</td></tr><tr><td>3</td><td>    1297-1<a name=\"cdcrec-1297-1\"> </a></td><td>Juaneno</td><td>Juaneno</td></tr><tr><td>3</td><td>    1299-7<a name=\"cdcrec-1299-7\"> </a></td><td>Kalispel</td><td>Kalispel</td></tr><tr><td>3</td><td>    1301-1<a name=\"cdcrec-1301-1\"> </a></td><td>Karuk</td><td>Karuk</td></tr><tr><td>3</td><td>    1303-7<a name=\"cdcrec-1303-7\"> </a></td><td>Kaw</td><td>Kaw</td></tr><tr><td>3</td><td>    1305-2<a name=\"cdcrec-1305-2\"> </a></td><td>Kickapoo</td><td>Kickapoo</td></tr><tr><td>3</td><td>    1309-4<a name=\"cdcrec-1309-4\"> </a></td><td>Kiowa</td><td>Kiowa</td></tr><tr><td>3</td><td>    1312-8<a name=\"cdcrec-1312-8\"> </a></td><td>Klallam</td><td>Klallam</td></tr><tr><td>3</td><td>    1317-7<a name=\"cdcrec-1317-7\"> </a></td><td>Klamath</td><td>Klamath</td></tr><tr><td>3</td><td>    1319-3<a name=\"cdcrec-1319-3\"> </a></td><td>Konkow</td><td>Konkow</td></tr><tr><td>3</td><td>    1321-9<a name=\"cdcrec-1321-9\"> </a></td><td>Kootenai</td><td>Kootenai</td></tr><tr><td>3</td><td>    1323-5<a name=\"cdcrec-1323-5\"> </a></td><td>Lassik</td><td>Lassik</td></tr><tr><td>3</td><td>    1325-0<a name=\"cdcrec-1325-0\"> </a></td><td>Long Island</td><td>Long Island</td></tr><tr><td>3</td><td>    1331-8<a name=\"cdcrec-1331-8\"> </a></td><td>Luiseno</td><td>Luiseno</td></tr><tr><td>3</td><td>    1340-9<a name=\"cdcrec-1340-9\"> </a></td><td>Lumbee</td><td>Lumbee</td></tr><tr><td>3</td><td>    1342-5<a name=\"cdcrec-1342-5\"> </a></td><td>Lummi</td><td>Lummi</td></tr><tr><td>3</td><td>    1344-1<a name=\"cdcrec-1344-1\"> </a></td><td>Maidu</td><td>Maidu</td></tr><tr><td>3</td><td>    1348-2<a name=\"cdcrec-1348-2\"> </a></td><td>Makah</td><td>Makah</td></tr><tr><td>3</td><td>    1350-8<a name=\"cdcrec-1350-8\"> </a></td><td>Maliseet</td><td>Maliseet</td></tr><tr><td>3</td><td>    1352-4<a name=\"cdcrec-1352-4\"> </a></td><td>Mandan</td><td>Mandan</td></tr><tr><td>3</td><td>    1354-0<a name=\"cdcrec-1354-0\"> </a></td><td>Mattaponi</td><td>Mattaponi</td></tr><tr><td>3</td><td>    1356-5<a name=\"cdcrec-1356-5\"> </a></td><td>Menominee</td><td>Menominee</td></tr><tr><td>3</td><td>    1358-1<a name=\"cdcrec-1358-1\"> </a></td><td>Miami</td><td>Miami</td></tr><tr><td>3</td><td>    1363-1<a name=\"cdcrec-1363-1\"> </a></td><td>Miccosukee</td><td>Miccosukee</td></tr><tr><td>3</td><td>    1365-6<a name=\"cdcrec-1365-6\"> </a></td><td>Micmac</td><td>Micmac</td></tr><tr><td>3</td><td>    1368-0<a name=\"cdcrec-1368-0\"> </a></td><td>Mission Indians</td><td>Mission Indians</td></tr><tr><td>3</td><td>    1370-6<a name=\"cdcrec-1370-6\"> </a></td><td>Miwok</td><td>Miwok</td></tr><tr><td>3</td><td>    1372-2<a name=\"cdcrec-1372-2\"> </a></td><td>Modoc</td><td>Modoc</td></tr><tr><td>3</td><td>    1374-8<a name=\"cdcrec-1374-8\"> </a></td><td>Mohegan</td><td>Mohegan</td></tr><tr><td>3</td><td>    1376-3<a name=\"cdcrec-1376-3\"> </a></td><td>Mono</td><td>Mono</td></tr><tr><td>3</td><td>    1378-9<a name=\"cdcrec-1378-9\"> </a></td><td>Nanticoke</td><td>Nanticoke</td></tr><tr><td>3</td><td>    1380-5<a name=\"cdcrec-1380-5\"> </a></td><td>Narragansett</td><td>Narragansett</td></tr><tr><td>3</td><td>    1382-1<a name=\"cdcrec-1382-1\"> </a></td><td>Navajo</td><td>Navajo</td></tr><tr><td>3</td><td>    1387-0<a name=\"cdcrec-1387-0\"> </a></td><td>Nez Perce</td><td>Nez Perce</td></tr><tr><td>3</td><td>    1389-6<a name=\"cdcrec-1389-6\"> </a></td><td>Nomalaki</td><td>Nomalaki</td></tr><tr><td>3</td><td>    1391-2<a name=\"cdcrec-1391-2\"> </a></td><td>Northwest Tribes</td><td>Northwest Tribes</td></tr><tr><td>3</td><td>    1403-5<a name=\"cdcrec-1403-5\"> </a></td><td>Omaha</td><td>Omaha</td></tr><tr><td>3</td><td>    1405-0<a name=\"cdcrec-1405-0\"> </a></td><td>Oregon Athabaskan</td><td>Oregon Athabaskan</td></tr><tr><td>3</td><td>    1407-6<a name=\"cdcrec-1407-6\"> </a></td><td>Osage</td><td>Osage</td></tr><tr><td>3</td><td>    1409-2<a name=\"cdcrec-1409-2\"> </a></td><td>Otoe-Missouria</td><td>Otoe-Missouria</td></tr><tr><td>3</td><td>    1411-8<a name=\"cdcrec-1411-8\"> </a></td><td>Ottawa</td><td>Ottawa</td></tr><tr><td>3</td><td>    1416-7<a name=\"cdcrec-1416-7\"> </a></td><td>Paiute</td><td>Paiute</td></tr><tr><td>3</td><td>    1439-9<a name=\"cdcrec-1439-9\"> </a></td><td>Pamunkey</td><td>Pamunkey</td></tr><tr><td>3</td><td>    1441-5<a name=\"cdcrec-1441-5\"> </a></td><td>Passamaquoddy</td><td>Passamaquoddy</td></tr><tr><td>3</td><td>    1445-6<a name=\"cdcrec-1445-6\"> </a></td><td>Pawnee</td><td>Pawnee</td></tr><tr><td>3</td><td>    1448-0<a name=\"cdcrec-1448-0\"> </a></td><td>Penobscot</td><td>Penobscot</td></tr><tr><td>3</td><td>    1450-6<a name=\"cdcrec-1450-6\"> </a></td><td>Peoria</td><td>Peoria</td></tr><tr><td>3</td><td>    1453-0<a name=\"cdcrec-1453-0\"> </a></td><td>Pequot</td><td>Pequot</td></tr><tr><td>3</td><td>    1456-3<a name=\"cdcrec-1456-3\"> </a></td><td>Pima</td><td>Pima</td></tr><tr><td>3</td><td>    1460-5<a name=\"cdcrec-1460-5\"> </a></td><td>Piscataway</td><td>Piscataway</td></tr><tr><td>3</td><td>    1462-1<a name=\"cdcrec-1462-1\"> </a></td><td>Pit River</td><td>Pit River</td></tr><tr><td>3</td><td>    1464-7<a name=\"cdcrec-1464-7\"> </a></td><td>Pomo</td><td>Pomo</td></tr><tr><td>3</td><td>    1474-6<a name=\"cdcrec-1474-6\"> </a></td><td>Ponca</td><td>Ponca</td></tr><tr><td>3</td><td>    1478-7<a name=\"cdcrec-1478-7\"> </a></td><td>Potawatomi</td><td>Potawatomi</td></tr><tr><td>3</td><td>    1487-8<a name=\"cdcrec-1487-8\"> </a></td><td>Powhatan</td><td>Powhatan</td></tr><tr><td>3</td><td>    1489-4<a name=\"cdcrec-1489-4\"> </a></td><td>Pueblo</td><td>Pueblo</td></tr><tr><td>3</td><td>    1518-0<a name=\"cdcrec-1518-0\"> </a></td><td>Puget Sound Salish</td><td>Puget Sound Salish</td></tr><tr><td>3</td><td>    1541-2<a name=\"cdcrec-1541-2\"> </a></td><td>Quapaw</td><td>Quapaw</td></tr><tr><td>3</td><td>    1543-8<a name=\"cdcrec-1543-8\"> </a></td><td>Quinault</td><td>Quinault</td></tr><tr><td>3</td><td>    1545-3<a name=\"cdcrec-1545-3\"> </a></td><td>Rappahannock</td><td>Rappahannock</td></tr><tr><td>3</td><td>    1547-9<a name=\"cdcrec-1547-9\"> </a></td><td>Reno-Sparks</td><td>Reno-Sparks</td></tr><tr><td>3</td><td>    1549-5<a name=\"cdcrec-1549-5\"> </a></td><td>Round Valley</td><td>Round Valley</td></tr><tr><td>3</td><td>    1551-1<a name=\"cdcrec-1551-1\"> </a></td><td>Sac and Fox</td><td>Sac and Fox</td></tr><tr><td>3</td><td>    1556-0<a name=\"cdcrec-1556-0\"> </a></td><td>Salinan</td><td>Salinan</td></tr><tr><td>3</td><td>    1558-6<a name=\"cdcrec-1558-6\"> </a></td><td>Salish</td><td>Salish</td></tr><tr><td>3</td><td>    1560-2<a name=\"cdcrec-1560-2\"> </a></td><td>Salish and Kootenai</td><td>Salish and Kootenai</td></tr><tr><td>3</td><td>    1562-8<a name=\"cdcrec-1562-8\"> </a></td><td>Schaghticoke</td><td>Schaghticoke</td></tr><tr><td>3</td><td>    1564-4<a name=\"cdcrec-1564-4\"> </a></td><td>Scott Valley</td><td>Scott Valley</td></tr><tr><td>3</td><td>    1566-9<a name=\"cdcrec-1566-9\"> </a></td><td>Seminole</td><td>Seminole</td></tr><tr><td>3</td><td>    1573-5<a name=\"cdcrec-1573-5\"> </a></td><td>Serrano</td><td>Serrano</td></tr><tr><td>3</td><td>    1576-8<a name=\"cdcrec-1576-8\"> </a></td><td>Shasta</td><td>Shasta</td></tr><tr><td>3</td><td>    1578-4<a name=\"cdcrec-1578-4\"> </a></td><td>Shawnee</td><td>Shawnee</td></tr><tr><td>3</td><td>    1582-6<a name=\"cdcrec-1582-6\"> </a></td><td>Shinnecock</td><td>Shinnecock</td></tr><tr><td>3</td><td>    1584-2<a name=\"cdcrec-1584-2\"> </a></td><td>Shoalwater Bay</td><td>Shoalwater Bay</td></tr><tr><td>3</td><td>    1586-7<a name=\"cdcrec-1586-7\"> </a></td><td>Shoshone</td><td>Shoshone</td></tr><tr><td>3</td><td>    1602-2<a name=\"cdcrec-1602-2\"> </a></td><td>Shoshone Paiute</td><td>Shoshone Paiute</td></tr><tr><td>3</td><td>    1607-1<a name=\"cdcrec-1607-1\"> </a></td><td>Siletz</td><td>Siletz</td></tr><tr><td>3</td><td>    1609-7<a name=\"cdcrec-1609-7\"> </a></td><td>Sioux</td><td>Sioux</td></tr><tr><td>3</td><td>    1643-6<a name=\"cdcrec-1643-6\"> </a></td><td>Siuslaw</td><td>Siuslaw</td></tr><tr><td>3</td><td>    1645-1<a name=\"cdcrec-1645-1\"> </a></td><td>Spokane</td><td>Spokane</td></tr><tr><td>3</td><td>    1647-7<a name=\"cdcrec-1647-7\"> </a></td><td>Stewart</td><td>Stewart</td></tr><tr><td>3</td><td>    1649-3<a name=\"cdcrec-1649-3\"> </a></td><td>Stockbridge</td><td>Stockbridge</td></tr><tr><td>3</td><td>    1651-9<a name=\"cdcrec-1651-9\"> </a></td><td>Susanville</td><td>Susanville</td></tr><tr><td>3</td><td>    1653-5<a name=\"cdcrec-1653-5\"> </a></td><td>Tohono O'Odham</td><td>Tohono O'Odham</td></tr><tr><td>3</td><td>    1659-2<a name=\"cdcrec-1659-2\"> </a></td><td>Tolowa</td><td>Tolowa</td></tr><tr><td>3</td><td>    1661-8<a name=\"cdcrec-1661-8\"> </a></td><td>Tonkawa</td><td>Tonkawa</td></tr><tr><td>3</td><td>    1663-4<a name=\"cdcrec-1663-4\"> </a></td><td>Tygh</td><td>Tygh</td></tr><tr><td>3</td><td>    1665-9<a name=\"cdcrec-1665-9\"> </a></td><td>Umatilla</td><td>Umatilla</td></tr><tr><td>3</td><td>    1667-5<a name=\"cdcrec-1667-5\"> </a></td><td>Umpqua</td><td>Umpqua</td></tr><tr><td>3</td><td>    1670-9<a name=\"cdcrec-1670-9\"> </a></td><td>Ute</td><td>Ute</td></tr><tr><td>3</td><td>    1675-8<a name=\"cdcrec-1675-8\"> </a></td><td>Wailaki</td><td>Wailaki</td></tr><tr><td>3</td><td>    1677-4<a name=\"cdcrec-1677-4\"> </a></td><td>Walla-Walla</td><td>Walla-Walla</td></tr><tr><td>3</td><td>    1679-0<a name=\"cdcrec-1679-0\"> </a></td><td>Wampanoag</td><td>Wampanoag</td></tr><tr><td>3</td><td>    1683-2<a name=\"cdcrec-1683-2\"> </a></td><td>Warm Springs</td><td>Warm Springs</td></tr><tr><td>3</td><td>    1685-7<a name=\"cdcrec-1685-7\"> </a></td><td>Wascopum</td><td>Wascopum</td></tr><tr><td>3</td><td>    1687-3<a name=\"cdcrec-1687-3\"> </a></td><td>Washoe</td><td>Washoe</td></tr><tr><td>3</td><td>    1692-3<a name=\"cdcrec-1692-3\"> </a></td><td>Wichita</td><td>Wichita</td></tr><tr><td>3</td><td>    1694-9<a name=\"cdcrec-1694-9\"> </a></td><td>Wind River</td><td>Wind River</td></tr><tr><td>3</td><td>    1696-4<a name=\"cdcrec-1696-4\"> </a></td><td>Winnebago</td><td>Winnebago</td></tr><tr><td>3</td><td>    1700-4<a name=\"cdcrec-1700-4\"> </a></td><td>Winnemucca</td><td>Winnemucca</td></tr><tr><td>3</td><td>    1702-0<a name=\"cdcrec-1702-0\"> </a></td><td>Wintun</td><td>Wintun</td></tr><tr><td>3</td><td>    1704-6<a name=\"cdcrec-1704-6\"> </a></td><td>Wiyot</td><td>Wiyot</td></tr><tr><td>3</td><td>    1707-9<a name=\"cdcrec-1707-9\"> </a></td><td>Yakama</td><td>Yakama</td></tr><tr><td>3</td><td>    1709-5<a name=\"cdcrec-1709-5\"> </a></td><td>Yakama Cowlitz</td><td>Yakama Cowlitz</td></tr><tr><td>3</td><td>    1711-1<a name=\"cdcrec-1711-1\"> </a></td><td>Yaqui</td><td>Yaqui</td></tr><tr><td>3</td><td>    1715-2<a name=\"cdcrec-1715-2\"> </a></td><td>Yavapai Apache</td><td>Yavapai Apache</td></tr><tr><td>3</td><td>    1717-8<a name=\"cdcrec-1717-8\"> </a></td><td>Yokuts</td><td>Yokuts</td></tr><tr><td>3</td><td>    1722-8<a name=\"cdcrec-1722-8\"> </a></td><td>Yuchi</td><td>Yuchi</td></tr><tr><td>3</td><td>    1724-4<a name=\"cdcrec-1724-4\"> </a></td><td>Yuman</td><td>Yuman</td></tr><tr><td>3</td><td>    1732-7<a name=\"cdcrec-1732-7\"> </a></td><td>Yurok</td><td>Yurok</td></tr><tr><td>3</td><td>    1011-6<a name=\"cdcrec-1011-6\"> </a></td><td>Chiricahua</td><td>Chiricahua</td></tr><tr><td>3</td><td>    1012-4<a name=\"cdcrec-1012-4\"> </a></td><td>Fort Sill Apache</td><td>Fort Sill Apache</td></tr><tr><td>3</td><td>    1013-2<a name=\"cdcrec-1013-2\"> </a></td><td>Jicarilla Apache</td><td>Jicarilla Apache</td></tr><tr><td>3</td><td>    1014-0<a name=\"cdcrec-1014-0\"> </a></td><td>Lipan Apache</td><td>Lipan Apache</td></tr><tr><td>3</td><td>    1015-7<a name=\"cdcrec-1015-7\"> </a></td><td>Mescalero Apache</td><td>Mescalero Apache</td></tr><tr><td>3</td><td>    1016-5<a name=\"cdcrec-1016-5\"> </a></td><td>Oklahoma Apache</td><td>Oklahoma Apache</td></tr><tr><td>3</td><td>    1017-3<a name=\"cdcrec-1017-3\"> </a></td><td>Payson Apache</td><td>Payson Apache</td></tr><tr><td>3</td><td>    1018-1<a name=\"cdcrec-1018-1\"> </a></td><td>San Carlos Apache</td><td>San Carlos Apache</td></tr><tr><td>3</td><td>    1019-9<a name=\"cdcrec-1019-9\"> </a></td><td>White Mountain Apache</td><td>White Mountain Apache</td></tr><tr><td>3</td><td>    1022-3<a name=\"cdcrec-1022-3\"> </a></td><td>Northern Arapaho</td><td>Northern Arapaho</td></tr><tr><td>3</td><td>    1023-1<a name=\"cdcrec-1023-1\"> </a></td><td>Southern Arapaho</td><td>Southern Arapaho</td></tr><tr><td>3</td><td>    1024-9<a name=\"cdcrec-1024-9\"> </a></td><td>Wind River Arapaho</td><td>Wind River Arapaho</td></tr><tr><td>3</td><td>    1031-4<a name=\"cdcrec-1031-4\"> </a></td><td>Fort Peck Assiniboine Sioux</td><td>Fort Peck Assiniboine Sioux</td></tr><tr><td>3</td><td>    1042-1<a name=\"cdcrec-1042-1\"> </a></td><td>Oklahoma Cado</td><td>Oklahoma Cado</td></tr><tr><td>3</td><td>    1045-4<a name=\"cdcrec-1045-4\"> </a></td><td>Agua Caliente Cahuilla</td><td>Agua Caliente Cahuilla</td></tr><tr><td>3</td><td>    1046-2<a name=\"cdcrec-1046-2\"> </a></td><td>Augustine</td><td>Augustine</td></tr><tr><td>3</td><td>    1047-0<a name=\"cdcrec-1047-0\"> </a></td><td>Cabazon</td><td>Cabazon</td></tr><tr><td>3</td><td>    1048-8<a name=\"cdcrec-1048-8\"> </a></td><td>Los Coyotes</td><td>Los Coyotes</td></tr><tr><td>3</td><td>    1049-6<a name=\"cdcrec-1049-6\"> </a></td><td>Morongo</td><td>Morongo</td></tr><tr><td>3</td><td>    1050-4<a name=\"cdcrec-1050-4\"> </a></td><td>Santa Rosa Cahuilla</td><td>Santa Rosa Cahuilla</td></tr><tr><td>3</td><td>    1051-2<a name=\"cdcrec-1051-2\"> </a></td><td>Torres-Martinez</td><td>Torres-Martinez</td></tr><tr><td>3</td><td>    1054-6<a name=\"cdcrec-1054-6\"> </a></td><td>Cahto</td><td>Cahto</td></tr><tr><td>3</td><td>    1055-3<a name=\"cdcrec-1055-3\"> </a></td><td>Chimariko</td><td>Chimariko</td></tr><tr><td>3</td><td>    1056-1<a name=\"cdcrec-1056-1\"> </a></td><td>Coast Miwok</td><td>Coast Miwok</td></tr><tr><td>3</td><td>    1057-9<a name=\"cdcrec-1057-9\"> </a></td><td>Digger</td><td>Digger</td></tr><tr><td>3</td><td>    1058-7<a name=\"cdcrec-1058-7\"> </a></td><td>Kawaiisu</td><td>Kawaiisu</td></tr><tr><td>3</td><td>    1059-5<a name=\"cdcrec-1059-5\"> </a></td><td>Kern River</td><td>Kern River</td></tr><tr><td>3</td><td>    1060-3<a name=\"cdcrec-1060-3\"> </a></td><td>Mattole</td><td>Mattole</td></tr><tr><td>3</td><td>    1061-1<a name=\"cdcrec-1061-1\"> </a></td><td>Red Wood</td><td>Red Wood</td></tr><tr><td>3</td><td>    1062-9<a name=\"cdcrec-1062-9\"> </a></td><td>Santa Rosa</td><td>Santa Rosa</td></tr><tr><td>3</td><td>    1063-7<a name=\"cdcrec-1063-7\"> </a></td><td>Takelma</td><td>Takelma</td></tr><tr><td>3</td><td>    1064-5<a name=\"cdcrec-1064-5\"> </a></td><td>Wappo</td><td>Wappo</td></tr><tr><td>3</td><td>    1065-2<a name=\"cdcrec-1065-2\"> </a></td><td>Yana</td><td>Yana</td></tr><tr><td>3</td><td>    1066-0<a name=\"cdcrec-1066-0\"> </a></td><td>Yuki</td><td>Yuki</td></tr><tr><td>3</td><td>    1069-4<a name=\"cdcrec-1069-4\"> </a></td><td>Canadian Indian</td><td>Canadian Indian</td></tr><tr><td>3</td><td>    1070-2<a name=\"cdcrec-1070-2\"> </a></td><td>Central American Indian</td><td>Central American Indian</td></tr><tr><td>3</td><td>    1071-0<a name=\"cdcrec-1071-0\"> </a></td><td>French American Indian</td><td>French American Indian</td></tr><tr><td>3</td><td>    1072-8<a name=\"cdcrec-1072-8\"> </a></td><td>Mexican American Indian</td><td>Mexican American Indian</td></tr><tr><td>3</td><td>    1073-6<a name=\"cdcrec-1073-6\"> </a></td><td>South American Indian</td><td>South American Indian</td></tr><tr><td>3</td><td>    1074-4<a name=\"cdcrec-1074-4\"> </a></td><td>Spanish American Indian</td><td>Spanish American Indian</td></tr><tr><td>3</td><td>    1083-5<a name=\"cdcrec-1083-5\"> </a></td><td>Hoh</td><td>Hoh</td></tr><tr><td>3</td><td>    1084-3<a name=\"cdcrec-1084-3\"> </a></td><td>Quileute</td><td>Quileute</td></tr><tr><td>3</td><td>    1089-2<a name=\"cdcrec-1089-2\"> </a></td><td>Cherokee Alabama</td><td>Cherokee Alabama</td></tr><tr><td>3</td><td>    1090-0<a name=\"cdcrec-1090-0\"> </a></td><td>Cherokees of Northeast Alabama</td><td>Cherokees of Northeast Alabama</td></tr><tr><td>3</td><td>    1091-8<a name=\"cdcrec-1091-8\"> </a></td><td>Cherokees of Southeast Alabama</td><td>Cherokees of Southeast Alabama</td></tr><tr><td>3</td><td>    1092-6<a name=\"cdcrec-1092-6\"> </a></td><td>Eastern Cherokee</td><td>Eastern Cherokee</td></tr><tr><td>3</td><td>    1093-4<a name=\"cdcrec-1093-4\"> </a></td><td>Echota Cherokee</td><td>Echota Cherokee</td></tr><tr><td>3</td><td>    1094-2<a name=\"cdcrec-1094-2\"> </a></td><td>Etowah Cherokee</td><td>Etowah Cherokee</td></tr><tr><td>3</td><td>    1095-9<a name=\"cdcrec-1095-9\"> </a></td><td>Northern Cherokee</td><td>Northern Cherokee</td></tr><tr><td>3</td><td>    1096-7<a name=\"cdcrec-1096-7\"> </a></td><td>Tuscola</td><td>Tuscola</td></tr><tr><td>3</td><td>    1097-5<a name=\"cdcrec-1097-5\"> </a></td><td>United Keetowah Band of Cherokee</td><td>United Keetowah Band of Cherokee</td></tr><tr><td>3</td><td>    1098-3<a name=\"cdcrec-1098-3\"> </a></td><td>Western Cherokee</td><td>Western Cherokee</td></tr><tr><td>3</td><td>    1103-1<a name=\"cdcrec-1103-1\"> </a></td><td>Northern Cheyenne</td><td>Northern Cheyenne</td></tr><tr><td>3</td><td>    1104-9<a name=\"cdcrec-1104-9\"> </a></td><td>Southern Cheyenne</td><td>Southern Cheyenne</td></tr><tr><td>3</td><td>    1109-8<a name=\"cdcrec-1109-8\"> </a></td><td>Eastern Chickahominy</td><td>Eastern Chickahominy</td></tr><tr><td>3</td><td>    1110-6<a name=\"cdcrec-1110-6\"> </a></td><td>Western Chickahominy</td><td>Western Chickahominy</td></tr><tr><td>3</td><td>    1115-5<a name=\"cdcrec-1115-5\"> </a></td><td>Clatsop</td><td>Clatsop</td></tr><tr><td>3</td><td>    1116-3<a name=\"cdcrec-1116-3\"> </a></td><td>Columbia River Chinook</td><td>Columbia River Chinook</td></tr><tr><td>3</td><td>    1117-1<a name=\"cdcrec-1117-1\"> </a></td><td>Kathlamet</td><td>Kathlamet</td></tr><tr><td>3</td><td>    1118-9<a name=\"cdcrec-1118-9\"> </a></td><td>Upper Chinook</td><td>Upper Chinook</td></tr><tr><td>3</td><td>    1119-7<a name=\"cdcrec-1119-7\"> </a></td><td>Wakiakum Chinook</td><td>Wakiakum Chinook</td></tr><tr><td>3</td><td>    1120-5<a name=\"cdcrec-1120-5\"> </a></td><td>Willapa Chinook</td><td>Willapa Chinook</td></tr><tr><td>3</td><td>    1121-3<a name=\"cdcrec-1121-3\"> </a></td><td>Wishram</td><td>Wishram</td></tr><tr><td>3</td><td>    1124-7<a name=\"cdcrec-1124-7\"> </a></td><td>Bad River</td><td>Bad River</td></tr><tr><td>3</td><td>    1125-4<a name=\"cdcrec-1125-4\"> </a></td><td>Bay Mills Chippewa</td><td>Bay Mills Chippewa</td></tr><tr><td>3</td><td>    1126-2<a name=\"cdcrec-1126-2\"> </a></td><td>Bois Forte</td><td>Bois Forte</td></tr><tr><td>3</td><td>    1127-0<a name=\"cdcrec-1127-0\"> </a></td><td>Burt Lake Chippewa</td><td>Burt Lake Chippewa</td></tr><tr><td>3</td><td>    1128-8<a name=\"cdcrec-1128-8\"> </a></td><td>Fond du Lac</td><td>Fond du Lac</td></tr><tr><td>3</td><td>    1129-6<a name=\"cdcrec-1129-6\"> </a></td><td>Grand Portage</td><td>Grand Portage</td></tr><tr><td>3</td><td>    1130-4<a name=\"cdcrec-1130-4\"> </a></td><td>Grand Traverse Band of Ottawa/Chippewa</td><td>Grand Traverse Band of Ottawa/Chippewa</td></tr><tr><td>3</td><td>    1131-2<a name=\"cdcrec-1131-2\"> </a></td><td>Keweenaw</td><td>Keweenaw</td></tr><tr><td>3</td><td>    1132-0<a name=\"cdcrec-1132-0\"> </a></td><td>Lac Courte Oreilles</td><td>Lac Courte Oreilles</td></tr><tr><td>3</td><td>    1133-8<a name=\"cdcrec-1133-8\"> </a></td><td>Lac du Flambeau</td><td>Lac du Flambeau</td></tr><tr><td>3</td><td>    1134-6<a name=\"cdcrec-1134-6\"> </a></td><td>Lac Vieux Desert Chippewa</td><td>Lac Vieux Desert Chippewa</td></tr><tr><td>3</td><td>    1135-3<a name=\"cdcrec-1135-3\"> </a></td><td>Lake Superior</td><td>Lake Superior</td></tr><tr><td>3</td><td>    1136-1<a name=\"cdcrec-1136-1\"> </a></td><td>Leech Lake</td><td>Leech Lake</td></tr><tr><td>3</td><td>    1137-9<a name=\"cdcrec-1137-9\"> </a></td><td>Little Shell Chippewa</td><td>Little Shell Chippewa</td></tr><tr><td>3</td><td>    1138-7<a name=\"cdcrec-1138-7\"> </a></td><td>Mille Lacs</td><td>Mille Lacs</td></tr><tr><td>3</td><td>    1139-5<a name=\"cdcrec-1139-5\"> </a></td><td>Minnesota Chippewa</td><td>Minnesota Chippewa</td></tr><tr><td>3</td><td>    1140-3<a name=\"cdcrec-1140-3\"> </a></td><td>Ontonagon</td><td>Ontonagon</td></tr><tr><td>3</td><td>    1141-1<a name=\"cdcrec-1141-1\"> </a></td><td>Red Cliff Chippewa</td><td>Red Cliff Chippewa</td></tr><tr><td>3</td><td>    1142-9<a name=\"cdcrec-1142-9\"> </a></td><td>Red Lake Chippewa</td><td>Red Lake Chippewa</td></tr><tr><td>3</td><td>    1143-7<a name=\"cdcrec-1143-7\"> </a></td><td>Saginaw Chippewa</td><td>Saginaw Chippewa</td></tr><tr><td>3</td><td>    1144-5<a name=\"cdcrec-1144-5\"> </a></td><td>St. Croix Chippewa</td><td>St. Croix Chippewa</td></tr><tr><td>3</td><td>    1145-2<a name=\"cdcrec-1145-2\"> </a></td><td>Sault Ste. Marie Chippewa</td><td>Sault Ste. Marie Chippewa</td></tr><tr><td>3</td><td>    1146-0<a name=\"cdcrec-1146-0\"> </a></td><td>Sokoagon Chippewa</td><td>Sokoagon Chippewa</td></tr><tr><td>3</td><td>    1147-8<a name=\"cdcrec-1147-8\"> </a></td><td>Turtle Mountain</td><td>Turtle Mountain</td></tr><tr><td>3</td><td>    1148-6<a name=\"cdcrec-1148-6\"> </a></td><td>White Earth</td><td>White Earth</td></tr><tr><td>3</td><td>    1151-0<a name=\"cdcrec-1151-0\"> </a></td><td>Rocky Boy's Chippewa Cree</td><td>Rocky Boy's Chippewa Cree</td></tr><tr><td>3</td><td>    1156-9<a name=\"cdcrec-1156-9\"> </a></td><td>Clifton Choctaw</td><td>Clifton Choctaw</td></tr><tr><td>3</td><td>    1157-7<a name=\"cdcrec-1157-7\"> </a></td><td>Jena Choctaw</td><td>Jena Choctaw</td></tr><tr><td>3</td><td>    1158-5<a name=\"cdcrec-1158-5\"> </a></td><td>Mississippi Choctaw</td><td>Mississippi Choctaw</td></tr><tr><td>3</td><td>    1159-3<a name=\"cdcrec-1159-3\"> </a></td><td>Mowa Band of Choctaw</td><td>Mowa Band of Choctaw</td></tr><tr><td>3</td><td>    1160-1<a name=\"cdcrec-1160-1\"> </a></td><td>Oklahoma Choctaw</td><td>Oklahoma Choctaw</td></tr><tr><td>3</td><td>    1163-5<a name=\"cdcrec-1163-5\"> </a></td><td>Santa Ynez</td><td>Santa Ynez</td></tr><tr><td>3</td><td>    1176-7<a name=\"cdcrec-1176-7\"> </a></td><td>Oklahoma Comanche</td><td>Oklahoma Comanche</td></tr><tr><td>3</td><td>    1187-4<a name=\"cdcrec-1187-4\"> </a></td><td>Alabama Coushatta</td><td>Alabama Coushatta</td></tr><tr><td>3</td><td>    1194-0<a name=\"cdcrec-1194-0\"> </a></td><td>Alabama Creek</td><td>Alabama Creek</td></tr><tr><td>3</td><td>    1195-7<a name=\"cdcrec-1195-7\"> </a></td><td>Alabama Quassarte</td><td>Alabama Quassarte</td></tr><tr><td>3</td><td>    1196-5<a name=\"cdcrec-1196-5\"> </a></td><td>Eastern Creek</td><td>Eastern Creek</td></tr><tr><td>3</td><td>    1197-3<a name=\"cdcrec-1197-3\"> </a></td><td>Eastern Muscogee</td><td>Eastern Muscogee</td></tr><tr><td>3</td><td>    1198-1<a name=\"cdcrec-1198-1\"> </a></td><td>Kialegee</td><td>Kialegee</td></tr><tr><td>3</td><td>    1199-9<a name=\"cdcrec-1199-9\"> </a></td><td>Lower Muscogee</td><td>Lower Muscogee</td></tr><tr><td>3</td><td>    1200-5<a name=\"cdcrec-1200-5\"> </a></td><td>Machis Lower Creek Indian</td><td>Machis Lower Creek Indian</td></tr><tr><td>3</td><td>    1201-3<a name=\"cdcrec-1201-3\"> </a></td><td>Poarch Band</td><td>Poarch Band</td></tr><tr><td>3</td><td>    1202-1<a name=\"cdcrec-1202-1\"> </a></td><td>Principal Creek Indian Nation</td><td>Principal Creek Indian Nation</td></tr><tr><td>3</td><td>    1203-9<a name=\"cdcrec-1203-9\"> </a></td><td>Star Clan of Muscogee Creeks</td><td>Star Clan of Muscogee Creeks</td></tr><tr><td>3</td><td>    1204-7<a name=\"cdcrec-1204-7\"> </a></td><td>Thlopthlocco</td><td>Thlopthlocco</td></tr><tr><td>3</td><td>    1205-4<a name=\"cdcrec-1205-4\"> </a></td><td>Tuckabachee</td><td>Tuckabachee</td></tr><tr><td>3</td><td>    1212-0<a name=\"cdcrec-1212-0\"> </a></td><td>Agua Caliente</td><td>Agua Caliente</td></tr><tr><td>3</td><td>    1215-3<a name=\"cdcrec-1215-3\"> </a></td><td>Eastern Delaware</td><td>Eastern Delaware</td></tr><tr><td>3</td><td>    1216-1<a name=\"cdcrec-1216-1\"> </a></td><td>Lenni-Lenape</td><td>Lenni-Lenape</td></tr><tr><td>3</td><td>    1217-9<a name=\"cdcrec-1217-9\"> </a></td><td>Munsee</td><td>Munsee</td></tr><tr><td>3</td><td>    1218-7<a name=\"cdcrec-1218-7\"> </a></td><td>Oklahoma Delaware</td><td>Oklahoma Delaware</td></tr><tr><td>3</td><td>    1219-5<a name=\"cdcrec-1219-5\"> </a></td><td>Rampough Mountain</td><td>Rampough Mountain</td></tr><tr><td>3</td><td>    1220-3<a name=\"cdcrec-1220-3\"> </a></td><td>Sand Hill</td><td>Sand Hill</td></tr><tr><td>3</td><td>    1223-7<a name=\"cdcrec-1223-7\"> </a></td><td>Campo</td><td>Campo</td></tr><tr><td>3</td><td>    1224-5<a name=\"cdcrec-1224-5\"> </a></td><td>Capitan Grande</td><td>Capitan Grande</td></tr><tr><td>3</td><td>    1225-2<a name=\"cdcrec-1225-2\"> </a></td><td>Cuyapaipe</td><td>Cuyapaipe</td></tr><tr><td>3</td><td>    1226-0<a name=\"cdcrec-1226-0\"> </a></td><td>La Posta</td><td>La Posta</td></tr><tr><td>3</td><td>    1227-8<a name=\"cdcrec-1227-8\"> </a></td><td>Manzanita</td><td>Manzanita</td></tr><tr><td>3</td><td>    1228-6<a name=\"cdcrec-1228-6\"> </a></td><td>Mesa Grande</td><td>Mesa Grande</td></tr><tr><td>3</td><td>    1229-4<a name=\"cdcrec-1229-4\"> </a></td><td>San Pasqual</td><td>San Pasqual</td></tr><tr><td>3</td><td>    1230-2<a name=\"cdcrec-1230-2\"> </a></td><td>Santa Ysabel</td><td>Santa Ysabel</td></tr><tr><td>3</td><td>    1231-0<a name=\"cdcrec-1231-0\"> </a></td><td>Sycuan</td><td>Sycuan</td></tr><tr><td>3</td><td>    1234-4<a name=\"cdcrec-1234-4\"> </a></td><td>Attacapa</td><td>Attacapa</td></tr><tr><td>3</td><td>    1235-1<a name=\"cdcrec-1235-1\"> </a></td><td>Biloxi</td><td>Biloxi</td></tr><tr><td>3</td><td>    1236-9<a name=\"cdcrec-1236-9\"> </a></td><td>Georgetown (Eastern Tribes)</td><td>Georgetown (Eastern Tribes)</td></tr><tr><td>3</td><td>    1237-7<a name=\"cdcrec-1237-7\"> </a></td><td>Moor</td><td>Moor</td></tr><tr><td>3</td><td>    1238-5<a name=\"cdcrec-1238-5\"> </a></td><td>Nansemond</td><td>Nansemond</td></tr><tr><td>3</td><td>    1239-3<a name=\"cdcrec-1239-3\"> </a></td><td>Natchez</td><td>Natchez</td></tr><tr><td>3</td><td>    1240-1<a name=\"cdcrec-1240-1\"> </a></td><td>Nausu Waiwash</td><td>Nausu Waiwash</td></tr><tr><td>3</td><td>    1241-9<a name=\"cdcrec-1241-9\"> </a></td><td>Nipmuc</td><td>Nipmuc</td></tr><tr><td>3</td><td>    1242-7<a name=\"cdcrec-1242-7\"> </a></td><td>Paugussett</td><td>Paugussett</td></tr><tr><td>3</td><td>    1243-5<a name=\"cdcrec-1243-5\"> </a></td><td>Pocomoke Acohonock</td><td>Pocomoke Acohonock</td></tr><tr><td>3</td><td>    1244-3<a name=\"cdcrec-1244-3\"> </a></td><td>Southeastern Indians</td><td>Southeastern Indians</td></tr><tr><td>3</td><td>    1245-0<a name=\"cdcrec-1245-0\"> </a></td><td>Susquehanock</td><td>Susquehanock</td></tr><tr><td>3</td><td>    1246-8<a name=\"cdcrec-1246-8\"> </a></td><td>Tunica Biloxi</td><td>Tunica Biloxi</td></tr><tr><td>3</td><td>    1247-6<a name=\"cdcrec-1247-6\"> </a></td><td>Waccamaw-Siousan</td><td>Waccamaw-Siousan</td></tr><tr><td>3</td><td>    1248-4<a name=\"cdcrec-1248-4\"> </a></td><td>Wicomico</td><td>Wicomico</td></tr><tr><td>3</td><td>    1265-8<a name=\"cdcrec-1265-8\"> </a></td><td>Atsina</td><td>Atsina</td></tr><tr><td>3</td><td>    1272-4<a name=\"cdcrec-1272-4\"> </a></td><td>Trinity</td><td>Trinity</td></tr><tr><td>3</td><td>    1273-2<a name=\"cdcrec-1273-2\"> </a></td><td>Whilkut</td><td>Whilkut</td></tr><tr><td>3</td><td>    1282-3<a name=\"cdcrec-1282-3\"> </a></td><td>Iowa of Kansas-Nebraska</td><td>Iowa of Kansas-Nebraska</td></tr><tr><td>3</td><td>    1283-1<a name=\"cdcrec-1283-1\"> </a></td><td>Iowa of Oklahoma</td><td>Iowa of Oklahoma</td></tr><tr><td>3</td><td>    1286-4<a name=\"cdcrec-1286-4\"> </a></td><td>Cayuga</td><td>Cayuga</td></tr><tr><td>3</td><td>    1287-2<a name=\"cdcrec-1287-2\"> </a></td><td>Mohawk</td><td>Mohawk</td></tr><tr><td>3</td><td>    1288-0<a name=\"cdcrec-1288-0\"> </a></td><td>Oneida</td><td>Oneida</td></tr><tr><td>3</td><td>    1289-8<a name=\"cdcrec-1289-8\"> </a></td><td>Onondaga</td><td>Onondaga</td></tr><tr><td>3</td><td>    1290-6<a name=\"cdcrec-1290-6\"> </a></td><td>Seneca</td><td>Seneca</td></tr><tr><td>3</td><td>    1291-4<a name=\"cdcrec-1291-4\"> </a></td><td>Seneca Nation</td><td>Seneca Nation</td></tr><tr><td>3</td><td>    1292-2<a name=\"cdcrec-1292-2\"> </a></td><td>Seneca-Cayuga</td><td>Seneca-Cayuga</td></tr><tr><td>3</td><td>    1293-0<a name=\"cdcrec-1293-0\"> </a></td><td>Tonawanda Seneca</td><td>Tonawanda Seneca</td></tr><tr><td>3</td><td>    1294-8<a name=\"cdcrec-1294-8\"> </a></td><td>Tuscarora</td><td>Tuscarora</td></tr><tr><td>3</td><td>    1295-5<a name=\"cdcrec-1295-5\"> </a></td><td>Wyandotte</td><td>Wyandotte</td></tr><tr><td>3</td><td>    1306-0<a name=\"cdcrec-1306-0\"> </a></td><td>Oklahoma Kickapoo</td><td>Oklahoma Kickapoo</td></tr><tr><td>3</td><td>    1307-8<a name=\"cdcrec-1307-8\"> </a></td><td>Texas Kickapoo</td><td>Texas Kickapoo</td></tr><tr><td>3</td><td>    1310-2<a name=\"cdcrec-1310-2\"> </a></td><td>Oklahoma Kiowa</td><td>Oklahoma Kiowa</td></tr><tr><td>3</td><td>    1313-6<a name=\"cdcrec-1313-6\"> </a></td><td>Jamestown</td><td>Jamestown</td></tr><tr><td>3</td><td>    1314-4<a name=\"cdcrec-1314-4\"> </a></td><td>Lower Elwha</td><td>Lower Elwha</td></tr><tr><td>3</td><td>    1315-1<a name=\"cdcrec-1315-1\"> </a></td><td>Port Gamble Klallam</td><td>Port Gamble Klallam</td></tr><tr><td>3</td><td>    1326-8<a name=\"cdcrec-1326-8\"> </a></td><td>Matinecock</td><td>Matinecock</td></tr><tr><td>3</td><td>    1327-6<a name=\"cdcrec-1327-6\"> </a></td><td>Montauk</td><td>Montauk</td></tr><tr><td>3</td><td>    1328-4<a name=\"cdcrec-1328-4\"> </a></td><td>Poospatuck</td><td>Poospatuck</td></tr><tr><td>3</td><td>    1329-2<a name=\"cdcrec-1329-2\"> </a></td><td>Setauket</td><td>Setauket</td></tr><tr><td>3</td><td>    1332-6<a name=\"cdcrec-1332-6\"> </a></td><td>La Jolla</td><td>La Jolla</td></tr><tr><td>3</td><td>    1333-4<a name=\"cdcrec-1333-4\"> </a></td><td>Pala</td><td>Pala</td></tr><tr><td>3</td><td>    1334-2<a name=\"cdcrec-1334-2\"> </a></td><td>Pauma</td><td>Pauma</td></tr><tr><td>3</td><td>    1335-9<a name=\"cdcrec-1335-9\"> </a></td><td>Pechanga</td><td>Pechanga</td></tr><tr><td>3</td><td>    1336-7<a name=\"cdcrec-1336-7\"> </a></td><td>Soboba</td><td>Soboba</td></tr><tr><td>3</td><td>    1337-5<a name=\"cdcrec-1337-5\"> </a></td><td>Twenty-Nine Palms</td><td>Twenty-Nine Palms</td></tr><tr><td>3</td><td>    1338-3<a name=\"cdcrec-1338-3\"> </a></td><td>Temecula</td><td>Temecula</td></tr><tr><td>3</td><td>    1345-8<a name=\"cdcrec-1345-8\"> </a></td><td>Mountain Maidu</td><td>Mountain Maidu</td></tr><tr><td>3</td><td>    1346-6<a name=\"cdcrec-1346-6\"> </a></td><td>Nishinam</td><td>Nishinam</td></tr><tr><td>3</td><td>    1359-9<a name=\"cdcrec-1359-9\"> </a></td><td>Illinois Miami</td><td>Illinois Miami</td></tr><tr><td>3</td><td>    1360-7<a name=\"cdcrec-1360-7\"> </a></td><td>Indiana Miami</td><td>Indiana Miami</td></tr><tr><td>3</td><td>    1361-5<a name=\"cdcrec-1361-5\"> </a></td><td>Oklahoma Miami</td><td>Oklahoma Miami</td></tr><tr><td>3</td><td>    1366-4<a name=\"cdcrec-1366-4\"> </a></td><td>Aroostook</td><td>Aroostook</td></tr><tr><td>3</td><td>    1383-9<a name=\"cdcrec-1383-9\"> </a></td><td>Alamo Navajo</td><td>Alamo Navajo</td></tr><tr><td>3</td><td>    1384-7<a name=\"cdcrec-1384-7\"> </a></td><td>Canoncito Navajo</td><td>Canoncito Navajo</td></tr><tr><td>3</td><td>    1385-4<a name=\"cdcrec-1385-4\"> </a></td><td>Ramah Navajo</td><td>Ramah Navajo</td></tr><tr><td>3</td><td>    1392-0<a name=\"cdcrec-1392-0\"> </a></td><td>Alsea</td><td>Alsea</td></tr><tr><td>3</td><td>    1393-8<a name=\"cdcrec-1393-8\"> </a></td><td>Celilo</td><td>Celilo</td></tr><tr><td>3</td><td>    1394-6<a name=\"cdcrec-1394-6\"> </a></td><td>Columbia</td><td>Columbia</td></tr><tr><td>3</td><td>    1395-3<a name=\"cdcrec-1395-3\"> </a></td><td>Kalapuya</td><td>Kalapuya</td></tr><tr><td>3</td><td>    1396-1<a name=\"cdcrec-1396-1\"> </a></td><td>Molala</td><td>Molala</td></tr><tr><td>3</td><td>    1397-9<a name=\"cdcrec-1397-9\"> </a></td><td>Talakamish</td><td>Talakamish</td></tr><tr><td>3</td><td>    1398-7<a name=\"cdcrec-1398-7\"> </a></td><td>Tenino</td><td>Tenino</td></tr><tr><td>3</td><td>    1399-5<a name=\"cdcrec-1399-5\"> </a></td><td>Tillamook</td><td>Tillamook</td></tr><tr><td>3</td><td>    1400-1<a name=\"cdcrec-1400-1\"> </a></td><td>Wenatchee</td><td>Wenatchee</td></tr><tr><td>3</td><td>    1401-9<a name=\"cdcrec-1401-9\"> </a></td><td>Yahooskin</td><td>Yahooskin</td></tr><tr><td>3</td><td>    1412-6<a name=\"cdcrec-1412-6\"> </a></td><td>Burt Lake Ottawa</td><td>Burt Lake Ottawa</td></tr><tr><td>3</td><td>    1413-4<a name=\"cdcrec-1413-4\"> </a></td><td>Michigan Ottawa</td><td>Michigan Ottawa</td></tr><tr><td>3</td><td>    1414-2<a name=\"cdcrec-1414-2\"> </a></td><td>Oklahoma Ottawa</td><td>Oklahoma Ottawa</td></tr><tr><td>3</td><td>    1417-5<a name=\"cdcrec-1417-5\"> </a></td><td>Bishop</td><td>Bishop</td></tr><tr><td>3</td><td>    1418-3<a name=\"cdcrec-1418-3\"> </a></td><td>Bridgeport</td><td>Bridgeport</td></tr><tr><td>3</td><td>    1419-1<a name=\"cdcrec-1419-1\"> </a></td><td>Burns Paiute</td><td>Burns Paiute</td></tr><tr><td>3</td><td>    1420-9<a name=\"cdcrec-1420-9\"> </a></td><td>Cedarville</td><td>Cedarville</td></tr><tr><td>3</td><td>    1421-7<a name=\"cdcrec-1421-7\"> </a></td><td>Fort Bidwell</td><td>Fort Bidwell</td></tr><tr><td>3</td><td>    1422-5<a name=\"cdcrec-1422-5\"> </a></td><td>Fort Independence</td><td>Fort Independence</td></tr><tr><td>3</td><td>    1423-3<a name=\"cdcrec-1423-3\"> </a></td><td>Kaibab</td><td>Kaibab</td></tr><tr><td>3</td><td>    1424-1<a name=\"cdcrec-1424-1\"> </a></td><td>Las Vegas</td><td>Las Vegas</td></tr><tr><td>3</td><td>    1425-8<a name=\"cdcrec-1425-8\"> </a></td><td>Lone Pine</td><td>Lone Pine</td></tr><tr><td>3</td><td>    1426-6<a name=\"cdcrec-1426-6\"> </a></td><td>Lovelock</td><td>Lovelock</td></tr><tr><td>3</td><td>    1427-4<a name=\"cdcrec-1427-4\"> </a></td><td>Malheur Paiute</td><td>Malheur Paiute</td></tr><tr><td>3</td><td>    1428-2<a name=\"cdcrec-1428-2\"> </a></td><td>Moapa</td><td>Moapa</td></tr><tr><td>3</td><td>    1429-0<a name=\"cdcrec-1429-0\"> </a></td><td>Northern Paiute</td><td>Northern Paiute</td></tr><tr><td>3</td><td>    1430-8<a name=\"cdcrec-1430-8\"> </a></td><td>Owens Valley</td><td>Owens Valley</td></tr><tr><td>3</td><td>    1431-6<a name=\"cdcrec-1431-6\"> </a></td><td>Pyramid Lake</td><td>Pyramid Lake</td></tr><tr><td>3</td><td>    1432-4<a name=\"cdcrec-1432-4\"> </a></td><td>San Juan Southern Paiute</td><td>San Juan Southern Paiute</td></tr><tr><td>3</td><td>    1433-2<a name=\"cdcrec-1433-2\"> </a></td><td>Southern Paiute</td><td>Southern Paiute</td></tr><tr><td>3</td><td>    1434-0<a name=\"cdcrec-1434-0\"> </a></td><td>Summit Lake</td><td>Summit Lake</td></tr><tr><td>3</td><td>    1435-7<a name=\"cdcrec-1435-7\"> </a></td><td>Utu Utu Gwaitu Paiute</td><td>Utu Utu Gwaitu Paiute</td></tr><tr><td>3</td><td>    1436-5<a name=\"cdcrec-1436-5\"> </a></td><td>Walker River</td><td>Walker River</td></tr><tr><td>3</td><td>    1437-3<a name=\"cdcrec-1437-3\"> </a></td><td>Yerington Paiute</td><td>Yerington Paiute</td></tr><tr><td>3</td><td>    1442-3<a name=\"cdcrec-1442-3\"> </a></td><td>Indian Township</td><td>Indian Township</td></tr><tr><td>3</td><td>    1443-1<a name=\"cdcrec-1443-1\"> </a></td><td>Pleasant Point Passamaquoddy</td><td>Pleasant Point Passamaquoddy</td></tr><tr><td>3</td><td>    1446-4<a name=\"cdcrec-1446-4\"> </a></td><td>Oklahoma Pawnee</td><td>Oklahoma Pawnee</td></tr><tr><td>3</td><td>    1451-4<a name=\"cdcrec-1451-4\"> </a></td><td>Oklahoma Peoria</td><td>Oklahoma Peoria</td></tr><tr><td>3</td><td>    1454-8<a name=\"cdcrec-1454-8\"> </a></td><td>Marshantucket Pequot</td><td>Marshantucket Pequot</td></tr><tr><td>3</td><td>    1457-1<a name=\"cdcrec-1457-1\"> </a></td><td>Gila River Pima-Maricopa</td><td>Gila River Pima-Maricopa</td></tr><tr><td>3</td><td>    1458-9<a name=\"cdcrec-1458-9\"> </a></td><td>Salt River Pima-Maricopa</td><td>Salt River Pima-Maricopa</td></tr><tr><td>3</td><td>    1465-4<a name=\"cdcrec-1465-4\"> </a></td><td>Central Pomo</td><td>Central Pomo</td></tr><tr><td>3</td><td>    1466-2<a name=\"cdcrec-1466-2\"> </a></td><td>Dry Creek</td><td>Dry Creek</td></tr><tr><td>3</td><td>    1467-0<a name=\"cdcrec-1467-0\"> </a></td><td>Eastern Pomo</td><td>Eastern Pomo</td></tr><tr><td>3</td><td>    1468-8<a name=\"cdcrec-1468-8\"> </a></td><td>Kashia</td><td>Kashia</td></tr><tr><td>3</td><td>    1469-6<a name=\"cdcrec-1469-6\"> </a></td><td>Northern Pomo</td><td>Northern Pomo</td></tr><tr><td>3</td><td>    1470-4<a name=\"cdcrec-1470-4\"> </a></td><td>Scotts Valley</td><td>Scotts Valley</td></tr><tr><td>3</td><td>    1471-2<a name=\"cdcrec-1471-2\"> </a></td><td>Stonyford</td><td>Stonyford</td></tr><tr><td>3</td><td>    1472-0<a name=\"cdcrec-1472-0\"> </a></td><td>Sulphur Bank</td><td>Sulphur Bank</td></tr><tr><td>3</td><td>    1475-3<a name=\"cdcrec-1475-3\"> </a></td><td>Nebraska Ponca</td><td>Nebraska Ponca</td></tr><tr><td>3</td><td>    1476-1<a name=\"cdcrec-1476-1\"> </a></td><td>Oklahoma Ponca</td><td>Oklahoma Ponca</td></tr><tr><td>3</td><td>    1479-5<a name=\"cdcrec-1479-5\"> </a></td><td>Citizen Band Potawatomi</td><td>Citizen Band Potawatomi</td></tr><tr><td>3</td><td>    1480-3<a name=\"cdcrec-1480-3\"> </a></td><td>Forest County</td><td>Forest County</td></tr><tr><td>3</td><td>    1481-1<a name=\"cdcrec-1481-1\"> </a></td><td>Hannahville</td><td>Hannahville</td></tr><tr><td>3</td><td>    1482-9<a name=\"cdcrec-1482-9\"> </a></td><td>Huron Potawatomi</td><td>Huron Potawatomi</td></tr><tr><td>3</td><td>    1483-7<a name=\"cdcrec-1483-7\"> </a></td><td>Pokagon Potawatomi</td><td>Pokagon Potawatomi</td></tr><tr><td>3</td><td>    1484-5<a name=\"cdcrec-1484-5\"> </a></td><td>Prairie Band</td><td>Prairie Band</td></tr><tr><td>3</td><td>    1485-2<a name=\"cdcrec-1485-2\"> </a></td><td>Wisconsin Potawatomi</td><td>Wisconsin Potawatomi</td></tr><tr><td>3</td><td>    1490-2<a name=\"cdcrec-1490-2\"> </a></td><td>Acoma</td><td>Acoma</td></tr><tr><td>3</td><td>    1491-0<a name=\"cdcrec-1491-0\"> </a></td><td>Arizona Tewa</td><td>Arizona Tewa</td></tr><tr><td>3</td><td>    1492-8<a name=\"cdcrec-1492-8\"> </a></td><td>Cochiti</td><td>Cochiti</td></tr><tr><td>3</td><td>    1493-6<a name=\"cdcrec-1493-6\"> </a></td><td>Hopi</td><td>Hopi</td></tr><tr><td>3</td><td>    1494-4<a name=\"cdcrec-1494-4\"> </a></td><td>Isleta</td><td>Isleta</td></tr><tr><td>3</td><td>    1495-1<a name=\"cdcrec-1495-1\"> </a></td><td>Jemez</td><td>Jemez</td></tr><tr><td>3</td><td>    1496-9<a name=\"cdcrec-1496-9\"> </a></td><td>Keres</td><td>Keres</td></tr><tr><td>3</td><td>    1497-7<a name=\"cdcrec-1497-7\"> </a></td><td>Laguna</td><td>Laguna</td></tr><tr><td>3</td><td>    1498-5<a name=\"cdcrec-1498-5\"> </a></td><td>Nambe</td><td>Nambe</td></tr><tr><td>3</td><td>    1499-3<a name=\"cdcrec-1499-3\"> </a></td><td>Picuris</td><td>Picuris</td></tr><tr><td>3</td><td>    1500-8<a name=\"cdcrec-1500-8\"> </a></td><td>Piro</td><td>Piro</td></tr><tr><td>3</td><td>    1501-6<a name=\"cdcrec-1501-6\"> </a></td><td>Pojoaque</td><td>Pojoaque</td></tr><tr><td>3</td><td>    1502-4<a name=\"cdcrec-1502-4\"> </a></td><td>San Felipe</td><td>San Felipe</td></tr><tr><td>3</td><td>    1503-2<a name=\"cdcrec-1503-2\"> </a></td><td>San Ildefonso</td><td>San Ildefonso</td></tr><tr><td>3</td><td>    1504-0<a name=\"cdcrec-1504-0\"> </a></td><td>San Juan Pueblo</td><td>San Juan Pueblo</td></tr><tr><td>3</td><td>    1505-7<a name=\"cdcrec-1505-7\"> </a></td><td>San Juan De</td><td>San Juan De</td></tr><tr><td>3</td><td>    1506-5<a name=\"cdcrec-1506-5\"> </a></td><td>San Juan</td><td>San Juan</td></tr><tr><td>3</td><td>    1507-3<a name=\"cdcrec-1507-3\"> </a></td><td>Sandia</td><td>Sandia</td></tr><tr><td>3</td><td>    1508-1<a name=\"cdcrec-1508-1\"> </a></td><td>Santa Ana</td><td>Santa Ana</td></tr><tr><td>3</td><td>    1509-9<a name=\"cdcrec-1509-9\"> </a></td><td>Santa Clara</td><td>Santa Clara</td></tr><tr><td>3</td><td>    1510-7<a name=\"cdcrec-1510-7\"> </a></td><td>Santo Domingo</td><td>Santo Domingo</td></tr><tr><td>3</td><td>    1511-5<a name=\"cdcrec-1511-5\"> </a></td><td>Taos</td><td>Taos</td></tr><tr><td>3</td><td>    1512-3<a name=\"cdcrec-1512-3\"> </a></td><td>Tesuque</td><td>Tesuque</td></tr><tr><td>3</td><td>    1513-1<a name=\"cdcrec-1513-1\"> </a></td><td>Tewa</td><td>Tewa</td></tr><tr><td>3</td><td>    1514-9<a name=\"cdcrec-1514-9\"> </a></td><td>Tigua</td><td>Tigua</td></tr><tr><td>3</td><td>    1515-6<a name=\"cdcrec-1515-6\"> </a></td><td>Zia</td><td>Zia</td></tr><tr><td>3</td><td>    1516-4<a name=\"cdcrec-1516-4\"> </a></td><td>Zuni</td><td>Zuni</td></tr><tr><td>3</td><td>    1519-8<a name=\"cdcrec-1519-8\"> </a></td><td>Duwamish</td><td>Duwamish</td></tr><tr><td>3</td><td>    1520-6<a name=\"cdcrec-1520-6\"> </a></td><td>Kikiallus</td><td>Kikiallus</td></tr><tr><td>3</td><td>    1521-4<a name=\"cdcrec-1521-4\"> </a></td><td>Lower Skagit</td><td>Lower Skagit</td></tr><tr><td>3</td><td>    1522-2<a name=\"cdcrec-1522-2\"> </a></td><td>Muckleshoot</td><td>Muckleshoot</td></tr><tr><td>3</td><td>    1523-0<a name=\"cdcrec-1523-0\"> </a></td><td>Nisqually</td><td>Nisqually</td></tr><tr><td>3</td><td>    1524-8<a name=\"cdcrec-1524-8\"> </a></td><td>Nooksack</td><td>Nooksack</td></tr><tr><td>3</td><td>    1525-5<a name=\"cdcrec-1525-5\"> </a></td><td>Port Madison</td><td>Port Madison</td></tr><tr><td>3</td><td>    1526-3<a name=\"cdcrec-1526-3\"> </a></td><td>Puyallup</td><td>Puyallup</td></tr><tr><td>3</td><td>    1527-1<a name=\"cdcrec-1527-1\"> </a></td><td>Samish</td><td>Samish</td></tr><tr><td>3</td><td>    1528-9<a name=\"cdcrec-1528-9\"> </a></td><td>Sauk-Suiattle</td><td>Sauk-Suiattle</td></tr><tr><td>3</td><td>    1529-7<a name=\"cdcrec-1529-7\"> </a></td><td>Skokomish</td><td>Skokomish</td></tr><tr><td>3</td><td>    1530-5<a name=\"cdcrec-1530-5\"> </a></td><td>Skykomish</td><td>Skykomish</td></tr><tr><td>3</td><td>    1531-3<a name=\"cdcrec-1531-3\"> </a></td><td>Snohomish</td><td>Snohomish</td></tr><tr><td>3</td><td>    1532-1<a name=\"cdcrec-1532-1\"> </a></td><td>Snoqualmie</td><td>Snoqualmie</td></tr><tr><td>3</td><td>    1533-9<a name=\"cdcrec-1533-9\"> </a></td><td>Squaxin Island</td><td>Squaxin Island</td></tr><tr><td>3</td><td>    1534-7<a name=\"cdcrec-1534-7\"> </a></td><td>Steilacoom</td><td>Steilacoom</td></tr><tr><td>3</td><td>    1535-4<a name=\"cdcrec-1535-4\"> </a></td><td>Stillaguamish</td><td>Stillaguamish</td></tr><tr><td>3</td><td>    1536-2<a name=\"cdcrec-1536-2\"> </a></td><td>Suquamish</td><td>Suquamish</td></tr><tr><td>3</td><td>    1537-0<a name=\"cdcrec-1537-0\"> </a></td><td>Swinomish</td><td>Swinomish</td></tr><tr><td>3</td><td>    1538-8<a name=\"cdcrec-1538-8\"> </a></td><td>Tulalip</td><td>Tulalip</td></tr><tr><td>3</td><td>    1539-6<a name=\"cdcrec-1539-6\"> </a></td><td>Upper Skagit</td><td>Upper Skagit</td></tr><tr><td>3</td><td>    1552-9<a name=\"cdcrec-1552-9\"> </a></td><td>Iowa Sac and Fox</td><td>Iowa Sac and Fox</td></tr><tr><td>3</td><td>    1553-7<a name=\"cdcrec-1553-7\"> </a></td><td>Missouri Sac and Fox</td><td>Missouri Sac and Fox</td></tr><tr><td>3</td><td>    1554-5<a name=\"cdcrec-1554-5\"> </a></td><td>Oklahoma Sac and Fox</td><td>Oklahoma Sac and Fox</td></tr><tr><td>3</td><td>    1567-7<a name=\"cdcrec-1567-7\"> </a></td><td>Big Cypress</td><td>Big Cypress</td></tr><tr><td>3</td><td>    1568-5<a name=\"cdcrec-1568-5\"> </a></td><td>Brighton</td><td>Brighton</td></tr><tr><td>3</td><td>    1569-3<a name=\"cdcrec-1569-3\"> </a></td><td>Florida Seminole</td><td>Florida Seminole</td></tr><tr><td>3</td><td>    1570-1<a name=\"cdcrec-1570-1\"> </a></td><td>Hollywood Seminole</td><td>Hollywood Seminole</td></tr><tr><td>3</td><td>    1571-9<a name=\"cdcrec-1571-9\"> </a></td><td>Oklahoma Seminole</td><td>Oklahoma Seminole</td></tr><tr><td>3</td><td>    1574-3<a name=\"cdcrec-1574-3\"> </a></td><td>San Manual</td><td>San Manual</td></tr><tr><td>3</td><td>    1579-2<a name=\"cdcrec-1579-2\"> </a></td><td>Absentee Shawnee</td><td>Absentee Shawnee</td></tr><tr><td>3</td><td>    1580-0<a name=\"cdcrec-1580-0\"> </a></td><td>Eastern Shawnee</td><td>Eastern Shawnee</td></tr><tr><td>3</td><td>    1587-5<a name=\"cdcrec-1587-5\"> </a></td><td>Battle Mountain</td><td>Battle Mountain</td></tr><tr><td>3</td><td>    1588-3<a name=\"cdcrec-1588-3\"> </a></td><td>Duckwater</td><td>Duckwater</td></tr><tr><td>3</td><td>    1589-1<a name=\"cdcrec-1589-1\"> </a></td><td>Elko</td><td>Elko</td></tr><tr><td>3</td><td>    1590-9<a name=\"cdcrec-1590-9\"> </a></td><td>Ely</td><td>Ely</td></tr><tr><td>3</td><td>    1591-7<a name=\"cdcrec-1591-7\"> </a></td><td>Goshute</td><td>Goshute</td></tr><tr><td>3</td><td>    1592-5<a name=\"cdcrec-1592-5\"> </a></td><td>Panamint</td><td>Panamint</td></tr><tr><td>3</td><td>    1593-3<a name=\"cdcrec-1593-3\"> </a></td><td>Ruby Valley</td><td>Ruby Valley</td></tr><tr><td>3</td><td>    1594-1<a name=\"cdcrec-1594-1\"> </a></td><td>Skull Valley</td><td>Skull Valley</td></tr><tr><td>3</td><td>    1595-8<a name=\"cdcrec-1595-8\"> </a></td><td>South Fork Shoshone</td><td>South Fork Shoshone</td></tr><tr><td>3</td><td>    1596-6<a name=\"cdcrec-1596-6\"> </a></td><td>Te-Moak Western Shoshone</td><td>Te-Moak Western Shoshone</td></tr><tr><td>3</td><td>    1597-4<a name=\"cdcrec-1597-4\"> </a></td><td>Timbi-Sha Shoshone</td><td>Timbi-Sha Shoshone</td></tr><tr><td>3</td><td>    1598-2<a name=\"cdcrec-1598-2\"> </a></td><td>Washakie</td><td>Washakie</td></tr><tr><td>3</td><td>    1599-0<a name=\"cdcrec-1599-0\"> </a></td><td>Wind River Shoshone</td><td>Wind River Shoshone</td></tr><tr><td>3</td><td>    1600-6<a name=\"cdcrec-1600-6\"> </a></td><td>Yomba</td><td>Yomba</td></tr><tr><td>3</td><td>    1603-0<a name=\"cdcrec-1603-0\"> </a></td><td>Duck Valley</td><td>Duck Valley</td></tr><tr><td>3</td><td>    1604-8<a name=\"cdcrec-1604-8\"> </a></td><td>Fallon</td><td>Fallon</td></tr><tr><td>3</td><td>    1605-5<a name=\"cdcrec-1605-5\"> </a></td><td>Fort McDermitt</td><td>Fort McDermitt</td></tr><tr><td>3</td><td>    1610-5<a name=\"cdcrec-1610-5\"> </a></td><td>Blackfoot Sioux</td><td>Blackfoot Sioux</td></tr><tr><td>3</td><td>    1611-3<a name=\"cdcrec-1611-3\"> </a></td><td>Brule Sioux</td><td>Brule Sioux</td></tr><tr><td>3</td><td>    1612-1<a name=\"cdcrec-1612-1\"> </a></td><td>Cheyenne River Sioux</td><td>Cheyenne River Sioux</td></tr><tr><td>3</td><td>    1613-9<a name=\"cdcrec-1613-9\"> </a></td><td>Crow Creek Sioux</td><td>Crow Creek Sioux</td></tr><tr><td>3</td><td>    1614-7<a name=\"cdcrec-1614-7\"> </a></td><td>Dakota Sioux</td><td>Dakota Sioux</td></tr><tr><td>3</td><td>    1615-4<a name=\"cdcrec-1615-4\"> </a></td><td>Flandreau Santee</td><td>Flandreau Santee</td></tr><tr><td>3</td><td>    1616-2<a name=\"cdcrec-1616-2\"> </a></td><td>Fort Peck</td><td>Fort Peck</td></tr><tr><td>3</td><td>    1617-0<a name=\"cdcrec-1617-0\"> </a></td><td>Lake Traverse Sioux</td><td>Lake Traverse Sioux</td></tr><tr><td>3</td><td>    1618-8<a name=\"cdcrec-1618-8\"> </a></td><td>Lower Brule Sioux</td><td>Lower Brule Sioux</td></tr><tr><td>3</td><td>    1619-6<a name=\"cdcrec-1619-6\"> </a></td><td>Lower Sioux</td><td>Lower Sioux</td></tr><tr><td>3</td><td>    1620-4<a name=\"cdcrec-1620-4\"> </a></td><td>Mdewakanton Sioux</td><td>Mdewakanton Sioux</td></tr><tr><td>3</td><td>    1621-2<a name=\"cdcrec-1621-2\"> </a></td><td>Miniconjou</td><td>Miniconjou</td></tr><tr><td>3</td><td>    1622-0<a name=\"cdcrec-1622-0\"> </a></td><td>Oglala Sioux</td><td>Oglala Sioux</td></tr><tr><td>3</td><td>    1623-8<a name=\"cdcrec-1623-8\"> </a></td><td>Pine Ridge Sioux</td><td>Pine Ridge Sioux</td></tr><tr><td>3</td><td>    1624-6<a name=\"cdcrec-1624-6\"> </a></td><td>Pipestone Sioux</td><td>Pipestone Sioux</td></tr><tr><td>3</td><td>    1625-3<a name=\"cdcrec-1625-3\"> </a></td><td>Prairie Island Sioux</td><td>Prairie Island Sioux</td></tr><tr><td>3</td><td>    1626-1<a name=\"cdcrec-1626-1\"> </a></td><td>Prior Lake Sioux</td><td>Prior Lake Sioux</td></tr><tr><td>3</td><td>    1627-9<a name=\"cdcrec-1627-9\"> </a></td><td>Rosebud Sioux</td><td>Rosebud Sioux</td></tr><tr><td>3</td><td>    1628-7<a name=\"cdcrec-1628-7\"> </a></td><td>Sans Arc Sioux</td><td>Sans Arc Sioux</td></tr><tr><td>3</td><td>    1629-5<a name=\"cdcrec-1629-5\"> </a></td><td>Santee Sioux</td><td>Santee Sioux</td></tr><tr><td>3</td><td>    1630-3<a name=\"cdcrec-1630-3\"> </a></td><td>Sisseton-Wahpeton</td><td>Sisseton-Wahpeton</td></tr><tr><td>3</td><td>    1631-1<a name=\"cdcrec-1631-1\"> </a></td><td>Sisseton Sioux</td><td>Sisseton Sioux</td></tr><tr><td>3</td><td>    1632-9<a name=\"cdcrec-1632-9\"> </a></td><td>Spirit Lake Sioux</td><td>Spirit Lake Sioux</td></tr><tr><td>3</td><td>    1633-7<a name=\"cdcrec-1633-7\"> </a></td><td>Standing Rock Sioux</td><td>Standing Rock Sioux</td></tr><tr><td>3</td><td>    1634-5<a name=\"cdcrec-1634-5\"> </a></td><td>Teton Sioux</td><td>Teton Sioux</td></tr><tr><td>3</td><td>    1635-2<a name=\"cdcrec-1635-2\"> </a></td><td>Two Kettle Sioux</td><td>Two Kettle Sioux</td></tr><tr><td>3</td><td>    1636-0<a name=\"cdcrec-1636-0\"> </a></td><td>Upper Sioux</td><td>Upper Sioux</td></tr><tr><td>3</td><td>    1637-8<a name=\"cdcrec-1637-8\"> </a></td><td>Wahpekute Sioux</td><td>Wahpekute Sioux</td></tr><tr><td>3</td><td>    1638-6<a name=\"cdcrec-1638-6\"> </a></td><td>Wahpeton Sioux</td><td>Wahpeton Sioux</td></tr><tr><td>3</td><td>    1639-4<a name=\"cdcrec-1639-4\"> </a></td><td>Wazhaza Sioux</td><td>Wazhaza Sioux</td></tr><tr><td>3</td><td>    1640-2<a name=\"cdcrec-1640-2\"> </a></td><td>Yankton Sioux</td><td>Yankton Sioux</td></tr><tr><td>3</td><td>    1641-0<a name=\"cdcrec-1641-0\"> </a></td><td>Yanktonai Sioux</td><td>Yanktonai Sioux</td></tr><tr><td>3</td><td>    1654-3<a name=\"cdcrec-1654-3\"> </a></td><td>Ak-Chin</td><td>Ak-Chin</td></tr><tr><td>3</td><td>    1655-0<a name=\"cdcrec-1655-0\"> </a></td><td>Gila Bend</td><td>Gila Bend</td></tr><tr><td>3</td><td>    1656-8<a name=\"cdcrec-1656-8\"> </a></td><td>San Xavier</td><td>San Xavier</td></tr><tr><td>3</td><td>    1657-6<a name=\"cdcrec-1657-6\"> </a></td><td>Sells</td><td>Sells</td></tr><tr><td>3</td><td>    1668-3<a name=\"cdcrec-1668-3\"> </a></td><td>Cow Creek Umpqua</td><td>Cow Creek Umpqua</td></tr><tr><td>3</td><td>    1671-7<a name=\"cdcrec-1671-7\"> </a></td><td>Allen Canyon</td><td>Allen Canyon</td></tr><tr><td>3</td><td>    1672-5<a name=\"cdcrec-1672-5\"> </a></td><td>Uintah Ute</td><td>Uintah Ute</td></tr><tr><td>3</td><td>    1673-3<a name=\"cdcrec-1673-3\"> </a></td><td>Ute Mountain Ute</td><td>Ute Mountain Ute</td></tr><tr><td>3</td><td>    1680-8<a name=\"cdcrec-1680-8\"> </a></td><td>Gay Head Wampanoag</td><td>Gay Head Wampanoag</td></tr><tr><td>3</td><td>    1681-6<a name=\"cdcrec-1681-6\"> </a></td><td>Mashpee Wampanoag</td><td>Mashpee Wampanoag</td></tr><tr><td>3</td><td>    1688-1<a name=\"cdcrec-1688-1\"> </a></td><td>Alpine</td><td>Alpine</td></tr><tr><td>3</td><td>    1689-9<a name=\"cdcrec-1689-9\"> </a></td><td>Carson</td><td>Carson</td></tr><tr><td>3</td><td>    1690-7<a name=\"cdcrec-1690-7\"> </a></td><td>Dresslerville</td><td>Dresslerville</td></tr><tr><td>3</td><td>    1697-2<a name=\"cdcrec-1697-2\"> </a></td><td>Ho-chunk</td><td>Ho-chunk</td></tr><tr><td>3</td><td>    1698-0<a name=\"cdcrec-1698-0\"> </a></td><td>Nebraska Winnebago</td><td>Nebraska Winnebago</td></tr><tr><td>3</td><td>    1705-3<a name=\"cdcrec-1705-3\"> </a></td><td>Table Bluff</td><td>Table Bluff</td></tr><tr><td>3</td><td>    1712-9<a name=\"cdcrec-1712-9\"> </a></td><td>Barrio Libre</td><td>Barrio Libre</td></tr><tr><td>3</td><td>    1713-7<a name=\"cdcrec-1713-7\"> </a></td><td>Pascua Yaqui</td><td>Pascua Yaqui</td></tr><tr><td>3</td><td>    1718-6<a name=\"cdcrec-1718-6\"> </a></td><td>Chukchansi</td><td>Chukchansi</td></tr><tr><td>3</td><td>    1719-4<a name=\"cdcrec-1719-4\"> </a></td><td>Tachi</td><td>Tachi</td></tr><tr><td>3</td><td>    1720-2<a name=\"cdcrec-1720-2\"> </a></td><td>Tule River</td><td>Tule River</td></tr><tr><td>3</td><td>    1725-1<a name=\"cdcrec-1725-1\"> </a></td><td>Cocopah</td><td>Cocopah</td></tr><tr><td>3</td><td>    1726-9<a name=\"cdcrec-1726-9\"> </a></td><td>Havasupai</td><td>Havasupai</td></tr><tr><td>3</td><td>    1727-7<a name=\"cdcrec-1727-7\"> </a></td><td>Hualapai</td><td>Hualapai</td></tr><tr><td>3</td><td>    1728-5<a name=\"cdcrec-1728-5\"> </a></td><td>Maricopa</td><td>Maricopa</td></tr><tr><td>3</td><td>    1729-3<a name=\"cdcrec-1729-3\"> </a></td><td>Mohave</td><td>Mohave</td></tr><tr><td>3</td><td>    1730-1<a name=\"cdcrec-1730-1\"> </a></td><td>Quechan</td><td>Quechan</td></tr><tr><td>3</td><td>    1731-9<a name=\"cdcrec-1731-9\"> </a></td><td>Yavapai</td><td>Yavapai</td></tr><tr><td>3</td><td>    1733-5<a name=\"cdcrec-1733-5\"> </a></td><td>Coast Yurok</td><td>Coast Yurok</td></tr><tr><td>3</td><td>    1737-6<a name=\"cdcrec-1737-6\"> </a></td><td>Alaska Indian</td><td>Alaska Indian</td></tr><tr><td>3</td><td>    1840-8<a name=\"cdcrec-1840-8\"> </a></td><td>Eskimo</td><td>Eskimo</td></tr><tr><td>3</td><td>    1966-1<a name=\"cdcrec-1966-1\"> </a></td><td>Aleut</td><td>Aleut</td></tr><tr><td>3</td><td>    1739-2<a name=\"cdcrec-1739-2\"> </a></td><td>Alaskan Athabascan</td><td>Alaskan Athabascan</td></tr><tr><td>3</td><td>    1811-9<a name=\"cdcrec-1811-9\"> </a></td><td>Southeast Alaska</td><td>Southeast Alaska</td></tr><tr><td>3</td><td>    1740-0<a name=\"cdcrec-1740-0\"> </a></td><td>Ahtna</td><td>Ahtna</td></tr><tr><td>3</td><td>    1741-8<a name=\"cdcrec-1741-8\"> </a></td><td>Alatna</td><td>Alatna</td></tr><tr><td>3</td><td>    1742-6<a name=\"cdcrec-1742-6\"> </a></td><td>Alexander</td><td>Alexander</td></tr><tr><td>3</td><td>    1743-4<a name=\"cdcrec-1743-4\"> </a></td><td>Allakaket</td><td>Allakaket</td></tr><tr><td>3</td><td>    1744-2<a name=\"cdcrec-1744-2\"> </a></td><td>Alanvik</td><td>Alanvik</td></tr><tr><td>3</td><td>    1745-9<a name=\"cdcrec-1745-9\"> </a></td><td>Anvik</td><td>Anvik</td></tr><tr><td>3</td><td>    1746-7<a name=\"cdcrec-1746-7\"> </a></td><td>Arctic</td><td>Arctic</td></tr><tr><td>3</td><td>    1747-5<a name=\"cdcrec-1747-5\"> </a></td><td>Beaver</td><td>Beaver</td></tr><tr><td>3</td><td>    1748-3<a name=\"cdcrec-1748-3\"> </a></td><td>Birch Creek</td><td>Birch Creek</td></tr><tr><td>3</td><td>    1749-1<a name=\"cdcrec-1749-1\"> </a></td><td>Cantwell</td><td>Cantwell</td></tr><tr><td>3</td><td>    1750-9<a name=\"cdcrec-1750-9\"> </a></td><td>Chalkyitsik</td><td>Chalkyitsik</td></tr><tr><td>3</td><td>    1751-7<a name=\"cdcrec-1751-7\"> </a></td><td>Chickaloon</td><td>Chickaloon</td></tr><tr><td>3</td><td>    1752-5<a name=\"cdcrec-1752-5\"> </a></td><td>Chistochina</td><td>Chistochina</td></tr><tr><td>3</td><td>    1753-3<a name=\"cdcrec-1753-3\"> </a></td><td>Chitina</td><td>Chitina</td></tr><tr><td>3</td><td>    1754-1<a name=\"cdcrec-1754-1\"> </a></td><td>Circle</td><td>Circle</td></tr><tr><td>3</td><td>    1755-8<a name=\"cdcrec-1755-8\"> </a></td><td>Cook Inlet</td><td>Cook Inlet</td></tr><tr><td>3</td><td>    1756-6<a name=\"cdcrec-1756-6\"> </a></td><td>Copper Center</td><td>Copper Center</td></tr><tr><td>3</td><td>    1757-4<a name=\"cdcrec-1757-4\"> </a></td><td>Copper River</td><td>Copper River</td></tr><tr><td>3</td><td>    1758-2<a name=\"cdcrec-1758-2\"> </a></td><td>Dot Lake</td><td>Dot Lake</td></tr><tr><td>3</td><td>    1759-0<a name=\"cdcrec-1759-0\"> </a></td><td>Doyon</td><td>Doyon</td></tr><tr><td>3</td><td>    1760-8<a name=\"cdcrec-1760-8\"> </a></td><td>Eagle</td><td>Eagle</td></tr><tr><td>3</td><td>    1761-6<a name=\"cdcrec-1761-6\"> </a></td><td>Eklutna</td><td>Eklutna</td></tr><tr><td>3</td><td>    1762-4<a name=\"cdcrec-1762-4\"> </a></td><td>Evansville</td><td>Evansville</td></tr><tr><td>3</td><td>    1763-2<a name=\"cdcrec-1763-2\"> </a></td><td>Fort Yukon</td><td>Fort Yukon</td></tr><tr><td>3</td><td>    1764-0<a name=\"cdcrec-1764-0\"> </a></td><td>Gakona</td><td>Gakona</td></tr><tr><td>3</td><td>    1765-7<a name=\"cdcrec-1765-7\"> </a></td><td>Galena</td><td>Galena</td></tr><tr><td>3</td><td>    1766-5<a name=\"cdcrec-1766-5\"> </a></td><td>Grayling</td><td>Grayling</td></tr><tr><td>3</td><td>    1767-3<a name=\"cdcrec-1767-3\"> </a></td><td>Gulkana</td><td>Gulkana</td></tr><tr><td>3</td><td>    1768-1<a name=\"cdcrec-1768-1\"> </a></td><td>Healy Lake</td><td>Healy Lake</td></tr><tr><td>3</td><td>    1769-9<a name=\"cdcrec-1769-9\"> </a></td><td>Holy Cross</td><td>Holy Cross</td></tr><tr><td>3</td><td>    1770-7<a name=\"cdcrec-1770-7\"> </a></td><td>Hughes</td><td>Hughes</td></tr><tr><td>3</td><td>    1771-5<a name=\"cdcrec-1771-5\"> </a></td><td>Huslia</td><td>Huslia</td></tr><tr><td>3</td><td>    1772-3<a name=\"cdcrec-1772-3\"> </a></td><td>Iliamna</td><td>Iliamna</td></tr><tr><td>3</td><td>    1773-1<a name=\"cdcrec-1773-1\"> </a></td><td>Kaltag</td><td>Kaltag</td></tr><tr><td>3</td><td>    1774-9<a name=\"cdcrec-1774-9\"> </a></td><td>Kluti Kaah</td><td>Kluti Kaah</td></tr><tr><td>3</td><td>    1775-6<a name=\"cdcrec-1775-6\"> </a></td><td>Knik</td><td>Knik</td></tr><tr><td>3</td><td>    1776-4<a name=\"cdcrec-1776-4\"> </a></td><td>Koyukuk</td><td>Koyukuk</td></tr><tr><td>3</td><td>    1777-2<a name=\"cdcrec-1777-2\"> </a></td><td>Lake Minchumina</td><td>Lake Minchumina</td></tr><tr><td>3</td><td>    1778-0<a name=\"cdcrec-1778-0\"> </a></td><td>Lime</td><td>Lime</td></tr><tr><td>3</td><td>    1779-8<a name=\"cdcrec-1779-8\"> </a></td><td>Mcgrath</td><td>Mcgrath</td></tr><tr><td>3</td><td>    1780-6<a name=\"cdcrec-1780-6\"> </a></td><td>Manley Hot Springs</td><td>Manley Hot Springs</td></tr><tr><td>3</td><td>    1781-4<a name=\"cdcrec-1781-4\"> </a></td><td>Mentasta Lake</td><td>Mentasta Lake</td></tr><tr><td>3</td><td>    1782-2<a name=\"cdcrec-1782-2\"> </a></td><td>Minto</td><td>Minto</td></tr><tr><td>3</td><td>    1783-0<a name=\"cdcrec-1783-0\"> </a></td><td>Nenana</td><td>Nenana</td></tr><tr><td>3</td><td>    1784-8<a name=\"cdcrec-1784-8\"> </a></td><td>Nikolai</td><td>Nikolai</td></tr><tr><td>3</td><td>    1785-5<a name=\"cdcrec-1785-5\"> </a></td><td>Ninilchik</td><td>Ninilchik</td></tr><tr><td>3</td><td>    1786-3<a name=\"cdcrec-1786-3\"> </a></td><td>Nondalton</td><td>Nondalton</td></tr><tr><td>3</td><td>    1787-1<a name=\"cdcrec-1787-1\"> </a></td><td>Northway</td><td>Northway</td></tr><tr><td>3</td><td>    1788-9<a name=\"cdcrec-1788-9\"> </a></td><td>Nulato</td><td>Nulato</td></tr><tr><td>3</td><td>    1789-7<a name=\"cdcrec-1789-7\"> </a></td><td>Pedro Bay</td><td>Pedro Bay</td></tr><tr><td>3</td><td>    1790-5<a name=\"cdcrec-1790-5\"> </a></td><td>Rampart</td><td>Rampart</td></tr><tr><td>3</td><td>    1791-3<a name=\"cdcrec-1791-3\"> </a></td><td>Ruby</td><td>Ruby</td></tr><tr><td>3</td><td>    1792-1<a name=\"cdcrec-1792-1\"> </a></td><td>Salamatof</td><td>Salamatof</td></tr><tr><td>3</td><td>    1793-9<a name=\"cdcrec-1793-9\"> </a></td><td>Seldovia</td><td>Seldovia</td></tr><tr><td>3</td><td>    1794-7<a name=\"cdcrec-1794-7\"> </a></td><td>Slana</td><td>Slana</td></tr><tr><td>3</td><td>    1795-4<a name=\"cdcrec-1795-4\"> </a></td><td>Shageluk</td><td>Shageluk</td></tr><tr><td>3</td><td>    1796-2<a name=\"cdcrec-1796-2\"> </a></td><td>Stevens</td><td>Stevens</td></tr><tr><td>3</td><td>    1797-0<a name=\"cdcrec-1797-0\"> </a></td><td>Stony River</td><td>Stony River</td></tr><tr><td>3</td><td>    1798-8<a name=\"cdcrec-1798-8\"> </a></td><td>Takotna</td><td>Takotna</td></tr><tr><td>3</td><td>    1799-6<a name=\"cdcrec-1799-6\"> </a></td><td>Tanacross</td><td>Tanacross</td></tr><tr><td>3</td><td>    1800-2<a name=\"cdcrec-1800-2\"> </a></td><td>Tanaina</td><td>Tanaina</td></tr><tr><td>3</td><td>    1801-0<a name=\"cdcrec-1801-0\"> </a></td><td>Tanana</td><td>Tanana</td></tr><tr><td>3</td><td>    1802-8<a name=\"cdcrec-1802-8\"> </a></td><td>Tanana Chiefs</td><td>Tanana Chiefs</td></tr><tr><td>3</td><td>    1803-6<a name=\"cdcrec-1803-6\"> </a></td><td>Tazlina</td><td>Tazlina</td></tr><tr><td>3</td><td>    1804-4<a name=\"cdcrec-1804-4\"> </a></td><td>Telida</td><td>Telida</td></tr><tr><td>3</td><td>    1805-1<a name=\"cdcrec-1805-1\"> </a></td><td>Tetlin</td><td>Tetlin</td></tr><tr><td>3</td><td>    1806-9<a name=\"cdcrec-1806-9\"> </a></td><td>Tok</td><td>Tok</td></tr><tr><td>3</td><td>    1807-7<a name=\"cdcrec-1807-7\"> </a></td><td>Tyonek</td><td>Tyonek</td></tr><tr><td>3</td><td>    1808-5<a name=\"cdcrec-1808-5\"> </a></td><td>Venetie</td><td>Venetie</td></tr><tr><td>3</td><td>    1809-3<a name=\"cdcrec-1809-3\"> </a></td><td>Wiseman</td><td>Wiseman</td></tr><tr><td>3</td><td>    1813-5<a name=\"cdcrec-1813-5\"> </a></td><td>Tlingit-Haida</td><td>Tlingit-Haida</td></tr><tr><td>3</td><td>    1837-4<a name=\"cdcrec-1837-4\"> </a></td><td>Tsimshian</td><td>Tsimshian</td></tr><tr><td>3</td><td>    1814-3<a name=\"cdcrec-1814-3\"> </a></td><td>Angoon</td><td>Angoon</td></tr><tr><td>3</td><td>    1815-0<a name=\"cdcrec-1815-0\"> </a></td><td>Central Council of Tlingit and Haida Tribes</td><td>Central Council of Tlingit and Haida Tribes</td></tr><tr><td>3</td><td>    1816-8<a name=\"cdcrec-1816-8\"> </a></td><td>Chilkat</td><td>Chilkat</td></tr><tr><td>3</td><td>    1817-6<a name=\"cdcrec-1817-6\"> </a></td><td>Chilkoot</td><td>Chilkoot</td></tr><tr><td>3</td><td>    1818-4<a name=\"cdcrec-1818-4\"> </a></td><td>Craig</td><td>Craig</td></tr><tr><td>3</td><td>    1819-2<a name=\"cdcrec-1819-2\"> </a></td><td>Douglas</td><td>Douglas</td></tr><tr><td>3</td><td>    1820-0<a name=\"cdcrec-1820-0\"> </a></td><td>Haida</td><td>Haida</td></tr><tr><td>3</td><td>    1821-8<a name=\"cdcrec-1821-8\"> </a></td><td>Hoonah</td><td>Hoonah</td></tr><tr><td>3</td><td>    1822-6<a name=\"cdcrec-1822-6\"> </a></td><td>Hydaburg</td><td>Hydaburg</td></tr><tr><td>3</td><td>    1823-4<a name=\"cdcrec-1823-4\"> </a></td><td>Kake</td><td>Kake</td></tr><tr><td>3</td><td>    1824-2<a name=\"cdcrec-1824-2\"> </a></td><td>Kasaan</td><td>Kasaan</td></tr><tr><td>3</td><td>    1825-9<a name=\"cdcrec-1825-9\"> </a></td><td>Kenaitze</td><td>Kenaitze</td></tr><tr><td>3</td><td>    1826-7<a name=\"cdcrec-1826-7\"> </a></td><td>Ketchikan</td><td>Ketchikan</td></tr><tr><td>3</td><td>    1827-5<a name=\"cdcrec-1827-5\"> </a></td><td>Klawock</td><td>Klawock</td></tr><tr><td>3</td><td>    1828-3<a name=\"cdcrec-1828-3\"> </a></td><td>Pelican</td><td>Pelican</td></tr><tr><td>3</td><td>    1829-1<a name=\"cdcrec-1829-1\"> </a></td><td>Petersburg</td><td>Petersburg</td></tr><tr><td>3</td><td>    1830-9<a name=\"cdcrec-1830-9\"> </a></td><td>Saxman</td><td>Saxman</td></tr><tr><td>3</td><td>    1831-7<a name=\"cdcrec-1831-7\"> </a></td><td>Sitka</td><td>Sitka</td></tr><tr><td>3</td><td>    1832-5<a name=\"cdcrec-1832-5\"> </a></td><td>Tenakee Springs</td><td>Tenakee Springs</td></tr><tr><td>3</td><td>    1833-3<a name=\"cdcrec-1833-3\"> </a></td><td>Tlingit</td><td>Tlingit</td></tr><tr><td>3</td><td>    1834-1<a name=\"cdcrec-1834-1\"> </a></td><td>Wrangell</td><td>Wrangell</td></tr><tr><td>3</td><td>    1835-8<a name=\"cdcrec-1835-8\"> </a></td><td>Yakutat</td><td>Yakutat</td></tr><tr><td>3</td><td>    1838-2<a name=\"cdcrec-1838-2\"> </a></td><td>Metlakatla</td><td>Metlakatla</td></tr><tr><td>3</td><td>    1842-4<a name=\"cdcrec-1842-4\"> </a></td><td>Greenland Eskimo</td><td>Greenland Eskimo</td></tr><tr><td>3</td><td>    1844-0<a name=\"cdcrec-1844-0\"> </a></td><td>Inupiat Eskimo</td><td>Inupiat Eskimo</td></tr><tr><td>3</td><td>    1891-1<a name=\"cdcrec-1891-1\"> </a></td><td>Siberian Eskimo</td><td>Siberian Eskimo</td></tr><tr><td>3</td><td>    1896-0<a name=\"cdcrec-1896-0\"> </a></td><td>Yupik Eskimo</td><td>Yupik Eskimo</td></tr><tr><td>3</td><td>    1845-7<a name=\"cdcrec-1845-7\"> </a></td><td>Ambler</td><td>Ambler</td></tr><tr><td>3</td><td>    1846-5<a name=\"cdcrec-1846-5\"> </a></td><td>Anaktuvuk</td><td>Anaktuvuk</td></tr><tr><td>3</td><td>    1847-3<a name=\"cdcrec-1847-3\"> </a></td><td>Anaktuvuk Pass</td><td>Anaktuvuk Pass</td></tr><tr><td>3</td><td>    1848-1<a name=\"cdcrec-1848-1\"> </a></td><td>Arctic Slope Inupiat</td><td>Arctic Slope Inupiat</td></tr><tr><td>3</td><td>    1849-9<a name=\"cdcrec-1849-9\"> </a></td><td>Arctic Slope Corporation</td><td>Arctic Slope Corporation</td></tr><tr><td>3</td><td>    1850-7<a name=\"cdcrec-1850-7\"> </a></td><td>Atqasuk</td><td>Atqasuk</td></tr><tr><td>3</td><td>    1851-5<a name=\"cdcrec-1851-5\"> </a></td><td>Barrow</td><td>Barrow</td></tr><tr><td>3</td><td>    1852-3<a name=\"cdcrec-1852-3\"> </a></td><td>Bering Straits Inupiat</td><td>Bering Straits Inupiat</td></tr><tr><td>3</td><td>    1853-1<a name=\"cdcrec-1853-1\"> </a></td><td>Brevig Mission</td><td>Brevig Mission</td></tr><tr><td>3</td><td>    1854-9<a name=\"cdcrec-1854-9\"> </a></td><td>Buckland</td><td>Buckland</td></tr><tr><td>3</td><td>    1855-6<a name=\"cdcrec-1855-6\"> </a></td><td>Chinik</td><td>Chinik</td></tr><tr><td>3</td><td>    1856-4<a name=\"cdcrec-1856-4\"> </a></td><td>Council</td><td>Council</td></tr><tr><td>3</td><td>    1857-2<a name=\"cdcrec-1857-2\"> </a></td><td>Deering</td><td>Deering</td></tr><tr><td>3</td><td>    1858-0<a name=\"cdcrec-1858-0\"> </a></td><td>Elim</td><td>Elim</td></tr><tr><td>3</td><td>    1859-8<a name=\"cdcrec-1859-8\"> </a></td><td>Golovin</td><td>Golovin</td></tr><tr><td>3</td><td>    1860-6<a name=\"cdcrec-1860-6\"> </a></td><td>Inalik Diomede</td><td>Inalik Diomede</td></tr><tr><td>3</td><td>    1861-4<a name=\"cdcrec-1861-4\"> </a></td><td>Inupiaq</td><td>Inupiaq</td></tr><tr><td>3</td><td>    1862-2<a name=\"cdcrec-1862-2\"> </a></td><td>Kaktovik</td><td>Kaktovik</td></tr><tr><td>3</td><td>    1863-0<a name=\"cdcrec-1863-0\"> </a></td><td>Kawerak</td><td>Kawerak</td></tr><tr><td>3</td><td>    1864-8<a name=\"cdcrec-1864-8\"> </a></td><td>Kiana</td><td>Kiana</td></tr><tr><td>3</td><td>    1865-5<a name=\"cdcrec-1865-5\"> </a></td><td>Kivalina</td><td>Kivalina</td></tr><tr><td>3</td><td>    1866-3<a name=\"cdcrec-1866-3\"> </a></td><td>Kobuk</td><td>Kobuk</td></tr><tr><td>3</td><td>    1867-1<a name=\"cdcrec-1867-1\"> </a></td><td>Kotzebue</td><td>Kotzebue</td></tr><tr><td>3</td><td>    1868-9<a name=\"cdcrec-1868-9\"> </a></td><td>Koyuk</td><td>Koyuk</td></tr><tr><td>3</td><td>    1869-7<a name=\"cdcrec-1869-7\"> </a></td><td>Kwiguk</td><td>Kwiguk</td></tr><tr><td>3</td><td>    1870-5<a name=\"cdcrec-1870-5\"> </a></td><td>Mauneluk Inupiat</td><td>Mauneluk Inupiat</td></tr><tr><td>3</td><td>    1871-3<a name=\"cdcrec-1871-3\"> </a></td><td>Nana Inupiat</td><td>Nana Inupiat</td></tr><tr><td>3</td><td>    1872-1<a name=\"cdcrec-1872-1\"> </a></td><td>Noatak</td><td>Noatak</td></tr><tr><td>3</td><td>    1873-9<a name=\"cdcrec-1873-9\"> </a></td><td>Nome</td><td>Nome</td></tr><tr><td>3</td><td>    1874-7<a name=\"cdcrec-1874-7\"> </a></td><td>Noorvik</td><td>Noorvik</td></tr><tr><td>3</td><td>    1875-4<a name=\"cdcrec-1875-4\"> </a></td><td>Nuiqsut</td><td>Nuiqsut</td></tr><tr><td>3</td><td>    1876-2<a name=\"cdcrec-1876-2\"> </a></td><td>Point Hope</td><td>Point Hope</td></tr><tr><td>3</td><td>    1877-0<a name=\"cdcrec-1877-0\"> </a></td><td>Point Lay</td><td>Point Lay</td></tr><tr><td>3</td><td>    1878-8<a name=\"cdcrec-1878-8\"> </a></td><td>Selawik</td><td>Selawik</td></tr><tr><td>3</td><td>    1879-6<a name=\"cdcrec-1879-6\"> </a></td><td>Shaktoolik</td><td>Shaktoolik</td></tr><tr><td>3</td><td>    1880-4<a name=\"cdcrec-1880-4\"> </a></td><td>Shishmaref</td><td>Shishmaref</td></tr><tr><td>3</td><td>    1881-2<a name=\"cdcrec-1881-2\"> </a></td><td>Shungnak</td><td>Shungnak</td></tr><tr><td>3</td><td>    1882-0<a name=\"cdcrec-1882-0\"> </a></td><td>Solomon</td><td>Solomon</td></tr><tr><td>3</td><td>    1883-8<a name=\"cdcrec-1883-8\"> </a></td><td>Teller</td><td>Teller</td></tr><tr><td>3</td><td>    1884-6<a name=\"cdcrec-1884-6\"> </a></td><td>Unalakleet</td><td>Unalakleet</td></tr><tr><td>3</td><td>    1885-3<a name=\"cdcrec-1885-3\"> </a></td><td>Wainwright</td><td>Wainwright</td></tr><tr><td>3</td><td>    1886-1<a name=\"cdcrec-1886-1\"> </a></td><td>Wales</td><td>Wales</td></tr><tr><td>3</td><td>    1887-9<a name=\"cdcrec-1887-9\"> </a></td><td>White Mountain</td><td>White Mountain</td></tr><tr><td>3</td><td>    1888-7<a name=\"cdcrec-1888-7\"> </a></td><td>White Mountain Inupiat</td><td>White Mountain Inupiat</td></tr><tr><td>3</td><td>    1889-5<a name=\"cdcrec-1889-5\"> </a></td><td>Mary's Igloo</td><td>Mary's Igloo</td></tr><tr><td>3</td><td>    1892-9<a name=\"cdcrec-1892-9\"> </a></td><td>Gambell</td><td>Gambell</td></tr><tr><td>3</td><td>    1893-7<a name=\"cdcrec-1893-7\"> </a></td><td>Savoonga</td><td>Savoonga</td></tr><tr><td>3</td><td>    1894-5<a name=\"cdcrec-1894-5\"> </a></td><td>Siberian Yupik</td><td>Siberian Yupik</td></tr><tr><td>3</td><td>    1897-8<a name=\"cdcrec-1897-8\"> </a></td><td>Akiachak</td><td>Akiachak</td></tr><tr><td>3</td><td>    1898-6<a name=\"cdcrec-1898-6\"> </a></td><td>Akiak</td><td>Akiak</td></tr><tr><td>3</td><td>    1899-4<a name=\"cdcrec-1899-4\"> </a></td><td>Alakanuk</td><td>Alakanuk</td></tr><tr><td>3</td><td>    1900-0<a name=\"cdcrec-1900-0\"> </a></td><td>Aleknagik</td><td>Aleknagik</td></tr><tr><td>3</td><td>    1901-8<a name=\"cdcrec-1901-8\"> </a></td><td>Andreafsky</td><td>Andreafsky</td></tr><tr><td>3</td><td>    1902-6<a name=\"cdcrec-1902-6\"> </a></td><td>Aniak</td><td>Aniak</td></tr><tr><td>3</td><td>    1903-4<a name=\"cdcrec-1903-4\"> </a></td><td>Atmautluak</td><td>Atmautluak</td></tr><tr><td>3</td><td>    1904-2<a name=\"cdcrec-1904-2\"> </a></td><td>Bethel</td><td>Bethel</td></tr><tr><td>3</td><td>    1905-9<a name=\"cdcrec-1905-9\"> </a></td><td>Bill Moore's Slough</td><td>Bill Moore's Slough</td></tr><tr><td>3</td><td>    1906-7<a name=\"cdcrec-1906-7\"> </a></td><td>Bristol Bay Yupik</td><td>Bristol Bay Yupik</td></tr><tr><td>3</td><td>    1907-5<a name=\"cdcrec-1907-5\"> </a></td><td>Calista Yupik</td><td>Calista Yupik</td></tr><tr><td>3</td><td>    1908-3<a name=\"cdcrec-1908-3\"> </a></td><td>Chefornak</td><td>Chefornak</td></tr><tr><td>3</td><td>    1909-1<a name=\"cdcrec-1909-1\"> </a></td><td>Chevak</td><td>Chevak</td></tr><tr><td>3</td><td>    1910-9<a name=\"cdcrec-1910-9\"> </a></td><td>Chuathbaluk</td><td>Chuathbaluk</td></tr><tr><td>3</td><td>    1911-7<a name=\"cdcrec-1911-7\"> </a></td><td>Clark's Point</td><td>Clark's Point</td></tr><tr><td>3</td><td>    1912-5<a name=\"cdcrec-1912-5\"> </a></td><td>Crooked Creek</td><td>Crooked Creek</td></tr><tr><td>3</td><td>    1913-3<a name=\"cdcrec-1913-3\"> </a></td><td>Dillingham</td><td>Dillingham</td></tr><tr><td>3</td><td>    1914-1<a name=\"cdcrec-1914-1\"> </a></td><td>Eek</td><td>Eek</td></tr><tr><td>3</td><td>    1915-8<a name=\"cdcrec-1915-8\"> </a></td><td>Ekuk</td><td>Ekuk</td></tr><tr><td>3</td><td>    1916-6<a name=\"cdcrec-1916-6\"> </a></td><td>Ekwok</td><td>Ekwok</td></tr><tr><td>3</td><td>    1917-4<a name=\"cdcrec-1917-4\"> </a></td><td>Emmonak</td><td>Emmonak</td></tr><tr><td>3</td><td>    1918-2<a name=\"cdcrec-1918-2\"> </a></td><td>Goodnews Bay</td><td>Goodnews Bay</td></tr><tr><td>3</td><td>    1919-0<a name=\"cdcrec-1919-0\"> </a></td><td>Hooper Bay</td><td>Hooper Bay</td></tr><tr><td>3</td><td>    1920-8<a name=\"cdcrec-1920-8\"> </a></td><td>Iqurmuit (Russian Mission)</td><td>Iqurmuit (Russian Mission)</td></tr><tr><td>3</td><td>    1921-6<a name=\"cdcrec-1921-6\"> </a></td><td>Kalskag</td><td>Kalskag</td></tr><tr><td>3</td><td>    1922-4<a name=\"cdcrec-1922-4\"> </a></td><td>Kasigluk</td><td>Kasigluk</td></tr><tr><td>3</td><td>    1923-2<a name=\"cdcrec-1923-2\"> </a></td><td>Kipnuk</td><td>Kipnuk</td></tr><tr><td>3</td><td>    1924-0<a name=\"cdcrec-1924-0\"> </a></td><td>Koliganek</td><td>Koliganek</td></tr><tr><td>3</td><td>    1925-7<a name=\"cdcrec-1925-7\"> </a></td><td>Kongiganak</td><td>Kongiganak</td></tr><tr><td>3</td><td>    1926-5<a name=\"cdcrec-1926-5\"> </a></td><td>Kotlik</td><td>Kotlik</td></tr><tr><td>3</td><td>    1927-3<a name=\"cdcrec-1927-3\"> </a></td><td>Kwethluk</td><td>Kwethluk</td></tr><tr><td>3</td><td>    1928-1<a name=\"cdcrec-1928-1\"> </a></td><td>Kwigillingok</td><td>Kwigillingok</td></tr><tr><td>3</td><td>    1929-9<a name=\"cdcrec-1929-9\"> </a></td><td>Levelock</td><td>Levelock</td></tr><tr><td>3</td><td>    1930-7<a name=\"cdcrec-1930-7\"> </a></td><td>Lower Kalskag</td><td>Lower Kalskag</td></tr><tr><td>3</td><td>    1931-5<a name=\"cdcrec-1931-5\"> </a></td><td>Manokotak</td><td>Manokotak</td></tr><tr><td>3</td><td>    1932-3<a name=\"cdcrec-1932-3\"> </a></td><td>Marshall</td><td>Marshall</td></tr><tr><td>3</td><td>    1933-1<a name=\"cdcrec-1933-1\"> </a></td><td>Mekoryuk</td><td>Mekoryuk</td></tr><tr><td>3</td><td>    1934-9<a name=\"cdcrec-1934-9\"> </a></td><td>Mountain Village</td><td>Mountain Village</td></tr><tr><td>3</td><td>    1935-6<a name=\"cdcrec-1935-6\"> </a></td><td>Naknek</td><td>Naknek</td></tr><tr><td>3</td><td>    1936-4<a name=\"cdcrec-1936-4\"> </a></td><td>Napaumute</td><td>Napaumute</td></tr><tr><td>3</td><td>    1937-2<a name=\"cdcrec-1937-2\"> </a></td><td>Napakiak</td><td>Napakiak</td></tr><tr><td>3</td><td>    1938-0<a name=\"cdcrec-1938-0\"> </a></td><td>Napaskiak</td><td>Napaskiak</td></tr><tr><td>3</td><td>    1939-8<a name=\"cdcrec-1939-8\"> </a></td><td>Newhalen</td><td>Newhalen</td></tr><tr><td>3</td><td>    1940-6<a name=\"cdcrec-1940-6\"> </a></td><td>New Stuyahok</td><td>New Stuyahok</td></tr><tr><td>3</td><td>    1941-4<a name=\"cdcrec-1941-4\"> </a></td><td>Newtok</td><td>Newtok</td></tr><tr><td>3</td><td>    1942-2<a name=\"cdcrec-1942-2\"> </a></td><td>Nightmute</td><td>Nightmute</td></tr><tr><td>3</td><td>    1943-0<a name=\"cdcrec-1943-0\"> </a></td><td>Nunapitchukv</td><td>Nunapitchukv</td></tr><tr><td>3</td><td>    1944-8<a name=\"cdcrec-1944-8\"> </a></td><td>Oscarville</td><td>Oscarville</td></tr><tr><td>3</td><td>    1945-5<a name=\"cdcrec-1945-5\"> </a></td><td>Pilot Station</td><td>Pilot Station</td></tr><tr><td>3</td><td>    1946-3<a name=\"cdcrec-1946-3\"> </a></td><td>Pitkas Point</td><td>Pitkas Point</td></tr><tr><td>3</td><td>    1947-1<a name=\"cdcrec-1947-1\"> </a></td><td>Platinum</td><td>Platinum</td></tr><tr><td>3</td><td>    1948-9<a name=\"cdcrec-1948-9\"> </a></td><td>Portage Creek</td><td>Portage Creek</td></tr><tr><td>3</td><td>    1949-7<a name=\"cdcrec-1949-7\"> </a></td><td>Quinhagak</td><td>Quinhagak</td></tr><tr><td>3</td><td>    1950-5<a name=\"cdcrec-1950-5\"> </a></td><td>Red Devil</td><td>Red Devil</td></tr><tr><td>3</td><td>    1951-3<a name=\"cdcrec-1951-3\"> </a></td><td>St. Michael</td><td>St. Michael</td></tr><tr><td>3</td><td>    1952-1<a name=\"cdcrec-1952-1\"> </a></td><td>Scammon Bay</td><td>Scammon Bay</td></tr><tr><td>3</td><td>    1953-9<a name=\"cdcrec-1953-9\"> </a></td><td>Sheldon's Point</td><td>Sheldon's Point</td></tr><tr><td>3</td><td>    1954-7<a name=\"cdcrec-1954-7\"> </a></td><td>Sleetmute</td><td>Sleetmute</td></tr><tr><td>3</td><td>    1955-4<a name=\"cdcrec-1955-4\"> </a></td><td>Stebbins</td><td>Stebbins</td></tr><tr><td>3</td><td>    1956-2<a name=\"cdcrec-1956-2\"> </a></td><td>Togiak</td><td>Togiak</td></tr><tr><td>3</td><td>    1957-0<a name=\"cdcrec-1957-0\"> </a></td><td>Toksook</td><td>Toksook</td></tr><tr><td>3</td><td>    1958-8<a name=\"cdcrec-1958-8\"> </a></td><td>Tulukskak</td><td>Tulukskak</td></tr><tr><td>3</td><td>    1959-6<a name=\"cdcrec-1959-6\"> </a></td><td>Tuntutuliak</td><td>Tuntutuliak</td></tr><tr><td>3</td><td>    1960-4<a name=\"cdcrec-1960-4\"> </a></td><td>Tununak</td><td>Tununak</td></tr><tr><td>3</td><td>    1961-2<a name=\"cdcrec-1961-2\"> </a></td><td>Twin Hills</td><td>Twin Hills</td></tr><tr><td>3</td><td>    1962-0<a name=\"cdcrec-1962-0\"> </a></td><td>Georgetown (Yupik-Eskimo)</td><td>Georgetown (Yupik-Eskimo)</td></tr><tr><td>3</td><td>    1963-8<a name=\"cdcrec-1963-8\"> </a></td><td>St. Mary's</td><td>St. Mary's</td></tr><tr><td>3</td><td>    1964-6<a name=\"cdcrec-1964-6\"> </a></td><td>Umkumiate</td><td>Umkumiate</td></tr><tr><td>3</td><td>    1968-7<a name=\"cdcrec-1968-7\"> </a></td><td>Alutiiq Aleut</td><td>Alutiiq Aleut</td></tr><tr><td>3</td><td>    1972-9<a name=\"cdcrec-1972-9\"> </a></td><td>Bristol Bay Aleut</td><td>Bristol Bay Aleut</td></tr><tr><td>3</td><td>    1984-4<a name=\"cdcrec-1984-4\"> </a></td><td>Chugach Aleut</td><td>Chugach Aleut</td></tr><tr><td>3</td><td>    1990-1<a name=\"cdcrec-1990-1\"> </a></td><td>Eyak</td><td>Eyak</td></tr><tr><td>3</td><td>    1992-7<a name=\"cdcrec-1992-7\"> </a></td><td>Koniag Aleut</td><td>Koniag Aleut</td></tr><tr><td>3</td><td>    2002-4<a name=\"cdcrec-2002-4\"> </a></td><td>Sugpiaq</td><td>Sugpiaq</td></tr><tr><td>3</td><td>    2004-0<a name=\"cdcrec-2004-0\"> </a></td><td>Suqpigaq</td><td>Suqpigaq</td></tr><tr><td>3</td><td>    2006-5<a name=\"cdcrec-2006-5\"> </a></td><td>Unangan Aleut</td><td>Unangan Aleut</td></tr><tr><td>3</td><td>    1969-5<a name=\"cdcrec-1969-5\"> </a></td><td>Tatitlek</td><td>Tatitlek</td></tr><tr><td>3</td><td>    1970-3<a name=\"cdcrec-1970-3\"> </a></td><td>Ugashik</td><td>Ugashik</td></tr><tr><td>3</td><td>    1973-7<a name=\"cdcrec-1973-7\"> </a></td><td>Chignik</td><td>Chignik</td></tr><tr><td>3</td><td>    1974-5<a name=\"cdcrec-1974-5\"> </a></td><td>Chignik Lake</td><td>Chignik Lake</td></tr><tr><td>3</td><td>    1975-2<a name=\"cdcrec-1975-2\"> </a></td><td>Egegik</td><td>Egegik</td></tr><tr><td>3</td><td>    1976-0<a name=\"cdcrec-1976-0\"> </a></td><td>Igiugig</td><td>Igiugig</td></tr><tr><td>3</td><td>    1977-8<a name=\"cdcrec-1977-8\"> </a></td><td>Ivanof Bay</td><td>Ivanof Bay</td></tr><tr><td>3</td><td>    1978-6<a name=\"cdcrec-1978-6\"> </a></td><td>King Salmon</td><td>King Salmon</td></tr><tr><td>3</td><td>    1979-4<a name=\"cdcrec-1979-4\"> </a></td><td>Kokhanok</td><td>Kokhanok</td></tr><tr><td>3</td><td>    1980-2<a name=\"cdcrec-1980-2\"> </a></td><td>Perryville</td><td>Perryville</td></tr><tr><td>3</td><td>    1981-0<a name=\"cdcrec-1981-0\"> </a></td><td>Pilot Point</td><td>Pilot Point</td></tr><tr><td>3</td><td>    1982-8<a name=\"cdcrec-1982-8\"> </a></td><td>Port Heiden</td><td>Port Heiden</td></tr><tr><td>3</td><td>    1985-1<a name=\"cdcrec-1985-1\"> </a></td><td>Chenega</td><td>Chenega</td></tr><tr><td>3</td><td>    1986-9<a name=\"cdcrec-1986-9\"> </a></td><td>Chugach Corporation</td><td>Chugach Corporation</td></tr><tr><td>3</td><td>    1987-7<a name=\"cdcrec-1987-7\"> </a></td><td>English Bay</td><td>English Bay</td></tr><tr><td>3</td><td>    1988-5<a name=\"cdcrec-1988-5\"> </a></td><td>Port Graham</td><td>Port Graham</td></tr><tr><td>3</td><td>    1993-5<a name=\"cdcrec-1993-5\"> </a></td><td>Akhiok</td><td>Akhiok</td></tr><tr><td>3</td><td>    1994-3<a name=\"cdcrec-1994-3\"> </a></td><td>Agdaagux</td><td>Agdaagux</td></tr><tr><td>3</td><td>    1995-0<a name=\"cdcrec-1995-0\"> </a></td><td>Karluk</td><td>Karluk</td></tr><tr><td>3</td><td>    1996-8<a name=\"cdcrec-1996-8\"> </a></td><td>Kodiak</td><td>Kodiak</td></tr><tr><td>3</td><td>    1997-6<a name=\"cdcrec-1997-6\"> </a></td><td>Larsen Bay</td><td>Larsen Bay</td></tr><tr><td>3</td><td>    1998-4<a name=\"cdcrec-1998-4\"> </a></td><td>Old Harbor</td><td>Old Harbor</td></tr><tr><td>3</td><td>    1999-2<a name=\"cdcrec-1999-2\"> </a></td><td>Ouzinkie</td><td>Ouzinkie</td></tr><tr><td>3</td><td>    2000-8<a name=\"cdcrec-2000-8\"> </a></td><td>Port Lions</td><td>Port Lions</td></tr><tr><td>3</td><td>    2007-3<a name=\"cdcrec-2007-3\"> </a></td><td>Akutan</td><td>Akutan</td></tr><tr><td>3</td><td>    2008-1<a name=\"cdcrec-2008-1\"> </a></td><td>Aleut Corporation</td><td>Aleut Corporation</td></tr><tr><td>3</td><td>    2009-9<a name=\"cdcrec-2009-9\"> </a></td><td>Aleutian</td><td>Aleutian</td></tr><tr><td>3</td><td>    2010-7<a name=\"cdcrec-2010-7\"> </a></td><td>Aleutian Islander</td><td>Aleutian Islander</td></tr><tr><td>3</td><td>    2011-5<a name=\"cdcrec-2011-5\"> </a></td><td>Atka</td><td>Atka</td></tr><tr><td>3</td><td>    2012-3<a name=\"cdcrec-2012-3\"> </a></td><td>Belkofski</td><td>Belkofski</td></tr><tr><td>3</td><td>    2013-1<a name=\"cdcrec-2013-1\"> </a></td><td>Chignik Lagoon</td><td>Chignik Lagoon</td></tr><tr><td>3</td><td>    2014-9<a name=\"cdcrec-2014-9\"> </a></td><td>King Cove</td><td>King Cove</td></tr><tr><td>3</td><td>    2015-6<a name=\"cdcrec-2015-6\"> </a></td><td>False Pass</td><td>False Pass</td></tr><tr><td>3</td><td>    2016-4<a name=\"cdcrec-2016-4\"> </a></td><td>Nelson Lagoon</td><td>Nelson Lagoon</td></tr><tr><td>3</td><td>    2017-2<a name=\"cdcrec-2017-2\"> </a></td><td>Nikolski</td><td>Nikolski</td></tr><tr><td>3</td><td>    2018-0<a name=\"cdcrec-2018-0\"> </a></td><td>Pauloff Harbor</td><td>Pauloff Harbor</td></tr><tr><td>3</td><td>    2019-8<a name=\"cdcrec-2019-8\"> </a></td><td>Qagan Toyagungin</td><td>Qagan Toyagungin</td></tr><tr><td>3</td><td>    2020-6<a name=\"cdcrec-2020-6\"> </a></td><td>Qawalangin</td><td>Qawalangin</td></tr><tr><td>3</td><td>    2021-4<a name=\"cdcrec-2021-4\"> </a></td><td>St. George</td><td>St. George</td></tr><tr><td>3</td><td>    2022-2<a name=\"cdcrec-2022-2\"> </a></td><td>St. Paul</td><td>St. Paul</td></tr><tr><td>3</td><td>    2023-0<a name=\"cdcrec-2023-0\"> </a></td><td>Sand Point</td><td>Sand Point</td></tr><tr><td>3</td><td>    2024-8<a name=\"cdcrec-2024-8\"> </a></td><td>South Naknek</td><td>South Naknek</td></tr><tr><td>3</td><td>    2025-5<a name=\"cdcrec-2025-5\"> </a></td><td>Unalaska</td><td>Unalaska</td></tr><tr><td>3</td><td>    2026-3<a name=\"cdcrec-2026-3\"> </a></td><td>Unga</td><td>Unga</td></tr><tr><td>2</td><td>  2028-9<a name=\"cdcrec-2028-9\"> </a></td><td>Asian</td><td>Asian</td></tr><tr><td>3</td><td>    2029-7<a name=\"cdcrec-2029-7\"> </a></td><td>Asian Indian</td><td>Asian Indian</td></tr><tr><td>3</td><td>    2030-5<a name=\"cdcrec-2030-5\"> </a></td><td>Bangladeshi</td><td>Bangladeshi</td></tr><tr><td>3</td><td>    2031-3<a name=\"cdcrec-2031-3\"> </a></td><td>Bhutanese</td><td>Bhutanese</td></tr><tr><td>3</td><td>    2032-1<a name=\"cdcrec-2032-1\"> </a></td><td>Burmese</td><td>Burmese</td></tr><tr><td>3</td><td>    2033-9<a name=\"cdcrec-2033-9\"> </a></td><td>Cambodian</td><td>Cambodian</td></tr><tr><td>3</td><td>    2034-7<a name=\"cdcrec-2034-7\"> </a></td><td>Chinese</td><td>Chinese</td></tr><tr><td>3</td><td>    2035-4<a name=\"cdcrec-2035-4\"> </a></td><td>Taiwanese</td><td>Taiwanese</td></tr><tr><td>3</td><td>    2036-2<a name=\"cdcrec-2036-2\"> </a></td><td>Filipino</td><td>Filipino</td></tr><tr><td>3</td><td>    2037-0<a name=\"cdcrec-2037-0\"> </a></td><td>Hmong</td><td>Hmong</td></tr><tr><td>3</td><td>    2038-8<a name=\"cdcrec-2038-8\"> </a></td><td>Indonesian</td><td>Indonesian</td></tr><tr><td>3</td><td>    2039-6<a name=\"cdcrec-2039-6\"> </a></td><td>Japanese</td><td>Japanese</td></tr><tr><td>3</td><td>    2040-4<a name=\"cdcrec-2040-4\"> </a></td><td>Korean</td><td>Korean</td></tr><tr><td>3</td><td>    2041-2<a name=\"cdcrec-2041-2\"> </a></td><td>Laotian</td><td>Laotian</td></tr><tr><td>3</td><td>    2042-0<a name=\"cdcrec-2042-0\"> </a></td><td>Malaysian</td><td>Malaysian</td></tr><tr><td>3</td><td>    2043-8<a name=\"cdcrec-2043-8\"> </a></td><td>Okinawan</td><td>Okinawan</td></tr><tr><td>3</td><td>    2044-6<a name=\"cdcrec-2044-6\"> </a></td><td>Pakistani</td><td>Pakistani</td></tr><tr><td>3</td><td>    2045-3<a name=\"cdcrec-2045-3\"> </a></td><td>Sri Lankan</td><td>Sri Lankan</td></tr><tr><td>3</td><td>    2046-1<a name=\"cdcrec-2046-1\"> </a></td><td>Thai</td><td>Thai</td></tr><tr><td>3</td><td>    2047-9<a name=\"cdcrec-2047-9\"> </a></td><td>Vietnamese</td><td>Vietnamese</td></tr><tr><td>3</td><td>    2048-7<a name=\"cdcrec-2048-7\"> </a></td><td>Iwo Jiman</td><td>Iwo Jiman</td></tr><tr><td>3</td><td>    2049-5<a name=\"cdcrec-2049-5\"> </a></td><td>Maldivian</td><td>Maldivian</td></tr><tr><td>3</td><td>    2050-3<a name=\"cdcrec-2050-3\"> </a></td><td>Nepalese</td><td>Nepalese</td></tr><tr><td>3</td><td>    2051-1<a name=\"cdcrec-2051-1\"> </a></td><td>Singaporean</td><td>Singaporean</td></tr><tr><td>3</td><td>    2052-9<a name=\"cdcrec-2052-9\"> </a></td><td>Madagascar</td><td>Madagascar</td></tr><tr><td>2</td><td>  2054-5<a name=\"cdcrec-2054-5\"> </a></td><td>Black or African American</td><td>Black or African American</td></tr><tr><td>3</td><td>    2056-0<a name=\"cdcrec-2056-0\"> </a></td><td>Black</td><td>Black</td></tr><tr><td>3</td><td>    2058-6<a name=\"cdcrec-2058-6\"> </a></td><td>African American</td><td>African American</td></tr><tr><td>3</td><td>    2060-2<a name=\"cdcrec-2060-2\"> </a></td><td>African</td><td>African</td></tr><tr><td>3</td><td>    2067-7<a name=\"cdcrec-2067-7\"> </a></td><td>Bahamian</td><td>Bahamian</td></tr><tr><td>3</td><td>    2068-5<a name=\"cdcrec-2068-5\"> </a></td><td>Barbadian</td><td>Barbadian</td></tr><tr><td>3</td><td>    2069-3<a name=\"cdcrec-2069-3\"> </a></td><td>Dominican</td><td>Dominican</td></tr><tr><td>3</td><td>    2070-1<a name=\"cdcrec-2070-1\"> </a></td><td>Dominica Islander</td><td>Dominica Islander</td></tr><tr><td>3</td><td>    2071-9<a name=\"cdcrec-2071-9\"> </a></td><td>Haitian</td><td>Haitian</td></tr><tr><td>3</td><td>    2072-7<a name=\"cdcrec-2072-7\"> </a></td><td>Jamaican</td><td>Jamaican</td></tr><tr><td>3</td><td>    2073-5<a name=\"cdcrec-2073-5\"> </a></td><td>Tobagoan</td><td>Tobagoan</td></tr><tr><td>3</td><td>    2074-3<a name=\"cdcrec-2074-3\"> </a></td><td>Trinidadian</td><td>Trinidadian</td></tr><tr><td>3</td><td>    2075-0<a name=\"cdcrec-2075-0\"> </a></td><td>West Indian</td><td>West Indian</td></tr><tr><td>3</td><td>    2061-0<a name=\"cdcrec-2061-0\"> </a></td><td>Botswanan</td><td>Botswanan</td></tr><tr><td>3</td><td>    2062-8<a name=\"cdcrec-2062-8\"> </a></td><td>Ethiopian</td><td>Ethiopian</td></tr><tr><td>3</td><td>    2063-6<a name=\"cdcrec-2063-6\"> </a></td><td>Liberian</td><td>Liberian</td></tr><tr><td>3</td><td>    2064-4<a name=\"cdcrec-2064-4\"> </a></td><td>Namibian</td><td>Namibian</td></tr><tr><td>3</td><td>    2065-1<a name=\"cdcrec-2065-1\"> </a></td><td>Nigerian</td><td>Nigerian</td></tr><tr><td>3</td><td>    2066-9<a name=\"cdcrec-2066-9\"> </a></td><td>Zairean</td><td>Zairean</td></tr><tr><td>2</td><td>  2076-8<a name=\"cdcrec-2076-8\"> </a></td><td>Native Hawaiian or Other Pacific Islander</td><td>Native Hawaiian or Other Pacific Islander</td></tr><tr><td>3</td><td>    2078-4<a name=\"cdcrec-2078-4\"> </a></td><td>Polynesian</td><td>Polynesian</td></tr><tr><td>3</td><td>    2085-9<a name=\"cdcrec-2085-9\"> </a></td><td>Micronesian</td><td>Micronesian</td></tr><tr><td>3</td><td>    2100-6<a name=\"cdcrec-2100-6\"> </a></td><td>Melanesian</td><td>Melanesian</td></tr><tr><td>3</td><td>    2500-7<a name=\"cdcrec-2500-7\"> </a></td><td>Other Pacific Islander</td><td>Other Pacific Islander</td></tr><tr><td>3</td><td>    2079-2<a name=\"cdcrec-2079-2\"> </a></td><td>Native Hawaiian</td><td>Native Hawaiian</td></tr><tr><td>3</td><td>    2080-0<a name=\"cdcrec-2080-0\"> </a></td><td>Samoan</td><td>Samoan</td></tr><tr><td>3</td><td>    2081-8<a name=\"cdcrec-2081-8\"> </a></td><td>Tahitian</td><td>Tahitian</td></tr><tr><td>3</td><td>    2082-6<a name=\"cdcrec-2082-6\"> </a></td><td>Tongan</td><td>Tongan</td></tr><tr><td>3</td><td>    2083-4<a name=\"cdcrec-2083-4\"> </a></td><td>Tokelauan</td><td>Tokelauan</td></tr><tr><td>3</td><td>    2086-7<a name=\"cdcrec-2086-7\"> </a></td><td>Guamanian or Chamorro</td><td>Guamanian or Chamorro</td></tr><tr><td>3</td><td>    2087-5<a name=\"cdcrec-2087-5\"> </a></td><td>Guamanian</td><td>Guamanian</td></tr><tr><td>3</td><td>    2088-3<a name=\"cdcrec-2088-3\"> </a></td><td>Chamorro</td><td>Chamorro</td></tr><tr><td>3</td><td>    2089-1<a name=\"cdcrec-2089-1\"> </a></td><td>Mariana Islander</td><td>Mariana Islander</td></tr><tr><td>3</td><td>    2090-9<a name=\"cdcrec-2090-9\"> </a></td><td>Marshallese</td><td>Marshallese</td></tr><tr><td>3</td><td>    2091-7<a name=\"cdcrec-2091-7\"> </a></td><td>Palauan</td><td>Palauan</td></tr><tr><td>3</td><td>    2092-5<a name=\"cdcrec-2092-5\"> </a></td><td>Carolinian</td><td>Carolinian</td></tr><tr><td>3</td><td>    2093-3<a name=\"cdcrec-2093-3\"> </a></td><td>Kosraean</td><td>Kosraean</td></tr><tr><td>3</td><td>    2094-1<a name=\"cdcrec-2094-1\"> </a></td><td>Pohnpeian</td><td>Pohnpeian</td></tr><tr><td>3</td><td>    2095-8<a name=\"cdcrec-2095-8\"> </a></td><td>Saipanese</td><td>Saipanese</td></tr><tr><td>3</td><td>    2096-6<a name=\"cdcrec-2096-6\"> </a></td><td>Kiribati</td><td>Kiribati</td></tr><tr><td>3</td><td>    2097-4<a name=\"cdcrec-2097-4\"> </a></td><td>Chuukese</td><td>Chuukese</td></tr><tr><td>3</td><td>    2098-2<a name=\"cdcrec-2098-2\"> </a></td><td>Yapese</td><td>Yapese</td></tr><tr><td>3</td><td>    2101-4<a name=\"cdcrec-2101-4\"> </a></td><td>Fijian</td><td>Fijian</td></tr><tr><td>3</td><td>    2102-2<a name=\"cdcrec-2102-2\"> </a></td><td>Papua New Guinean</td><td>Papua New Guinean</td></tr><tr><td>3</td><td>    2103-0<a name=\"cdcrec-2103-0\"> </a></td><td>Solomon Islander</td><td>Solomon Islander</td></tr><tr><td>3</td><td>    2104-8<a name=\"cdcrec-2104-8\"> </a></td><td>New Hebrides</td><td>New Hebrides</td></tr><tr><td>2</td><td>  2106-3<a name=\"cdcrec-2106-3\"> </a></td><td>White</td><td>White</td></tr><tr><td>3</td><td>    2108-9<a name=\"cdcrec-2108-9\"> </a></td><td>European</td><td>European</td></tr><tr><td>3</td><td>    2118-8<a name=\"cdcrec-2118-8\"> </a></td><td>Middle Eastern or North African</td><td>Middle Eastern or North African</td></tr><tr><td>3</td><td>    2129-5<a name=\"cdcrec-2129-5\"> </a></td><td>Arab</td><td>Arab</td></tr><tr><td>3</td><td>    2109-7<a name=\"cdcrec-2109-7\"> </a></td><td>Armenian</td><td>Armenian</td></tr><tr><td>3</td><td>    2110-5<a name=\"cdcrec-2110-5\"> </a></td><td>English</td><td>English</td></tr><tr><td>3</td><td>    2111-3<a name=\"cdcrec-2111-3\"> </a></td><td>French</td><td>French</td></tr><tr><td>3</td><td>    2112-1<a name=\"cdcrec-2112-1\"> </a></td><td>German</td><td>German</td></tr><tr><td>3</td><td>    2113-9<a name=\"cdcrec-2113-9\"> </a></td><td>Irish</td><td>Irish</td></tr><tr><td>3</td><td>    2114-7<a name=\"cdcrec-2114-7\"> </a></td><td>Italian</td><td>Italian</td></tr><tr><td>3</td><td>    2115-4<a name=\"cdcrec-2115-4\"> </a></td><td>Polish</td><td>Polish</td></tr><tr><td>3</td><td>    2116-2<a name=\"cdcrec-2116-2\"> </a></td><td>Scottish</td><td>Scottish</td></tr><tr><td>3</td><td>    2119-6<a name=\"cdcrec-2119-6\"> </a></td><td>Assyrian</td><td>Assyrian</td></tr><tr><td>3</td><td>    2120-4<a name=\"cdcrec-2120-4\"> </a></td><td>Egyptian</td><td>Egyptian</td></tr><tr><td>3</td><td>    2121-2<a name=\"cdcrec-2121-2\"> </a></td><td>Iranian</td><td>Iranian</td></tr><tr><td>3</td><td>    2122-0<a name=\"cdcrec-2122-0\"> </a></td><td>Iraqi</td><td>Iraqi</td></tr><tr><td>3</td><td>    2123-8<a name=\"cdcrec-2123-8\"> </a></td><td>Lebanese</td><td>Lebanese</td></tr><tr><td>3</td><td>    2124-6<a name=\"cdcrec-2124-6\"> </a></td><td>Palestinian</td><td>Palestinian</td></tr><tr><td>3</td><td>    2125-3<a name=\"cdcrec-2125-3\"> </a></td><td>Syrian</td><td>Syrian</td></tr><tr><td>3</td><td>    2126-1<a name=\"cdcrec-2126-1\"> </a></td><td>Afghanistani</td><td>Afghanistani</td></tr><tr><td>3</td><td>    2127-9<a name=\"cdcrec-2127-9\"> </a></td><td>Israeili</td><td>Israeili</td></tr><tr><td>2</td><td>  2131-1<a name=\"cdcrec-2131-1\"> </a></td><td>Other Race</td><td>Note that this term remains in the table for completeness, even though within HL7, the notion of Other code is deprecated.</td></tr><tr><td>1</td><td>2133-7<a name=\"cdcrec-2133-7\"> </a></td><td>Ethnicity</td><td>Ethnicity</td></tr><tr><td>2</td><td>  2135-2<a name=\"cdcrec-2135-2\"> </a></td><td>Hispanic or Latino</td><td>Hispanic or Latino</td></tr><tr><td>3</td><td>    2137-8<a name=\"cdcrec-2137-8\"> </a></td><td>Spaniard</td><td>Spaniard</td></tr><tr><td>3</td><td>    2148-5<a name=\"cdcrec-2148-5\"> </a></td><td>Mexican</td><td>Mexican</td></tr><tr><td>3</td><td>    2155-0<a name=\"cdcrec-2155-0\"> </a></td><td>Central American</td><td>Central American</td></tr><tr><td>3</td><td>    2165-9<a name=\"cdcrec-2165-9\"> </a></td><td>South American</td><td>South American</td></tr><tr><td>3</td><td>    2178-2<a name=\"cdcrec-2178-2\"> </a></td><td>Latin American</td><td>Latin American</td></tr><tr><td>3</td><td>    2180-8<a name=\"cdcrec-2180-8\"> </a></td><td>Puerto Rican</td><td>Puerto Rican</td></tr><tr><td>3</td><td>    2182-4<a name=\"cdcrec-2182-4\"> </a></td><td>Cuban</td><td>Cuban</td></tr><tr><td>3</td><td>    2184-0<a name=\"cdcrec-2184-0\"> </a></td><td>Dominican</td><td>Dominican</td></tr><tr><td>3</td><td>    2138-6<a name=\"cdcrec-2138-6\"> </a></td><td>Andalusian</td><td>Andalusian</td></tr><tr><td>3</td><td>    2139-4<a name=\"cdcrec-2139-4\"> </a></td><td>Asturian</td><td>Asturian</td></tr><tr><td>3</td><td>    2140-2<a name=\"cdcrec-2140-2\"> </a></td><td>Castillian</td><td>Castillian</td></tr><tr><td>3</td><td>    2141-0<a name=\"cdcrec-2141-0\"> </a></td><td>Catalonian</td><td>Catalonian</td></tr><tr><td>3</td><td>    2142-8<a name=\"cdcrec-2142-8\"> </a></td><td>Belearic Islander</td><td>Belearic Islander</td></tr><tr><td>3</td><td>    2143-6<a name=\"cdcrec-2143-6\"> </a></td><td>Gallego</td><td>Gallego</td></tr><tr><td>3</td><td>    2144-4<a name=\"cdcrec-2144-4\"> </a></td><td>Valencian</td><td>Valencian</td></tr><tr><td>3</td><td>    2145-1<a name=\"cdcrec-2145-1\"> </a></td><td>Canarian</td><td>Canarian</td></tr><tr><td>3</td><td>    2146-9<a name=\"cdcrec-2146-9\"> </a></td><td>Spanish Basque</td><td>Spanish Basque</td></tr><tr><td>3</td><td>    2149-3<a name=\"cdcrec-2149-3\"> </a></td><td>Mexican American</td><td>Mexican American</td></tr><tr><td>3</td><td>    2150-1<a name=\"cdcrec-2150-1\"> </a></td><td>Mexicano</td><td>Mexicano</td></tr><tr><td>3</td><td>    2151-9<a name=\"cdcrec-2151-9\"> </a></td><td>Chicano</td><td>Chicano</td></tr><tr><td>3</td><td>    2152-7<a name=\"cdcrec-2152-7\"> </a></td><td>La Raza</td><td>La Raza</td></tr><tr><td>3</td><td>    2153-5<a name=\"cdcrec-2153-5\"> </a></td><td>Mexican American Indian</td><td>Mexican American Indian</td></tr><tr><td>3</td><td>    2156-8<a name=\"cdcrec-2156-8\"> </a></td><td>Costa Rican</td><td>Costa Rican</td></tr><tr><td>3</td><td>    2157-6<a name=\"cdcrec-2157-6\"> </a></td><td>Guatemalan</td><td>Guatemalan</td></tr><tr><td>3</td><td>    2158-4<a name=\"cdcrec-2158-4\"> </a></td><td>Honduran</td><td>Honduran</td></tr><tr><td>3</td><td>    2159-2<a name=\"cdcrec-2159-2\"> </a></td><td>Nicaraguan</td><td>Nicaraguan</td></tr><tr><td>3</td><td>    2160-0<a name=\"cdcrec-2160-0\"> </a></td><td>Panamanian</td><td>Panamanian</td></tr><tr><td>3</td><td>    2161-8<a name=\"cdcrec-2161-8\"> </a></td><td>Salvadoran</td><td>Salvadoran</td></tr><tr><td>3</td><td>    2162-6<a name=\"cdcrec-2162-6\"> </a></td><td>Central American Indian</td><td>Central American Indian</td></tr><tr><td>3</td><td>    2163-4<a name=\"cdcrec-2163-4\"> </a></td><td>Canal Zone</td><td>Canal Zone</td></tr><tr><td>3</td><td>    2166-7<a name=\"cdcrec-2166-7\"> </a></td><td>Argentinean</td><td>Argentinean</td></tr><tr><td>3</td><td>    2167-5<a name=\"cdcrec-2167-5\"> </a></td><td>Bolivian</td><td>Bolivian</td></tr><tr><td>3</td><td>    2168-3<a name=\"cdcrec-2168-3\"> </a></td><td>Chilean</td><td>Chilean</td></tr><tr><td>3</td><td>    2169-1<a name=\"cdcrec-2169-1\"> </a></td><td>Colombian</td><td>Colombian</td></tr><tr><td>3</td><td>    2170-9<a name=\"cdcrec-2170-9\"> </a></td><td>Ecuadorian</td><td>Ecuadorian</td></tr><tr><td>3</td><td>    2171-7<a name=\"cdcrec-2171-7\"> </a></td><td>Paraguayan</td><td>Paraguayan</td></tr><tr><td>3</td><td>    2172-5<a name=\"cdcrec-2172-5\"> </a></td><td>Peruvian</td><td>Peruvian</td></tr><tr><td>3</td><td>    2173-3<a name=\"cdcrec-2173-3\"> </a></td><td>Uruguayan</td><td>Uruguayan</td></tr><tr><td>3</td><td>    2174-1<a name=\"cdcrec-2174-1\"> </a></td><td>Venezuelan</td><td>Venezuelan</td></tr><tr><td>3</td><td>    2175-8<a name=\"cdcrec-2175-8\"> </a></td><td>South American Indian</td><td>South American Indian</td></tr><tr><td>3</td><td>    2176-6<a name=\"cdcrec-2176-6\"> </a></td><td>Criollo</td><td>Criollo</td></tr><tr><td>2</td><td>  2186-5<a name=\"cdcrec-2186-5\"> </a></td><td>Not Hispanic or Latino</td><td>Note that this term remains in the table for completeness, even though within HL7, the notion of &quot;not otherwise coded&quot; term is deprecated.</td></tr></table></div>"
+  },
+  "url": "urn:oid:2.16.840.1.113883.6.238",
+  "identifier": {
+    "value": "2.16.840.1.113883.6.238"
+  },
+  "version": "1.0.0",
+  "name": "Race And Ethnicity - CDC",
+  "title": "Race & Ethnicity - CDC",
+  "status": "active",
+  "experimental": false,
+  "date": "2017-02-28",
+  "publisher": "HL7 US Realm Steering Committee",
+  "contact": [
+    {
+      "telecom": [
+        {
+          "system": "url",
+          "value": "http://hl7.org"
+        }
+      ]
+    }
+  ],
+  "description": " The U.S. Centers for Disease Control and Prevention (CDC) has prepared a code set for use in coding race and ethnicity data. This code set is based on current federal standards for classifying data on race and ethnicity, specifically the minimum race and ethnicity categories defined by the U.S. Office of Management and Budget (OMB) and a more detailed set of race and ethnicity categories maintained by the U.S. Bureau of the Census (BC). The main purpose of the code set is to facilitate use of federal standards for classifying data on race and ethnicity when these data are exchanged, stored, retrieved, or analyzed in electronic form. At the same time, the code set can be applied to paper-based record systems to the extent that these systems are used to collect, maintain, and report data on race and ethnicity in accordance with current federal standards. Source: [Race and Ethnicity Code Set Version 1.0](https://www.cdc.gov/phin/resources/vocabulary/documents/cdc-race--ethnicity-background-and-purpose.pdf)",
+  "caseSensitive": true,
+  "valueSet": "http://hl7.org/fhir/us/core/ValueSet/cdcrec",
+  "hierarchyMeaning": "is-a",
+  "content": "complete",
+  "count": 966,
+  "concept": [
+    {
+      "code": "1000-9",
+      "display": "Race",
+      "definition": "Race",
+      "concept": [
+        {
+          "code": "1002-5",
+          "display": "American Indian or Alaska Native",
+          "definition": "American Indian or Alaska Native",
+          "concept": [
+            {
+              "code": "1004-1",
+              "display": "American Indian",
+              "definition": "American Indian"
+            },
+            {
+              "code": "1735-0",
+              "display": "Alaska Native",
+              "definition": "Alaska Native"
+            },
+            {
+              "code": "1006-6",
+              "display": "Abenaki",
+              "definition": "Abenaki"
+            },
+            {
+              "code": "1008-2",
+              "display": "Algonquian",
+              "definition": "Algonquian"
+            },
+            {
+              "code": "1010-8",
+              "display": "Apache",
+              "definition": "Apache"
+            },
+            {
+              "code": "1021-5",
+              "display": "Arapaho",
+              "definition": "Arapaho"
+            },
+            {
+              "code": "1026-4",
+              "display": "Arikara",
+              "definition": "Arikara"
+            },
+            {
+              "code": "1028-0",
+              "display": "Assiniboine",
+              "definition": "Assiniboine"
+            },
+            {
+              "code": "1030-6",
+              "display": "Assiniboine Sioux",
+              "definition": "Assiniboine Sioux"
+            },
+            {
+              "code": "1033-0",
+              "display": "Bannock",
+              "definition": "Bannock"
+            },
+            {
+              "code": "1035-5",
+              "display": "Blackfeet",
+              "definition": "Blackfeet"
+            },
+            {
+              "code": "1037-1",
+              "display": "Brotherton",
+              "definition": "Brotherton"
+            },
+            {
+              "code": "1039-7",
+              "display": "Burt Lake Band",
+              "definition": "Burt Lake Band"
+            },
+            {
+              "code": "1041-3",
+              "display": "Caddo",
+              "definition": "Caddo"
+            },
+            {
+              "code": "1044-7",
+              "display": "Cahuilla",
+              "definition": "Cahuilla"
+            },
+            {
+              "code": "1053-8",
+              "display": "California Tribes",
+              "definition": "California Tribes"
+            },
+            {
+              "code": "1068-6",
+              "display": "Canadian and Latin American Indian",
+              "definition": "Canadian and Latin American Indian"
+            },
+            {
+              "code": "1076-9",
+              "display": "Catawba",
+              "definition": "Catawba"
+            },
+            {
+              "code": "1078-5",
+              "display": "Cayuse",
+              "definition": "Cayuse"
+            },
+            {
+              "code": "1080-1",
+              "display": "Chehalis",
+              "definition": "Chehalis"
+            },
+            {
+              "code": "1082-7",
+              "display": "Chemakuan",
+              "definition": "Chemakuan"
+            },
+            {
+              "code": "1086-8",
+              "display": "Chemehuevi",
+              "definition": "Chemehuevi"
+            },
+            {
+              "code": "1088-4",
+              "display": "Cherokee",
+              "definition": "Cherokee"
+            },
+            {
+              "code": "1100-7",
+              "display": "Cherokee Shawnee",
+              "definition": "Cherokee Shawnee"
+            },
+            {
+              "code": "1102-3",
+              "display": "Cheyenne",
+              "definition": "Cheyenne"
+            },
+            {
+              "code": "1106-4",
+              "display": "Cheyenne-Arapaho",
+              "definition": "Cheyenne-Arapaho"
+            },
+            {
+              "code": "1108-0",
+              "display": "Chickahominy",
+              "definition": "Chickahominy"
+            },
+            {
+              "code": "1112-2",
+              "display": "Chickasaw",
+              "definition": "Chickasaw"
+            },
+            {
+              "code": "1114-8",
+              "display": "Chinook",
+              "definition": "Chinook"
+            },
+            {
+              "code": "1123-9",
+              "display": "Chippewa",
+              "definition": "Chippewa"
+            },
+            {
+              "code": "1150-2",
+              "display": "Chippewa Cree",
+              "definition": "Chippewa Cree"
+            },
+            {
+              "code": "1153-6",
+              "display": "Chitimacha",
+              "definition": "Chitimacha"
+            },
+            {
+              "code": "1155-1",
+              "display": "Choctaw",
+              "definition": "Choctaw"
+            },
+            {
+              "code": "1162-7",
+              "display": "Chumash",
+              "definition": "Chumash"
+            },
+            {
+              "code": "1165-0",
+              "display": "Clear Lake",
+              "definition": "Clear Lake"
+            },
+            {
+              "code": "1167-6",
+              "display": "Coeur D'Alene",
+              "definition": "Coeur D'Alene"
+            },
+            {
+              "code": "1169-2",
+              "display": "Coharie",
+              "definition": "Coharie"
+            },
+            {
+              "code": "1171-8",
+              "display": "Colorado River",
+              "definition": "Colorado River"
+            },
+            {
+              "code": "1173-4",
+              "display": "Colville",
+              "definition": "Colville"
+            },
+            {
+              "code": "1175-9",
+              "display": "Comanche",
+              "definition": "Comanche"
+            },
+            {
+              "code": "1178-3",
+              "display": "Coos, Lower Umpqua, Siuslaw",
+              "definition": "Coos, Lower Umpqua, Siuslaw"
+            },
+            {
+              "code": "1180-9",
+              "display": "Coos",
+              "definition": "Coos"
+            },
+            {
+              "code": "1182-5",
+              "display": "Coquilles",
+              "definition": "Coquilles"
+            },
+            {
+              "code": "1184-1",
+              "display": "Costanoan",
+              "definition": "Costanoan"
+            },
+            {
+              "code": "1186-6",
+              "display": "Coushatta",
+              "definition": "Coushatta"
+            },
+            {
+              "code": "1189-0",
+              "display": "Cowlitz",
+              "definition": "Cowlitz"
+            },
+            {
+              "code": "1191-6",
+              "display": "Cree",
+              "definition": "Cree"
+            },
+            {
+              "code": "1193-2",
+              "display": "Creek",
+              "definition": "Creek"
+            },
+            {
+              "code": "1207-0",
+              "display": "Croatan",
+              "definition": "Croatan"
+            },
+            {
+              "code": "1209-6",
+              "display": "Crow",
+              "definition": "Crow"
+            },
+            {
+              "code": "1211-2",
+              "display": "Cupeno",
+              "definition": "Cupeno"
+            },
+            {
+              "code": "1214-6",
+              "display": "Delaware",
+              "definition": "Delaware"
+            },
+            {
+              "code": "1222-9",
+              "display": "Diegueno",
+              "definition": "Diegueno"
+            },
+            {
+              "code": "1233-6",
+              "display": "Eastern Tribes",
+              "definition": "Eastern Tribes"
+            },
+            {
+              "code": "1250-0",
+              "display": "Esselen",
+              "definition": "Esselen"
+            },
+            {
+              "code": "1252-6",
+              "display": "Fort Belknap",
+              "definition": "Fort Belknap"
+            },
+            {
+              "code": "1254-2",
+              "display": "Fort Berthold",
+              "definition": "Fort Berthold"
+            },
+            {
+              "code": "1256-7",
+              "display": "Fort Mcdowell",
+              "definition": "Fort Mcdowell"
+            },
+            {
+              "code": "1258-3",
+              "display": "Fort Hall",
+              "definition": "Fort Hall"
+            },
+            {
+              "code": "1260-9",
+              "display": "Gabrieleno",
+              "definition": "Gabrieleno"
+            },
+            {
+              "code": "1262-5",
+              "display": "Grand Ronde",
+              "definition": "Grand Ronde"
+            },
+            {
+              "code": "1264-1",
+              "display": "Gros Ventres",
+              "definition": "Gros Ventres"
+            },
+            {
+              "code": "1267-4",
+              "display": "Haliwa",
+              "definition": "Haliwa"
+            },
+            {
+              "code": "1269-0",
+              "display": "Hidatsa",
+              "definition": "Hidatsa"
+            },
+            {
+              "code": "1271-6",
+              "display": "Hoopa",
+              "definition": "Hoopa"
+            },
+            {
+              "code": "1275-7",
+              "display": "Hoopa Extension",
+              "definition": "Hoopa Extension"
+            },
+            {
+              "code": "1277-3",
+              "display": "Houma",
+              "definition": "Houma"
+            },
+            {
+              "code": "1279-9",
+              "display": "Inaja-Cosmit",
+              "definition": "Inaja-Cosmit"
+            },
+            {
+              "code": "1281-5",
+              "display": "Iowa",
+              "definition": "Iowa"
+            },
+            {
+              "code": "1285-6",
+              "display": "Iroquois",
+              "definition": "Iroquois"
+            },
+            {
+              "code": "1297-1",
+              "display": "Juaneno",
+              "definition": "Juaneno"
+            },
+            {
+              "code": "1299-7",
+              "display": "Kalispel",
+              "definition": "Kalispel"
+            },
+            {
+              "code": "1301-1",
+              "display": "Karuk",
+              "definition": "Karuk"
+            },
+            {
+              "code": "1303-7",
+              "display": "Kaw",
+              "definition": "Kaw"
+            },
+            {
+              "code": "1305-2",
+              "display": "Kickapoo",
+              "definition": "Kickapoo"
+            },
+            {
+              "code": "1309-4",
+              "display": "Kiowa",
+              "definition": "Kiowa"
+            },
+            {
+              "code": "1312-8",
+              "display": "Klallam",
+              "definition": "Klallam"
+            },
+            {
+              "code": "1317-7",
+              "display": "Klamath",
+              "definition": "Klamath"
+            },
+            {
+              "code": "1319-3",
+              "display": "Konkow",
+              "definition": "Konkow"
+            },
+            {
+              "code": "1321-9",
+              "display": "Kootenai",
+              "definition": "Kootenai"
+            },
+            {
+              "code": "1323-5",
+              "display": "Lassik",
+              "definition": "Lassik"
+            },
+            {
+              "code": "1325-0",
+              "display": "Long Island",
+              "definition": "Long Island"
+            },
+            {
+              "code": "1331-8",
+              "display": "Luiseno",
+              "definition": "Luiseno"
+            },
+            {
+              "code": "1340-9",
+              "display": "Lumbee",
+              "definition": "Lumbee"
+            },
+            {
+              "code": "1342-5",
+              "display": "Lummi",
+              "definition": "Lummi"
+            },
+            {
+              "code": "1344-1",
+              "display": "Maidu",
+              "definition": "Maidu"
+            },
+            {
+              "code": "1348-2",
+              "display": "Makah",
+              "definition": "Makah"
+            },
+            {
+              "code": "1350-8",
+              "display": "Maliseet",
+              "definition": "Maliseet"
+            },
+            {
+              "code": "1352-4",
+              "display": "Mandan",
+              "definition": "Mandan"
+            },
+            {
+              "code": "1354-0",
+              "display": "Mattaponi",
+              "definition": "Mattaponi"
+            },
+            {
+              "code": "1356-5",
+              "display": "Menominee",
+              "definition": "Menominee"
+            },
+            {
+              "code": "1358-1",
+              "display": "Miami",
+              "definition": "Miami"
+            },
+            {
+              "code": "1363-1",
+              "display": "Miccosukee",
+              "definition": "Miccosukee"
+            },
+            {
+              "code": "1365-6",
+              "display": "Micmac",
+              "definition": "Micmac"
+            },
+            {
+              "code": "1368-0",
+              "display": "Mission Indians",
+              "definition": "Mission Indians"
+            },
+            {
+              "code": "1370-6",
+              "display": "Miwok",
+              "definition": "Miwok"
+            },
+            {
+              "code": "1372-2",
+              "display": "Modoc",
+              "definition": "Modoc"
+            },
+            {
+              "code": "1374-8",
+              "display": "Mohegan",
+              "definition": "Mohegan"
+            },
+            {
+              "code": "1376-3",
+              "display": "Mono",
+              "definition": "Mono"
+            },
+            {
+              "code": "1378-9",
+              "display": "Nanticoke",
+              "definition": "Nanticoke"
+            },
+            {
+              "code": "1380-5",
+              "display": "Narragansett",
+              "definition": "Narragansett"
+            },
+            {
+              "code": "1382-1",
+              "display": "Navajo",
+              "definition": "Navajo"
+            },
+            {
+              "code": "1387-0",
+              "display": "Nez Perce",
+              "definition": "Nez Perce"
+            },
+            {
+              "code": "1389-6",
+              "display": "Nomalaki",
+              "definition": "Nomalaki"
+            },
+            {
+              "code": "1391-2",
+              "display": "Northwest Tribes",
+              "definition": "Northwest Tribes"
+            },
+            {
+              "code": "1403-5",
+              "display": "Omaha",
+              "definition": "Omaha"
+            },
+            {
+              "code": "1405-0",
+              "display": "Oregon Athabaskan",
+              "definition": "Oregon Athabaskan"
+            },
+            {
+              "code": "1407-6",
+              "display": "Osage",
+              "definition": "Osage"
+            },
+            {
+              "code": "1409-2",
+              "display": "Otoe-Missouria",
+              "definition": "Otoe-Missouria"
+            },
+            {
+              "code": "1411-8",
+              "display": "Ottawa",
+              "definition": "Ottawa"
+            },
+            {
+              "code": "1416-7",
+              "display": "Paiute",
+              "definition": "Paiute"
+            },
+            {
+              "code": "1439-9",
+              "display": "Pamunkey",
+              "definition": "Pamunkey"
+            },
+            {
+              "code": "1441-5",
+              "display": "Passamaquoddy",
+              "definition": "Passamaquoddy"
+            },
+            {
+              "code": "1445-6",
+              "display": "Pawnee",
+              "definition": "Pawnee"
+            },
+            {
+              "code": "1448-0",
+              "display": "Penobscot",
+              "definition": "Penobscot"
+            },
+            {
+              "code": "1450-6",
+              "display": "Peoria",
+              "definition": "Peoria"
+            },
+            {
+              "code": "1453-0",
+              "display": "Pequot",
+              "definition": "Pequot"
+            },
+            {
+              "code": "1456-3",
+              "display": "Pima",
+              "definition": "Pima"
+            },
+            {
+              "code": "1460-5",
+              "display": "Piscataway",
+              "definition": "Piscataway"
+            },
+            {
+              "code": "1462-1",
+              "display": "Pit River",
+              "definition": "Pit River"
+            },
+            {
+              "code": "1464-7",
+              "display": "Pomo",
+              "definition": "Pomo"
+            },
+            {
+              "code": "1474-6",
+              "display": "Ponca",
+              "definition": "Ponca"
+            },
+            {
+              "code": "1478-7",
+              "display": "Potawatomi",
+              "definition": "Potawatomi"
+            },
+            {
+              "code": "1487-8",
+              "display": "Powhatan",
+              "definition": "Powhatan"
+            },
+            {
+              "code": "1489-4",
+              "display": "Pueblo",
+              "definition": "Pueblo"
+            },
+            {
+              "code": "1518-0",
+              "display": "Puget Sound Salish",
+              "definition": "Puget Sound Salish"
+            },
+            {
+              "code": "1541-2",
+              "display": "Quapaw",
+              "definition": "Quapaw"
+            },
+            {
+              "code": "1543-8",
+              "display": "Quinault",
+              "definition": "Quinault"
+            },
+            {
+              "code": "1545-3",
+              "display": "Rappahannock",
+              "definition": "Rappahannock"
+            },
+            {
+              "code": "1547-9",
+              "display": "Reno-Sparks",
+              "definition": "Reno-Sparks"
+            },
+            {
+              "code": "1549-5",
+              "display": "Round Valley",
+              "definition": "Round Valley"
+            },
+            {
+              "code": "1551-1",
+              "display": "Sac and Fox",
+              "definition": "Sac and Fox"
+            },
+            {
+              "code": "1556-0",
+              "display": "Salinan",
+              "definition": "Salinan"
+            },
+            {
+              "code": "1558-6",
+              "display": "Salish",
+              "definition": "Salish"
+            },
+            {
+              "code": "1560-2",
+              "display": "Salish and Kootenai",
+              "definition": "Salish and Kootenai"
+            },
+            {
+              "code": "1562-8",
+              "display": "Schaghticoke",
+              "definition": "Schaghticoke"
+            },
+            {
+              "code": "1564-4",
+              "display": "Scott Valley",
+              "definition": "Scott Valley"
+            },
+            {
+              "code": "1566-9",
+              "display": "Seminole",
+              "definition": "Seminole"
+            },
+            {
+              "code": "1573-5",
+              "display": "Serrano",
+              "definition": "Serrano"
+            },
+            {
+              "code": "1576-8",
+              "display": "Shasta",
+              "definition": "Shasta"
+            },
+            {
+              "code": "1578-4",
+              "display": "Shawnee",
+              "definition": "Shawnee"
+            },
+            {
+              "code": "1582-6",
+              "display": "Shinnecock",
+              "definition": "Shinnecock"
+            },
+            {
+              "code": "1584-2",
+              "display": "Shoalwater Bay",
+              "definition": "Shoalwater Bay"
+            },
+            {
+              "code": "1586-7",
+              "display": "Shoshone",
+              "definition": "Shoshone"
+            },
+            {
+              "code": "1602-2",
+              "display": "Shoshone Paiute",
+              "definition": "Shoshone Paiute"
+            },
+            {
+              "code": "1607-1",
+              "display": "Siletz",
+              "definition": "Siletz"
+            },
+            {
+              "code": "1609-7",
+              "display": "Sioux",
+              "definition": "Sioux"
+            },
+            {
+              "code": "1643-6",
+              "display": "Siuslaw",
+              "definition": "Siuslaw"
+            },
+            {
+              "code": "1645-1",
+              "display": "Spokane",
+              "definition": "Spokane"
+            },
+            {
+              "code": "1647-7",
+              "display": "Stewart",
+              "definition": "Stewart"
+            },
+            {
+              "code": "1649-3",
+              "display": "Stockbridge",
+              "definition": "Stockbridge"
+            },
+            {
+              "code": "1651-9",
+              "display": "Susanville",
+              "definition": "Susanville"
+            },
+            {
+              "code": "1653-5",
+              "display": "Tohono O'Odham",
+              "definition": "Tohono O'Odham"
+            },
+            {
+              "code": "1659-2",
+              "display": "Tolowa",
+              "definition": "Tolowa"
+            },
+            {
+              "code": "1661-8",
+              "display": "Tonkawa",
+              "definition": "Tonkawa"
+            },
+            {
+              "code": "1663-4",
+              "display": "Tygh",
+              "definition": "Tygh"
+            },
+            {
+              "code": "1665-9",
+              "display": "Umatilla",
+              "definition": "Umatilla"
+            },
+            {
+              "code": "1667-5",
+              "display": "Umpqua",
+              "definition": "Umpqua"
+            },
+            {
+              "code": "1670-9",
+              "display": "Ute",
+              "definition": "Ute"
+            },
+            {
+              "code": "1675-8",
+              "display": "Wailaki",
+              "definition": "Wailaki"
+            },
+            {
+              "code": "1677-4",
+              "display": "Walla-Walla",
+              "definition": "Walla-Walla"
+            },
+            {
+              "code": "1679-0",
+              "display": "Wampanoag",
+              "definition": "Wampanoag"
+            },
+            {
+              "code": "1683-2",
+              "display": "Warm Springs",
+              "definition": "Warm Springs"
+            },
+            {
+              "code": "1685-7",
+              "display": "Wascopum",
+              "definition": "Wascopum"
+            },
+            {
+              "code": "1687-3",
+              "display": "Washoe",
+              "definition": "Washoe"
+            },
+            {
+              "code": "1692-3",
+              "display": "Wichita",
+              "definition": "Wichita"
+            },
+            {
+              "code": "1694-9",
+              "display": "Wind River",
+              "definition": "Wind River"
+            },
+            {
+              "code": "1696-4",
+              "display": "Winnebago",
+              "definition": "Winnebago"
+            },
+            {
+              "code": "1700-4",
+              "display": "Winnemucca",
+              "definition": "Winnemucca"
+            },
+            {
+              "code": "1702-0",
+              "display": "Wintun",
+              "definition": "Wintun"
+            },
+            {
+              "code": "1704-6",
+              "display": "Wiyot",
+              "definition": "Wiyot"
+            },
+            {
+              "code": "1707-9",
+              "display": "Yakama",
+              "definition": "Yakama"
+            },
+            {
+              "code": "1709-5",
+              "display": "Yakama Cowlitz",
+              "definition": "Yakama Cowlitz"
+            },
+            {
+              "code": "1711-1",
+              "display": "Yaqui",
+              "definition": "Yaqui"
+            },
+            {
+              "code": "1715-2",
+              "display": "Yavapai Apache",
+              "definition": "Yavapai Apache"
+            },
+            {
+              "code": "1717-8",
+              "display": "Yokuts",
+              "definition": "Yokuts"
+            },
+            {
+              "code": "1722-8",
+              "display": "Yuchi",
+              "definition": "Yuchi"
+            },
+            {
+              "code": "1724-4",
+              "display": "Yuman",
+              "definition": "Yuman"
+            },
+            {
+              "code": "1732-7",
+              "display": "Yurok",
+              "definition": "Yurok"
+            },
+            {
+              "code": "1011-6",
+              "display": "Chiricahua",
+              "definition": "Chiricahua"
+            },
+            {
+              "code": "1012-4",
+              "display": "Fort Sill Apache",
+              "definition": "Fort Sill Apache"
+            },
+            {
+              "code": "1013-2",
+              "display": "Jicarilla Apache",
+              "definition": "Jicarilla Apache"
+            },
+            {
+              "code": "1014-0",
+              "display": "Lipan Apache",
+              "definition": "Lipan Apache"
+            },
+            {
+              "code": "1015-7",
+              "display": "Mescalero Apache",
+              "definition": "Mescalero Apache"
+            },
+            {
+              "code": "1016-5",
+              "display": "Oklahoma Apache",
+              "definition": "Oklahoma Apache"
+            },
+            {
+              "code": "1017-3",
+              "display": "Payson Apache",
+              "definition": "Payson Apache"
+            },
+            {
+              "code": "1018-1",
+              "display": "San Carlos Apache",
+              "definition": "San Carlos Apache"
+            },
+            {
+              "code": "1019-9",
+              "display": "White Mountain Apache",
+              "definition": "White Mountain Apache"
+            },
+            {
+              "code": "1022-3",
+              "display": "Northern Arapaho",
+              "definition": "Northern Arapaho"
+            },
+            {
+              "code": "1023-1",
+              "display": "Southern Arapaho",
+              "definition": "Southern Arapaho"
+            },
+            {
+              "code": "1024-9",
+              "display": "Wind River Arapaho",
+              "definition": "Wind River Arapaho"
+            },
+            {
+              "code": "1031-4",
+              "display": "Fort Peck Assiniboine Sioux",
+              "definition": "Fort Peck Assiniboine Sioux"
+            },
+            {
+              "code": "1042-1",
+              "display": "Oklahoma Cado",
+              "definition": "Oklahoma Cado"
+            },
+            {
+              "code": "1045-4",
+              "display": "Agua Caliente Cahuilla",
+              "definition": "Agua Caliente Cahuilla"
+            },
+            {
+              "code": "1046-2",
+              "display": "Augustine",
+              "definition": "Augustine"
+            },
+            {
+              "code": "1047-0",
+              "display": "Cabazon",
+              "definition": "Cabazon"
+            },
+            {
+              "code": "1048-8",
+              "display": "Los Coyotes",
+              "definition": "Los Coyotes"
+            },
+            {
+              "code": "1049-6",
+              "display": "Morongo",
+              "definition": "Morongo"
+            },
+            {
+              "code": "1050-4",
+              "display": "Santa Rosa Cahuilla",
+              "definition": "Santa Rosa Cahuilla"
+            },
+            {
+              "code": "1051-2",
+              "display": "Torres-Martinez",
+              "definition": "Torres-Martinez"
+            },
+            {
+              "code": "1054-6",
+              "display": "Cahto",
+              "definition": "Cahto"
+            },
+            {
+              "code": "1055-3",
+              "display": "Chimariko",
+              "definition": "Chimariko"
+            },
+            {
+              "code": "1056-1",
+              "display": "Coast Miwok",
+              "definition": "Coast Miwok"
+            },
+            {
+              "code": "1057-9",
+              "display": "Digger",
+              "definition": "Digger"
+            },
+            {
+              "code": "1058-7",
+              "display": "Kawaiisu",
+              "definition": "Kawaiisu"
+            },
+            {
+              "code": "1059-5",
+              "display": "Kern River",
+              "definition": "Kern River"
+            },
+            {
+              "code": "1060-3",
+              "display": "Mattole",
+              "definition": "Mattole"
+            },
+            {
+              "code": "1061-1",
+              "display": "Red Wood",
+              "definition": "Red Wood"
+            },
+            {
+              "code": "1062-9",
+              "display": "Santa Rosa",
+              "definition": "Santa Rosa"
+            },
+            {
+              "code": "1063-7",
+              "display": "Takelma",
+              "definition": "Takelma"
+            },
+            {
+              "code": "1064-5",
+              "display": "Wappo",
+              "definition": "Wappo"
+            },
+            {
+              "code": "1065-2",
+              "display": "Yana",
+              "definition": "Yana"
+            },
+            {
+              "code": "1066-0",
+              "display": "Yuki",
+              "definition": "Yuki"
+            },
+            {
+              "code": "1069-4",
+              "display": "Canadian Indian",
+              "definition": "Canadian Indian"
+            },
+            {
+              "code": "1070-2",
+              "display": "Central American Indian",
+              "definition": "Central American Indian"
+            },
+            {
+              "code": "1071-0",
+              "display": "French American Indian",
+              "definition": "French American Indian"
+            },
+            {
+              "code": "1072-8",
+              "display": "Mexican American Indian",
+              "definition": "Mexican American Indian"
+            },
+            {
+              "code": "1073-6",
+              "display": "South American Indian",
+              "definition": "South American Indian"
+            },
+            {
+              "code": "1074-4",
+              "display": "Spanish American Indian",
+              "definition": "Spanish American Indian"
+            },
+            {
+              "code": "1083-5",
+              "display": "Hoh",
+              "definition": "Hoh"
+            },
+            {
+              "code": "1084-3",
+              "display": "Quileute",
+              "definition": "Quileute"
+            },
+            {
+              "code": "1089-2",
+              "display": "Cherokee Alabama",
+              "definition": "Cherokee Alabama"
+            },
+            {
+              "code": "1090-0",
+              "display": "Cherokees of Northeast Alabama",
+              "definition": "Cherokees of Northeast Alabama"
+            },
+            {
+              "code": "1091-8",
+              "display": "Cherokees of Southeast Alabama",
+              "definition": "Cherokees of Southeast Alabama"
+            },
+            {
+              "code": "1092-6",
+              "display": "Eastern Cherokee",
+              "definition": "Eastern Cherokee"
+            },
+            {
+              "code": "1093-4",
+              "display": "Echota Cherokee",
+              "definition": "Echota Cherokee"
+            },
+            {
+              "code": "1094-2",
+              "display": "Etowah Cherokee",
+              "definition": "Etowah Cherokee"
+            },
+            {
+              "code": "1095-9",
+              "display": "Northern Cherokee",
+              "definition": "Northern Cherokee"
+            },
+            {
+              "code": "1096-7",
+              "display": "Tuscola",
+              "definition": "Tuscola"
+            },
+            {
+              "code": "1097-5",
+              "display": "United Keetowah Band of Cherokee",
+              "definition": "United Keetowah Band of Cherokee"
+            },
+            {
+              "code": "1098-3",
+              "display": "Western Cherokee",
+              "definition": "Western Cherokee"
+            },
+            {
+              "code": "1103-1",
+              "display": "Northern Cheyenne",
+              "definition": "Northern Cheyenne"
+            },
+            {
+              "code": "1104-9",
+              "display": "Southern Cheyenne",
+              "definition": "Southern Cheyenne"
+            },
+            {
+              "code": "1109-8",
+              "display": "Eastern Chickahominy",
+              "definition": "Eastern Chickahominy"
+            },
+            {
+              "code": "1110-6",
+              "display": "Western Chickahominy",
+              "definition": "Western Chickahominy"
+            },
+            {
+              "code": "1115-5",
+              "display": "Clatsop",
+              "definition": "Clatsop"
+            },
+            {
+              "code": "1116-3",
+              "display": "Columbia River Chinook",
+              "definition": "Columbia River Chinook"
+            },
+            {
+              "code": "1117-1",
+              "display": "Kathlamet",
+              "definition": "Kathlamet"
+            },
+            {
+              "code": "1118-9",
+              "display": "Upper Chinook",
+              "definition": "Upper Chinook"
+            },
+            {
+              "code": "1119-7",
+              "display": "Wakiakum Chinook",
+              "definition": "Wakiakum Chinook"
+            },
+            {
+              "code": "1120-5",
+              "display": "Willapa Chinook",
+              "definition": "Willapa Chinook"
+            },
+            {
+              "code": "1121-3",
+              "display": "Wishram",
+              "definition": "Wishram"
+            },
+            {
+              "code": "1124-7",
+              "display": "Bad River",
+              "definition": "Bad River"
+            },
+            {
+              "code": "1125-4",
+              "display": "Bay Mills Chippewa",
+              "definition": "Bay Mills Chippewa"
+            },
+            {
+              "code": "1126-2",
+              "display": "Bois Forte",
+              "definition": "Bois Forte"
+            },
+            {
+              "code": "1127-0",
+              "display": "Burt Lake Chippewa",
+              "definition": "Burt Lake Chippewa"
+            },
+            {
+              "code": "1128-8",
+              "display": "Fond du Lac",
+              "definition": "Fond du Lac"
+            },
+            {
+              "code": "1129-6",
+              "display": "Grand Portage",
+              "definition": "Grand Portage"
+            },
+            {
+              "code": "1130-4",
+              "display": "Grand Traverse Band of Ottawa/Chippewa",
+              "definition": "Grand Traverse Band of Ottawa/Chippewa"
+            },
+            {
+              "code": "1131-2",
+              "display": "Keweenaw",
+              "definition": "Keweenaw"
+            },
+            {
+              "code": "1132-0",
+              "display": "Lac Courte Oreilles",
+              "definition": "Lac Courte Oreilles"
+            },
+            {
+              "code": "1133-8",
+              "display": "Lac du Flambeau",
+              "definition": "Lac du Flambeau"
+            },
+            {
+              "code": "1134-6",
+              "display": "Lac Vieux Desert Chippewa",
+              "definition": "Lac Vieux Desert Chippewa"
+            },
+            {
+              "code": "1135-3",
+              "display": "Lake Superior",
+              "definition": "Lake Superior"
+            },
+            {
+              "code": "1136-1",
+              "display": "Leech Lake",
+              "definition": "Leech Lake"
+            },
+            {
+              "code": "1137-9",
+              "display": "Little Shell Chippewa",
+              "definition": "Little Shell Chippewa"
+            },
+            {
+              "code": "1138-7",
+              "display": "Mille Lacs",
+              "definition": "Mille Lacs"
+            },
+            {
+              "code": "1139-5",
+              "display": "Minnesota Chippewa",
+              "definition": "Minnesota Chippewa"
+            },
+            {
+              "code": "1140-3",
+              "display": "Ontonagon",
+              "definition": "Ontonagon"
+            },
+            {
+              "code": "1141-1",
+              "display": "Red Cliff Chippewa",
+              "definition": "Red Cliff Chippewa"
+            },
+            {
+              "code": "1142-9",
+              "display": "Red Lake Chippewa",
+              "definition": "Red Lake Chippewa"
+            },
+            {
+              "code": "1143-7",
+              "display": "Saginaw Chippewa",
+              "definition": "Saginaw Chippewa"
+            },
+            {
+              "code": "1144-5",
+              "display": "St. Croix Chippewa",
+              "definition": "St. Croix Chippewa"
+            },
+            {
+              "code": "1145-2",
+              "display": "Sault Ste. Marie Chippewa",
+              "definition": "Sault Ste. Marie Chippewa"
+            },
+            {
+              "code": "1146-0",
+              "display": "Sokoagon Chippewa",
+              "definition": "Sokoagon Chippewa"
+            },
+            {
+              "code": "1147-8",
+              "display": "Turtle Mountain",
+              "definition": "Turtle Mountain"
+            },
+            {
+              "code": "1148-6",
+              "display": "White Earth",
+              "definition": "White Earth"
+            },
+            {
+              "code": "1151-0",
+              "display": "Rocky Boy's Chippewa Cree",
+              "definition": "Rocky Boy's Chippewa Cree"
+            },
+            {
+              "code": "1156-9",
+              "display": "Clifton Choctaw",
+              "definition": "Clifton Choctaw"
+            },
+            {
+              "code": "1157-7",
+              "display": "Jena Choctaw",
+              "definition": "Jena Choctaw"
+            },
+            {
+              "code": "1158-5",
+              "display": "Mississippi Choctaw",
+              "definition": "Mississippi Choctaw"
+            },
+            {
+              "code": "1159-3",
+              "display": "Mowa Band of Choctaw",
+              "definition": "Mowa Band of Choctaw"
+            },
+            {
+              "code": "1160-1",
+              "display": "Oklahoma Choctaw",
+              "definition": "Oklahoma Choctaw"
+            },
+            {
+              "code": "1163-5",
+              "display": "Santa Ynez",
+              "definition": "Santa Ynez"
+            },
+            {
+              "code": "1176-7",
+              "display": "Oklahoma Comanche",
+              "definition": "Oklahoma Comanche"
+            },
+            {
+              "code": "1187-4",
+              "display": "Alabama Coushatta",
+              "definition": "Alabama Coushatta"
+            },
+            {
+              "code": "1194-0",
+              "display": "Alabama Creek",
+              "definition": "Alabama Creek"
+            },
+            {
+              "code": "1195-7",
+              "display": "Alabama Quassarte",
+              "definition": "Alabama Quassarte"
+            },
+            {
+              "code": "1196-5",
+              "display": "Eastern Creek",
+              "definition": "Eastern Creek"
+            },
+            {
+              "code": "1197-3",
+              "display": "Eastern Muscogee",
+              "definition": "Eastern Muscogee"
+            },
+            {
+              "code": "1198-1",
+              "display": "Kialegee",
+              "definition": "Kialegee"
+            },
+            {
+              "code": "1199-9",
+              "display": "Lower Muscogee",
+              "definition": "Lower Muscogee"
+            },
+            {
+              "code": "1200-5",
+              "display": "Machis Lower Creek Indian",
+              "definition": "Machis Lower Creek Indian"
+            },
+            {
+              "code": "1201-3",
+              "display": "Poarch Band",
+              "definition": "Poarch Band"
+            },
+            {
+              "code": "1202-1",
+              "display": "Principal Creek Indian Nation",
+              "definition": "Principal Creek Indian Nation"
+            },
+            {
+              "code": "1203-9",
+              "display": "Star Clan of Muscogee Creeks",
+              "definition": "Star Clan of Muscogee Creeks"
+            },
+            {
+              "code": "1204-7",
+              "display": "Thlopthlocco",
+              "definition": "Thlopthlocco"
+            },
+            {
+              "code": "1205-4",
+              "display": "Tuckabachee",
+              "definition": "Tuckabachee"
+            },
+            {
+              "code": "1212-0",
+              "display": "Agua Caliente",
+              "definition": "Agua Caliente"
+            },
+            {
+              "code": "1215-3",
+              "display": "Eastern Delaware",
+              "definition": "Eastern Delaware"
+            },
+            {
+              "code": "1216-1",
+              "display": "Lenni-Lenape",
+              "definition": "Lenni-Lenape"
+            },
+            {
+              "code": "1217-9",
+              "display": "Munsee",
+              "definition": "Munsee"
+            },
+            {
+              "code": "1218-7",
+              "display": "Oklahoma Delaware",
+              "definition": "Oklahoma Delaware"
+            },
+            {
+              "code": "1219-5",
+              "display": "Rampough Mountain",
+              "definition": "Rampough Mountain"
+            },
+            {
+              "code": "1220-3",
+              "display": "Sand Hill",
+              "definition": "Sand Hill"
+            },
+            {
+              "code": "1223-7",
+              "display": "Campo",
+              "definition": "Campo"
+            },
+            {
+              "code": "1224-5",
+              "display": "Capitan Grande",
+              "definition": "Capitan Grande"
+            },
+            {
+              "code": "1225-2",
+              "display": "Cuyapaipe",
+              "definition": "Cuyapaipe"
+            },
+            {
+              "code": "1226-0",
+              "display": "La Posta",
+              "definition": "La Posta"
+            },
+            {
+              "code": "1227-8",
+              "display": "Manzanita",
+              "definition": "Manzanita"
+            },
+            {
+              "code": "1228-6",
+              "display": "Mesa Grande",
+              "definition": "Mesa Grande"
+            },
+            {
+              "code": "1229-4",
+              "display": "San Pasqual",
+              "definition": "San Pasqual"
+            },
+            {
+              "code": "1230-2",
+              "display": "Santa Ysabel",
+              "definition": "Santa Ysabel"
+            },
+            {
+              "code": "1231-0",
+              "display": "Sycuan",
+              "definition": "Sycuan"
+            },
+            {
+              "code": "1234-4",
+              "display": "Attacapa",
+              "definition": "Attacapa"
+            },
+            {
+              "code": "1235-1",
+              "display": "Biloxi",
+              "definition": "Biloxi"
+            },
+            {
+              "code": "1236-9",
+              "display": "Georgetown (Eastern Tribes)",
+              "definition": "Georgetown (Eastern Tribes)"
+            },
+            {
+              "code": "1237-7",
+              "display": "Moor",
+              "definition": "Moor"
+            },
+            {
+              "code": "1238-5",
+              "display": "Nansemond",
+              "definition": "Nansemond"
+            },
+            {
+              "code": "1239-3",
+              "display": "Natchez",
+              "definition": "Natchez"
+            },
+            {
+              "code": "1240-1",
+              "display": "Nausu Waiwash",
+              "definition": "Nausu Waiwash"
+            },
+            {
+              "code": "1241-9",
+              "display": "Nipmuc",
+              "definition": "Nipmuc"
+            },
+            {
+              "code": "1242-7",
+              "display": "Paugussett",
+              "definition": "Paugussett"
+            },
+            {
+              "code": "1243-5",
+              "display": "Pocomoke Acohonock",
+              "definition": "Pocomoke Acohonock"
+            },
+            {
+              "code": "1244-3",
+              "display": "Southeastern Indians",
+              "definition": "Southeastern Indians"
+            },
+            {
+              "code": "1245-0",
+              "display": "Susquehanock",
+              "definition": "Susquehanock"
+            },
+            {
+              "code": "1246-8",
+              "display": "Tunica Biloxi",
+              "definition": "Tunica Biloxi"
+            },
+            {
+              "code": "1247-6",
+              "display": "Waccamaw-Siousan",
+              "definition": "Waccamaw-Siousan"
+            },
+            {
+              "code": "1248-4",
+              "display": "Wicomico",
+              "definition": "Wicomico"
+            },
+            {
+              "code": "1265-8",
+              "display": "Atsina",
+              "definition": "Atsina"
+            },
+            {
+              "code": "1272-4",
+              "display": "Trinity",
+              "definition": "Trinity"
+            },
+            {
+              "code": "1273-2",
+              "display": "Whilkut",
+              "definition": "Whilkut"
+            },
+            {
+              "code": "1282-3",
+              "display": "Iowa of Kansas-Nebraska",
+              "definition": "Iowa of Kansas-Nebraska"
+            },
+            {
+              "code": "1283-1",
+              "display": "Iowa of Oklahoma",
+              "definition": "Iowa of Oklahoma"
+            },
+            {
+              "code": "1286-4",
+              "display": "Cayuga",
+              "definition": "Cayuga"
+            },
+            {
+              "code": "1287-2",
+              "display": "Mohawk",
+              "definition": "Mohawk"
+            },
+            {
+              "code": "1288-0",
+              "display": "Oneida",
+              "definition": "Oneida"
+            },
+            {
+              "code": "1289-8",
+              "display": "Onondaga",
+              "definition": "Onondaga"
+            },
+            {
+              "code": "1290-6",
+              "display": "Seneca",
+              "definition": "Seneca"
+            },
+            {
+              "code": "1291-4",
+              "display": "Seneca Nation",
+              "definition": "Seneca Nation"
+            },
+            {
+              "code": "1292-2",
+              "display": "Seneca-Cayuga",
+              "definition": "Seneca-Cayuga"
+            },
+            {
+              "code": "1293-0",
+              "display": "Tonawanda Seneca",
+              "definition": "Tonawanda Seneca"
+            },
+            {
+              "code": "1294-8",
+              "display": "Tuscarora",
+              "definition": "Tuscarora"
+            },
+            {
+              "code": "1295-5",
+              "display": "Wyandotte",
+              "definition": "Wyandotte"
+            },
+            {
+              "code": "1306-0",
+              "display": "Oklahoma Kickapoo",
+              "definition": "Oklahoma Kickapoo"
+            },
+            {
+              "code": "1307-8",
+              "display": "Texas Kickapoo",
+              "definition": "Texas Kickapoo"
+            },
+            {
+              "code": "1310-2",
+              "display": "Oklahoma Kiowa",
+              "definition": "Oklahoma Kiowa"
+            },
+            {
+              "code": "1313-6",
+              "display": "Jamestown",
+              "definition": "Jamestown"
+            },
+            {
+              "code": "1314-4",
+              "display": "Lower Elwha",
+              "definition": "Lower Elwha"
+            },
+            {
+              "code": "1315-1",
+              "display": "Port Gamble Klallam",
+              "definition": "Port Gamble Klallam"
+            },
+            {
+              "code": "1326-8",
+              "display": "Matinecock",
+              "definition": "Matinecock"
+            },
+            {
+              "code": "1327-6",
+              "display": "Montauk",
+              "definition": "Montauk"
+            },
+            {
+              "code": "1328-4",
+              "display": "Poospatuck",
+              "definition": "Poospatuck"
+            },
+            {
+              "code": "1329-2",
+              "display": "Setauket",
+              "definition": "Setauket"
+            },
+            {
+              "code": "1332-6",
+              "display": "La Jolla",
+              "definition": "La Jolla"
+            },
+            {
+              "code": "1333-4",
+              "display": "Pala",
+              "definition": "Pala"
+            },
+            {
+              "code": "1334-2",
+              "display": "Pauma",
+              "definition": "Pauma"
+            },
+            {
+              "code": "1335-9",
+              "display": "Pechanga",
+              "definition": "Pechanga"
+            },
+            {
+              "code": "1336-7",
+              "display": "Soboba",
+              "definition": "Soboba"
+            },
+            {
+              "code": "1337-5",
+              "display": "Twenty-Nine Palms",
+              "definition": "Twenty-Nine Palms"
+            },
+            {
+              "code": "1338-3",
+              "display": "Temecula",
+              "definition": "Temecula"
+            },
+            {
+              "code": "1345-8",
+              "display": "Mountain Maidu",
+              "definition": "Mountain Maidu"
+            },
+            {
+              "code": "1346-6",
+              "display": "Nishinam",
+              "definition": "Nishinam"
+            },
+            {
+              "code": "1359-9",
+              "display": "Illinois Miami",
+              "definition": "Illinois Miami"
+            },
+            {
+              "code": "1360-7",
+              "display": "Indiana Miami",
+              "definition": "Indiana Miami"
+            },
+            {
+              "code": "1361-5",
+              "display": "Oklahoma Miami",
+              "definition": "Oklahoma Miami"
+            },
+            {
+              "code": "1366-4",
+              "display": "Aroostook",
+              "definition": "Aroostook"
+            },
+            {
+              "code": "1383-9",
+              "display": "Alamo Navajo",
+              "definition": "Alamo Navajo"
+            },
+            {
+              "code": "1384-7",
+              "display": "Canoncito Navajo",
+              "definition": "Canoncito Navajo"
+            },
+            {
+              "code": "1385-4",
+              "display": "Ramah Navajo",
+              "definition": "Ramah Navajo"
+            },
+            {
+              "code": "1392-0",
+              "display": "Alsea",
+              "definition": "Alsea"
+            },
+            {
+              "code": "1393-8",
+              "display": "Celilo",
+              "definition": "Celilo"
+            },
+            {
+              "code": "1394-6",
+              "display": "Columbia",
+              "definition": "Columbia"
+            },
+            {
+              "code": "1395-3",
+              "display": "Kalapuya",
+              "definition": "Kalapuya"
+            },
+            {
+              "code": "1396-1",
+              "display": "Molala",
+              "definition": "Molala"
+            },
+            {
+              "code": "1397-9",
+              "display": "Talakamish",
+              "definition": "Talakamish"
+            },
+            {
+              "code": "1398-7",
+              "display": "Tenino",
+              "definition": "Tenino"
+            },
+            {
+              "code": "1399-5",
+              "display": "Tillamook",
+              "definition": "Tillamook"
+            },
+            {
+              "code": "1400-1",
+              "display": "Wenatchee",
+              "definition": "Wenatchee"
+            },
+            {
+              "code": "1401-9",
+              "display": "Yahooskin",
+              "definition": "Yahooskin"
+            },
+            {
+              "code": "1412-6",
+              "display": "Burt Lake Ottawa",
+              "definition": "Burt Lake Ottawa"
+            },
+            {
+              "code": "1413-4",
+              "display": "Michigan Ottawa",
+              "definition": "Michigan Ottawa"
+            },
+            {
+              "code": "1414-2",
+              "display": "Oklahoma Ottawa",
+              "definition": "Oklahoma Ottawa"
+            },
+            {
+              "code": "1417-5",
+              "display": "Bishop",
+              "definition": "Bishop"
+            },
+            {
+              "code": "1418-3",
+              "display": "Bridgeport",
+              "definition": "Bridgeport"
+            },
+            {
+              "code": "1419-1",
+              "display": "Burns Paiute",
+              "definition": "Burns Paiute"
+            },
+            {
+              "code": "1420-9",
+              "display": "Cedarville",
+              "definition": "Cedarville"
+            },
+            {
+              "code": "1421-7",
+              "display": "Fort Bidwell",
+              "definition": "Fort Bidwell"
+            },
+            {
+              "code": "1422-5",
+              "display": "Fort Independence",
+              "definition": "Fort Independence"
+            },
+            {
+              "code": "1423-3",
+              "display": "Kaibab",
+              "definition": "Kaibab"
+            },
+            {
+              "code": "1424-1",
+              "display": "Las Vegas",
+              "definition": "Las Vegas"
+            },
+            {
+              "code": "1425-8",
+              "display": "Lone Pine",
+              "definition": "Lone Pine"
+            },
+            {
+              "code": "1426-6",
+              "display": "Lovelock",
+              "definition": "Lovelock"
+            },
+            {
+              "code": "1427-4",
+              "display": "Malheur Paiute",
+              "definition": "Malheur Paiute"
+            },
+            {
+              "code": "1428-2",
+              "display": "Moapa",
+              "definition": "Moapa"
+            },
+            {
+              "code": "1429-0",
+              "display": "Northern Paiute",
+              "definition": "Northern Paiute"
+            },
+            {
+              "code": "1430-8",
+              "display": "Owens Valley",
+              "definition": "Owens Valley"
+            },
+            {
+              "code": "1431-6",
+              "display": "Pyramid Lake",
+              "definition": "Pyramid Lake"
+            },
+            {
+              "code": "1432-4",
+              "display": "San Juan Southern Paiute",
+              "definition": "San Juan Southern Paiute"
+            },
+            {
+              "code": "1433-2",
+              "display": "Southern Paiute",
+              "definition": "Southern Paiute"
+            },
+            {
+              "code": "1434-0",
+              "display": "Summit Lake",
+              "definition": "Summit Lake"
+            },
+            {
+              "code": "1435-7",
+              "display": "Utu Utu Gwaitu Paiute",
+              "definition": "Utu Utu Gwaitu Paiute"
+            },
+            {
+              "code": "1436-5",
+              "display": "Walker River",
+              "definition": "Walker River"
+            },
+            {
+              "code": "1437-3",
+              "display": "Yerington Paiute",
+              "definition": "Yerington Paiute"
+            },
+            {
+              "code": "1442-3",
+              "display": "Indian Township",
+              "definition": "Indian Township"
+            },
+            {
+              "code": "1443-1",
+              "display": "Pleasant Point Passamaquoddy",
+              "definition": "Pleasant Point Passamaquoddy"
+            },
+            {
+              "code": "1446-4",
+              "display": "Oklahoma Pawnee",
+              "definition": "Oklahoma Pawnee"
+            },
+            {
+              "code": "1451-4",
+              "display": "Oklahoma Peoria",
+              "definition": "Oklahoma Peoria"
+            },
+            {
+              "code": "1454-8",
+              "display": "Marshantucket Pequot",
+              "definition": "Marshantucket Pequot"
+            },
+            {
+              "code": "1457-1",
+              "display": "Gila River Pima-Maricopa",
+              "definition": "Gila River Pima-Maricopa"
+            },
+            {
+              "code": "1458-9",
+              "display": "Salt River Pima-Maricopa",
+              "definition": "Salt River Pima-Maricopa"
+            },
+            {
+              "code": "1465-4",
+              "display": "Central Pomo",
+              "definition": "Central Pomo"
+            },
+            {
+              "code": "1466-2",
+              "display": "Dry Creek",
+              "definition": "Dry Creek"
+            },
+            {
+              "code": "1467-0",
+              "display": "Eastern Pomo",
+              "definition": "Eastern Pomo"
+            },
+            {
+              "code": "1468-8",
+              "display": "Kashia",
+              "definition": "Kashia"
+            },
+            {
+              "code": "1469-6",
+              "display": "Northern Pomo",
+              "definition": "Northern Pomo"
+            },
+            {
+              "code": "1470-4",
+              "display": "Scotts Valley",
+              "definition": "Scotts Valley"
+            },
+            {
+              "code": "1471-2",
+              "display": "Stonyford",
+              "definition": "Stonyford"
+            },
+            {
+              "code": "1472-0",
+              "display": "Sulphur Bank",
+              "definition": "Sulphur Bank"
+            },
+            {
+              "code": "1475-3",
+              "display": "Nebraska Ponca",
+              "definition": "Nebraska Ponca"
+            },
+            {
+              "code": "1476-1",
+              "display": "Oklahoma Ponca",
+              "definition": "Oklahoma Ponca"
+            },
+            {
+              "code": "1479-5",
+              "display": "Citizen Band Potawatomi",
+              "definition": "Citizen Band Potawatomi"
+            },
+            {
+              "code": "1480-3",
+              "display": "Forest County",
+              "definition": "Forest County"
+            },
+            {
+              "code": "1481-1",
+              "display": "Hannahville",
+              "definition": "Hannahville"
+            },
+            {
+              "code": "1482-9",
+              "display": "Huron Potawatomi",
+              "definition": "Huron Potawatomi"
+            },
+            {
+              "code": "1483-7",
+              "display": "Pokagon Potawatomi",
+              "definition": "Pokagon Potawatomi"
+            },
+            {
+              "code": "1484-5",
+              "display": "Prairie Band",
+              "definition": "Prairie Band"
+            },
+            {
+              "code": "1485-2",
+              "display": "Wisconsin Potawatomi",
+              "definition": "Wisconsin Potawatomi"
+            },
+            {
+              "code": "1490-2",
+              "display": "Acoma",
+              "definition": "Acoma"
+            },
+            {
+              "code": "1491-0",
+              "display": "Arizona Tewa",
+              "definition": "Arizona Tewa"
+            },
+            {
+              "code": "1492-8",
+              "display": "Cochiti",
+              "definition": "Cochiti"
+            },
+            {
+              "code": "1493-6",
+              "display": "Hopi",
+              "definition": "Hopi"
+            },
+            {
+              "code": "1494-4",
+              "display": "Isleta",
+              "definition": "Isleta"
+            },
+            {
+              "code": "1495-1",
+              "display": "Jemez",
+              "definition": "Jemez"
+            },
+            {
+              "code": "1496-9",
+              "display": "Keres",
+              "definition": "Keres"
+            },
+            {
+              "code": "1497-7",
+              "display": "Laguna",
+              "definition": "Laguna"
+            },
+            {
+              "code": "1498-5",
+              "display": "Nambe",
+              "definition": "Nambe"
+            },
+            {
+              "code": "1499-3",
+              "display": "Picuris",
+              "definition": "Picuris"
+            },
+            {
+              "code": "1500-8",
+              "display": "Piro",
+              "definition": "Piro"
+            },
+            {
+              "code": "1501-6",
+              "display": "Pojoaque",
+              "definition": "Pojoaque"
+            },
+            {
+              "code": "1502-4",
+              "display": "San Felipe",
+              "definition": "San Felipe"
+            },
+            {
+              "code": "1503-2",
+              "display": "San Ildefonso",
+              "definition": "San Ildefonso"
+            },
+            {
+              "code": "1504-0",
+              "display": "San Juan Pueblo",
+              "definition": "San Juan Pueblo"
+            },
+            {
+              "code": "1505-7",
+              "display": "San Juan De",
+              "definition": "San Juan De"
+            },
+            {
+              "code": "1506-5",
+              "display": "San Juan",
+              "definition": "San Juan"
+            },
+            {
+              "code": "1507-3",
+              "display": "Sandia",
+              "definition": "Sandia"
+            },
+            {
+              "code": "1508-1",
+              "display": "Santa Ana",
+              "definition": "Santa Ana"
+            },
+            {
+              "code": "1509-9",
+              "display": "Santa Clara",
+              "definition": "Santa Clara"
+            },
+            {
+              "code": "1510-7",
+              "display": "Santo Domingo",
+              "definition": "Santo Domingo"
+            },
+            {
+              "code": "1511-5",
+              "display": "Taos",
+              "definition": "Taos"
+            },
+            {
+              "code": "1512-3",
+              "display": "Tesuque",
+              "definition": "Tesuque"
+            },
+            {
+              "code": "1513-1",
+              "display": "Tewa",
+              "definition": "Tewa"
+            },
+            {
+              "code": "1514-9",
+              "display": "Tigua",
+              "definition": "Tigua"
+            },
+            {
+              "code": "1515-6",
+              "display": "Zia",
+              "definition": "Zia"
+            },
+            {
+              "code": "1516-4",
+              "display": "Zuni",
+              "definition": "Zuni"
+            },
+            {
+              "code": "1519-8",
+              "display": "Duwamish",
+              "definition": "Duwamish"
+            },
+            {
+              "code": "1520-6",
+              "display": "Kikiallus",
+              "definition": "Kikiallus"
+            },
+            {
+              "code": "1521-4",
+              "display": "Lower Skagit",
+              "definition": "Lower Skagit"
+            },
+            {
+              "code": "1522-2",
+              "display": "Muckleshoot",
+              "definition": "Muckleshoot"
+            },
+            {
+              "code": "1523-0",
+              "display": "Nisqually",
+              "definition": "Nisqually"
+            },
+            {
+              "code": "1524-8",
+              "display": "Nooksack",
+              "definition": "Nooksack"
+            },
+            {
+              "code": "1525-5",
+              "display": "Port Madison",
+              "definition": "Port Madison"
+            },
+            {
+              "code": "1526-3",
+              "display": "Puyallup",
+              "definition": "Puyallup"
+            },
+            {
+              "code": "1527-1",
+              "display": "Samish",
+              "definition": "Samish"
+            },
+            {
+              "code": "1528-9",
+              "display": "Sauk-Suiattle",
+              "definition": "Sauk-Suiattle"
+            },
+            {
+              "code": "1529-7",
+              "display": "Skokomish",
+              "definition": "Skokomish"
+            },
+            {
+              "code": "1530-5",
+              "display": "Skykomish",
+              "definition": "Skykomish"
+            },
+            {
+              "code": "1531-3",
+              "display": "Snohomish",
+              "definition": "Snohomish"
+            },
+            {
+              "code": "1532-1",
+              "display": "Snoqualmie",
+              "definition": "Snoqualmie"
+            },
+            {
+              "code": "1533-9",
+              "display": "Squaxin Island",
+              "definition": "Squaxin Island"
+            },
+            {
+              "code": "1534-7",
+              "display": "Steilacoom",
+              "definition": "Steilacoom"
+            },
+            {
+              "code": "1535-4",
+              "display": "Stillaguamish",
+              "definition": "Stillaguamish"
+            },
+            {
+              "code": "1536-2",
+              "display": "Suquamish",
+              "definition": "Suquamish"
+            },
+            {
+              "code": "1537-0",
+              "display": "Swinomish",
+              "definition": "Swinomish"
+            },
+            {
+              "code": "1538-8",
+              "display": "Tulalip",
+              "definition": "Tulalip"
+            },
+            {
+              "code": "1539-6",
+              "display": "Upper Skagit",
+              "definition": "Upper Skagit"
+            },
+            {
+              "code": "1552-9",
+              "display": "Iowa Sac and Fox",
+              "definition": "Iowa Sac and Fox"
+            },
+            {
+              "code": "1553-7",
+              "display": "Missouri Sac and Fox",
+              "definition": "Missouri Sac and Fox"
+            },
+            {
+              "code": "1554-5",
+              "display": "Oklahoma Sac and Fox",
+              "definition": "Oklahoma Sac and Fox"
+            },
+            {
+              "code": "1567-7",
+              "display": "Big Cypress",
+              "definition": "Big Cypress"
+            },
+            {
+              "code": "1568-5",
+              "display": "Brighton",
+              "definition": "Brighton"
+            },
+            {
+              "code": "1569-3",
+              "display": "Florida Seminole",
+              "definition": "Florida Seminole"
+            },
+            {
+              "code": "1570-1",
+              "display": "Hollywood Seminole",
+              "definition": "Hollywood Seminole"
+            },
+            {
+              "code": "1571-9",
+              "display": "Oklahoma Seminole",
+              "definition": "Oklahoma Seminole"
+            },
+            {
+              "code": "1574-3",
+              "display": "San Manual",
+              "definition": "San Manual"
+            },
+            {
+              "code": "1579-2",
+              "display": "Absentee Shawnee",
+              "definition": "Absentee Shawnee"
+            },
+            {
+              "code": "1580-0",
+              "display": "Eastern Shawnee",
+              "definition": "Eastern Shawnee"
+            },
+            {
+              "code": "1587-5",
+              "display": "Battle Mountain",
+              "definition": "Battle Mountain"
+            },
+            {
+              "code": "1588-3",
+              "display": "Duckwater",
+              "definition": "Duckwater"
+            },
+            {
+              "code": "1589-1",
+              "display": "Elko",
+              "definition": "Elko"
+            },
+            {
+              "code": "1590-9",
+              "display": "Ely",
+              "definition": "Ely"
+            },
+            {
+              "code": "1591-7",
+              "display": "Goshute",
+              "definition": "Goshute"
+            },
+            {
+              "code": "1592-5",
+              "display": "Panamint",
+              "definition": "Panamint"
+            },
+            {
+              "code": "1593-3",
+              "display": "Ruby Valley",
+              "definition": "Ruby Valley"
+            },
+            {
+              "code": "1594-1",
+              "display": "Skull Valley",
+              "definition": "Skull Valley"
+            },
+            {
+              "code": "1595-8",
+              "display": "South Fork Shoshone",
+              "definition": "South Fork Shoshone"
+            },
+            {
+              "code": "1596-6",
+              "display": "Te-Moak Western Shoshone",
+              "definition": "Te-Moak Western Shoshone"
+            },
+            {
+              "code": "1597-4",
+              "display": "Timbi-Sha Shoshone",
+              "definition": "Timbi-Sha Shoshone"
+            },
+            {
+              "code": "1598-2",
+              "display": "Washakie",
+              "definition": "Washakie"
+            },
+            {
+              "code": "1599-0",
+              "display": "Wind River Shoshone",
+              "definition": "Wind River Shoshone"
+            },
+            {
+              "code": "1600-6",
+              "display": "Yomba",
+              "definition": "Yomba"
+            },
+            {
+              "code": "1603-0",
+              "display": "Duck Valley",
+              "definition": "Duck Valley"
+            },
+            {
+              "code": "1604-8",
+              "display": "Fallon",
+              "definition": "Fallon"
+            },
+            {
+              "code": "1605-5",
+              "display": "Fort McDermitt",
+              "definition": "Fort McDermitt"
+            },
+            {
+              "code": "1610-5",
+              "display": "Blackfoot Sioux",
+              "definition": "Blackfoot Sioux"
+            },
+            {
+              "code": "1611-3",
+              "display": "Brule Sioux",
+              "definition": "Brule Sioux"
+            },
+            {
+              "code": "1612-1",
+              "display": "Cheyenne River Sioux",
+              "definition": "Cheyenne River Sioux"
+            },
+            {
+              "code": "1613-9",
+              "display": "Crow Creek Sioux",
+              "definition": "Crow Creek Sioux"
+            },
+            {
+              "code": "1614-7",
+              "display": "Dakota Sioux",
+              "definition": "Dakota Sioux"
+            },
+            {
+              "code": "1615-4",
+              "display": "Flandreau Santee",
+              "definition": "Flandreau Santee"
+            },
+            {
+              "code": "1616-2",
+              "display": "Fort Peck",
+              "definition": "Fort Peck"
+            },
+            {
+              "code": "1617-0",
+              "display": "Lake Traverse Sioux",
+              "definition": "Lake Traverse Sioux"
+            },
+            {
+              "code": "1618-8",
+              "display": "Lower Brule Sioux",
+              "definition": "Lower Brule Sioux"
+            },
+            {
+              "code": "1619-6",
+              "display": "Lower Sioux",
+              "definition": "Lower Sioux"
+            },
+            {
+              "code": "1620-4",
+              "display": "Mdewakanton Sioux",
+              "definition": "Mdewakanton Sioux"
+            },
+            {
+              "code": "1621-2",
+              "display": "Miniconjou",
+              "definition": "Miniconjou"
+            },
+            {
+              "code": "1622-0",
+              "display": "Oglala Sioux",
+              "definition": "Oglala Sioux"
+            },
+            {
+              "code": "1623-8",
+              "display": "Pine Ridge Sioux",
+              "definition": "Pine Ridge Sioux"
+            },
+            {
+              "code": "1624-6",
+              "display": "Pipestone Sioux",
+              "definition": "Pipestone Sioux"
+            },
+            {
+              "code": "1625-3",
+              "display": "Prairie Island Sioux",
+              "definition": "Prairie Island Sioux"
+            },
+            {
+              "code": "1626-1",
+              "display": "Prior Lake Sioux",
+              "definition": "Prior Lake Sioux"
+            },
+            {
+              "code": "1627-9",
+              "display": "Rosebud Sioux",
+              "definition": "Rosebud Sioux"
+            },
+            {
+              "code": "1628-7",
+              "display": "Sans Arc Sioux",
+              "definition": "Sans Arc Sioux"
+            },
+            {
+              "code": "1629-5",
+              "display": "Santee Sioux",
+              "definition": "Santee Sioux"
+            },
+            {
+              "code": "1630-3",
+              "display": "Sisseton-Wahpeton",
+              "definition": "Sisseton-Wahpeton"
+            },
+            {
+              "code": "1631-1",
+              "display": "Sisseton Sioux",
+              "definition": "Sisseton Sioux"
+            },
+            {
+              "code": "1632-9",
+              "display": "Spirit Lake Sioux",
+              "definition": "Spirit Lake Sioux"
+            },
+            {
+              "code": "1633-7",
+              "display": "Standing Rock Sioux",
+              "definition": "Standing Rock Sioux"
+            },
+            {
+              "code": "1634-5",
+              "display": "Teton Sioux",
+              "definition": "Teton Sioux"
+            },
+            {
+              "code": "1635-2",
+              "display": "Two Kettle Sioux",
+              "definition": "Two Kettle Sioux"
+            },
+            {
+              "code": "1636-0",
+              "display": "Upper Sioux",
+              "definition": "Upper Sioux"
+            },
+            {
+              "code": "1637-8",
+              "display": "Wahpekute Sioux",
+              "definition": "Wahpekute Sioux"
+            },
+            {
+              "code": "1638-6",
+              "display": "Wahpeton Sioux",
+              "definition": "Wahpeton Sioux"
+            },
+            {
+              "code": "1639-4",
+              "display": "Wazhaza Sioux",
+              "definition": "Wazhaza Sioux"
+            },
+            {
+              "code": "1640-2",
+              "display": "Yankton Sioux",
+              "definition": "Yankton Sioux"
+            },
+            {
+              "code": "1641-0",
+              "display": "Yanktonai Sioux",
+              "definition": "Yanktonai Sioux"
+            },
+            {
+              "code": "1654-3",
+              "display": "Ak-Chin",
+              "definition": "Ak-Chin"
+            },
+            {
+              "code": "1655-0",
+              "display": "Gila Bend",
+              "definition": "Gila Bend"
+            },
+            {
+              "code": "1656-8",
+              "display": "San Xavier",
+              "definition": "San Xavier"
+            },
+            {
+              "code": "1657-6",
+              "display": "Sells",
+              "definition": "Sells"
+            },
+            {
+              "code": "1668-3",
+              "display": "Cow Creek Umpqua",
+              "definition": "Cow Creek Umpqua"
+            },
+            {
+              "code": "1671-7",
+              "display": "Allen Canyon",
+              "definition": "Allen Canyon"
+            },
+            {
+              "code": "1672-5",
+              "display": "Uintah Ute",
+              "definition": "Uintah Ute"
+            },
+            {
+              "code": "1673-3",
+              "display": "Ute Mountain Ute",
+              "definition": "Ute Mountain Ute"
+            },
+            {
+              "code": "1680-8",
+              "display": "Gay Head Wampanoag",
+              "definition": "Gay Head Wampanoag"
+            },
+            {
+              "code": "1681-6",
+              "display": "Mashpee Wampanoag",
+              "definition": "Mashpee Wampanoag"
+            },
+            {
+              "code": "1688-1",
+              "display": "Alpine",
+              "definition": "Alpine"
+            },
+            {
+              "code": "1689-9",
+              "display": "Carson",
+              "definition": "Carson"
+            },
+            {
+              "code": "1690-7",
+              "display": "Dresslerville",
+              "definition": "Dresslerville"
+            },
+            {
+              "code": "1697-2",
+              "display": "Ho-chunk",
+              "definition": "Ho-chunk"
+            },
+            {
+              "code": "1698-0",
+              "display": "Nebraska Winnebago",
+              "definition": "Nebraska Winnebago"
+            },
+            {
+              "code": "1705-3",
+              "display": "Table Bluff",
+              "definition": "Table Bluff"
+            },
+            {
+              "code": "1712-9",
+              "display": "Barrio Libre",
+              "definition": "Barrio Libre"
+            },
+            {
+              "code": "1713-7",
+              "display": "Pascua Yaqui",
+              "definition": "Pascua Yaqui"
+            },
+            {
+              "code": "1718-6",
+              "display": "Chukchansi",
+              "definition": "Chukchansi"
+            },
+            {
+              "code": "1719-4",
+              "display": "Tachi",
+              "definition": "Tachi"
+            },
+            {
+              "code": "1720-2",
+              "display": "Tule River",
+              "definition": "Tule River"
+            },
+            {
+              "code": "1725-1",
+              "display": "Cocopah",
+              "definition": "Cocopah"
+            },
+            {
+              "code": "1726-9",
+              "display": "Havasupai",
+              "definition": "Havasupai"
+            },
+            {
+              "code": "1727-7",
+              "display": "Hualapai",
+              "definition": "Hualapai"
+            },
+            {
+              "code": "1728-5",
+              "display": "Maricopa",
+              "definition": "Maricopa"
+            },
+            {
+              "code": "1729-3",
+              "display": "Mohave",
+              "definition": "Mohave"
+            },
+            {
+              "code": "1730-1",
+              "display": "Quechan",
+              "definition": "Quechan"
+            },
+            {
+              "code": "1731-9",
+              "display": "Yavapai",
+              "definition": "Yavapai"
+            },
+            {
+              "code": "1733-5",
+              "display": "Coast Yurok",
+              "definition": "Coast Yurok"
+            },
+            {
+              "code": "1737-6",
+              "display": "Alaska Indian",
+              "definition": "Alaska Indian"
+            },
+            {
+              "code": "1840-8",
+              "display": "Eskimo",
+              "definition": "Eskimo"
+            },
+            {
+              "code": "1966-1",
+              "display": "Aleut",
+              "definition": "Aleut"
+            },
+            {
+              "code": "1739-2",
+              "display": "Alaskan Athabascan",
+              "definition": "Alaskan Athabascan"
+            },
+            {
+              "code": "1811-9",
+              "display": "Southeast Alaska",
+              "definition": "Southeast Alaska"
+            },
+            {
+              "code": "1740-0",
+              "display": "Ahtna",
+              "definition": "Ahtna"
+            },
+            {
+              "code": "1741-8",
+              "display": "Alatna",
+              "definition": "Alatna"
+            },
+            {
+              "code": "1742-6",
+              "display": "Alexander",
+              "definition": "Alexander"
+            },
+            {
+              "code": "1743-4",
+              "display": "Allakaket",
+              "definition": "Allakaket"
+            },
+            {
+              "code": "1744-2",
+              "display": "Alanvik",
+              "definition": "Alanvik"
+            },
+            {
+              "code": "1745-9",
+              "display": "Anvik",
+              "definition": "Anvik"
+            },
+            {
+              "code": "1746-7",
+              "display": "Arctic",
+              "definition": "Arctic"
+            },
+            {
+              "code": "1747-5",
+              "display": "Beaver",
+              "definition": "Beaver"
+            },
+            {
+              "code": "1748-3",
+              "display": "Birch Creek",
+              "definition": "Birch Creek"
+            },
+            {
+              "code": "1749-1",
+              "display": "Cantwell",
+              "definition": "Cantwell"
+            },
+            {
+              "code": "1750-9",
+              "display": "Chalkyitsik",
+              "definition": "Chalkyitsik"
+            },
+            {
+              "code": "1751-7",
+              "display": "Chickaloon",
+              "definition": "Chickaloon"
+            },
+            {
+              "code": "1752-5",
+              "display": "Chistochina",
+              "definition": "Chistochina"
+            },
+            {
+              "code": "1753-3",
+              "display": "Chitina",
+              "definition": "Chitina"
+            },
+            {
+              "code": "1754-1",
+              "display": "Circle",
+              "definition": "Circle"
+            },
+            {
+              "code": "1755-8",
+              "display": "Cook Inlet",
+              "definition": "Cook Inlet"
+            },
+            {
+              "code": "1756-6",
+              "display": "Copper Center",
+              "definition": "Copper Center"
+            },
+            {
+              "code": "1757-4",
+              "display": "Copper River",
+              "definition": "Copper River"
+            },
+            {
+              "code": "1758-2",
+              "display": "Dot Lake",
+              "definition": "Dot Lake"
+            },
+            {
+              "code": "1759-0",
+              "display": "Doyon",
+              "definition": "Doyon"
+            },
+            {
+              "code": "1760-8",
+              "display": "Eagle",
+              "definition": "Eagle"
+            },
+            {
+              "code": "1761-6",
+              "display": "Eklutna",
+              "definition": "Eklutna"
+            },
+            {
+              "code": "1762-4",
+              "display": "Evansville",
+              "definition": "Evansville"
+            },
+            {
+              "code": "1763-2",
+              "display": "Fort Yukon",
+              "definition": "Fort Yukon"
+            },
+            {
+              "code": "1764-0",
+              "display": "Gakona",
+              "definition": "Gakona"
+            },
+            {
+              "code": "1765-7",
+              "display": "Galena",
+              "definition": "Galena"
+            },
+            {
+              "code": "1766-5",
+              "display": "Grayling",
+              "definition": "Grayling"
+            },
+            {
+              "code": "1767-3",
+              "display": "Gulkana",
+              "definition": "Gulkana"
+            },
+            {
+              "code": "1768-1",
+              "display": "Healy Lake",
+              "definition": "Healy Lake"
+            },
+            {
+              "code": "1769-9",
+              "display": "Holy Cross",
+              "definition": "Holy Cross"
+            },
+            {
+              "code": "1770-7",
+              "display": "Hughes",
+              "definition": "Hughes"
+            },
+            {
+              "code": "1771-5",
+              "display": "Huslia",
+              "definition": "Huslia"
+            },
+            {
+              "code": "1772-3",
+              "display": "Iliamna",
+              "definition": "Iliamna"
+            },
+            {
+              "code": "1773-1",
+              "display": "Kaltag",
+              "definition": "Kaltag"
+            },
+            {
+              "code": "1774-9",
+              "display": "Kluti Kaah",
+              "definition": "Kluti Kaah"
+            },
+            {
+              "code": "1775-6",
+              "display": "Knik",
+              "definition": "Knik"
+            },
+            {
+              "code": "1776-4",
+              "display": "Koyukuk",
+              "definition": "Koyukuk"
+            },
+            {
+              "code": "1777-2",
+              "display": "Lake Minchumina",
+              "definition": "Lake Minchumina"
+            },
+            {
+              "code": "1778-0",
+              "display": "Lime",
+              "definition": "Lime"
+            },
+            {
+              "code": "1779-8",
+              "display": "Mcgrath",
+              "definition": "Mcgrath"
+            },
+            {
+              "code": "1780-6",
+              "display": "Manley Hot Springs",
+              "definition": "Manley Hot Springs"
+            },
+            {
+              "code": "1781-4",
+              "display": "Mentasta Lake",
+              "definition": "Mentasta Lake"
+            },
+            {
+              "code": "1782-2",
+              "display": "Minto",
+              "definition": "Minto"
+            },
+            {
+              "code": "1783-0",
+              "display": "Nenana",
+              "definition": "Nenana"
+            },
+            {
+              "code": "1784-8",
+              "display": "Nikolai",
+              "definition": "Nikolai"
+            },
+            {
+              "code": "1785-5",
+              "display": "Ninilchik",
+              "definition": "Ninilchik"
+            },
+            {
+              "code": "1786-3",
+              "display": "Nondalton",
+              "definition": "Nondalton"
+            },
+            {
+              "code": "1787-1",
+              "display": "Northway",
+              "definition": "Northway"
+            },
+            {
+              "code": "1788-9",
+              "display": "Nulato",
+              "definition": "Nulato"
+            },
+            {
+              "code": "1789-7",
+              "display": "Pedro Bay",
+              "definition": "Pedro Bay"
+            },
+            {
+              "code": "1790-5",
+              "display": "Rampart",
+              "definition": "Rampart"
+            },
+            {
+              "code": "1791-3",
+              "display": "Ruby",
+              "definition": "Ruby"
+            },
+            {
+              "code": "1792-1",
+              "display": "Salamatof",
+              "definition": "Salamatof"
+            },
+            {
+              "code": "1793-9",
+              "display": "Seldovia",
+              "definition": "Seldovia"
+            },
+            {
+              "code": "1794-7",
+              "display": "Slana",
+              "definition": "Slana"
+            },
+            {
+              "code": "1795-4",
+              "display": "Shageluk",
+              "definition": "Shageluk"
+            },
+            {
+              "code": "1796-2",
+              "display": "Stevens",
+              "definition": "Stevens"
+            },
+            {
+              "code": "1797-0",
+              "display": "Stony River",
+              "definition": "Stony River"
+            },
+            {
+              "code": "1798-8",
+              "display": "Takotna",
+              "definition": "Takotna"
+            },
+            {
+              "code": "1799-6",
+              "display": "Tanacross",
+              "definition": "Tanacross"
+            },
+            {
+              "code": "1800-2",
+              "display": "Tanaina",
+              "definition": "Tanaina"
+            },
+            {
+              "code": "1801-0",
+              "display": "Tanana",
+              "definition": "Tanana"
+            },
+            {
+              "code": "1802-8",
+              "display": "Tanana Chiefs",
+              "definition": "Tanana Chiefs"
+            },
+            {
+              "code": "1803-6",
+              "display": "Tazlina",
+              "definition": "Tazlina"
+            },
+            {
+              "code": "1804-4",
+              "display": "Telida",
+              "definition": "Telida"
+            },
+            {
+              "code": "1805-1",
+              "display": "Tetlin",
+              "definition": "Tetlin"
+            },
+            {
+              "code": "1806-9",
+              "display": "Tok",
+              "definition": "Tok"
+            },
+            {
+              "code": "1807-7",
+              "display": "Tyonek",
+              "definition": "Tyonek"
+            },
+            {
+              "code": "1808-5",
+              "display": "Venetie",
+              "definition": "Venetie"
+            },
+            {
+              "code": "1809-3",
+              "display": "Wiseman",
+              "definition": "Wiseman"
+            },
+            {
+              "code": "1813-5",
+              "display": "Tlingit-Haida",
+              "definition": "Tlingit-Haida"
+            },
+            {
+              "code": "1837-4",
+              "display": "Tsimshian",
+              "definition": "Tsimshian"
+            },
+            {
+              "code": "1814-3",
+              "display": "Angoon",
+              "definition": "Angoon"
+            },
+            {
+              "code": "1815-0",
+              "display": "Central Council of Tlingit and Haida Tribes",
+              "definition": "Central Council of Tlingit and Haida Tribes"
+            },
+            {
+              "code": "1816-8",
+              "display": "Chilkat",
+              "definition": "Chilkat"
+            },
+            {
+              "code": "1817-6",
+              "display": "Chilkoot",
+              "definition": "Chilkoot"
+            },
+            {
+              "code": "1818-4",
+              "display": "Craig",
+              "definition": "Craig"
+            },
+            {
+              "code": "1819-2",
+              "display": "Douglas",
+              "definition": "Douglas"
+            },
+            {
+              "code": "1820-0",
+              "display": "Haida",
+              "definition": "Haida"
+            },
+            {
+              "code": "1821-8",
+              "display": "Hoonah",
+              "definition": "Hoonah"
+            },
+            {
+              "code": "1822-6",
+              "display": "Hydaburg",
+              "definition": "Hydaburg"
+            },
+            {
+              "code": "1823-4",
+              "display": "Kake",
+              "definition": "Kake"
+            },
+            {
+              "code": "1824-2",
+              "display": "Kasaan",
+              "definition": "Kasaan"
+            },
+            {
+              "code": "1825-9",
+              "display": "Kenaitze",
+              "definition": "Kenaitze"
+            },
+            {
+              "code": "1826-7",
+              "display": "Ketchikan",
+              "definition": "Ketchikan"
+            },
+            {
+              "code": "1827-5",
+              "display": "Klawock",
+              "definition": "Klawock"
+            },
+            {
+              "code": "1828-3",
+              "display": "Pelican",
+              "definition": "Pelican"
+            },
+            {
+              "code": "1829-1",
+              "display": "Petersburg",
+              "definition": "Petersburg"
+            },
+            {
+              "code": "1830-9",
+              "display": "Saxman",
+              "definition": "Saxman"
+            },
+            {
+              "code": "1831-7",
+              "display": "Sitka",
+              "definition": "Sitka"
+            },
+            {
+              "code": "1832-5",
+              "display": "Tenakee Springs",
+              "definition": "Tenakee Springs"
+            },
+            {
+              "code": "1833-3",
+              "display": "Tlingit",
+              "definition": "Tlingit"
+            },
+            {
+              "code": "1834-1",
+              "display": "Wrangell",
+              "definition": "Wrangell"
+            },
+            {
+              "code": "1835-8",
+              "display": "Yakutat",
+              "definition": "Yakutat"
+            },
+            {
+              "code": "1838-2",
+              "display": "Metlakatla",
+              "definition": "Metlakatla"
+            },
+            {
+              "code": "1842-4",
+              "display": "Greenland Eskimo",
+              "definition": "Greenland Eskimo"
+            },
+            {
+              "code": "1844-0",
+              "display": "Inupiat Eskimo",
+              "definition": "Inupiat Eskimo"
+            },
+            {
+              "code": "1891-1",
+              "display": "Siberian Eskimo",
+              "definition": "Siberian Eskimo"
+            },
+            {
+              "code": "1896-0",
+              "display": "Yupik Eskimo",
+              "definition": "Yupik Eskimo"
+            },
+            {
+              "code": "1845-7",
+              "display": "Ambler",
+              "definition": "Ambler"
+            },
+            {
+              "code": "1846-5",
+              "display": "Anaktuvuk",
+              "definition": "Anaktuvuk"
+            },
+            {
+              "code": "1847-3",
+              "display": "Anaktuvuk Pass",
+              "definition": "Anaktuvuk Pass"
+            },
+            {
+              "code": "1848-1",
+              "display": "Arctic Slope Inupiat",
+              "definition": "Arctic Slope Inupiat"
+            },
+            {
+              "code": "1849-9",
+              "display": "Arctic Slope Corporation",
+              "definition": "Arctic Slope Corporation"
+            },
+            {
+              "code": "1850-7",
+              "display": "Atqasuk",
+              "definition": "Atqasuk"
+            },
+            {
+              "code": "1851-5",
+              "display": "Barrow",
+              "definition": "Barrow"
+            },
+            {
+              "code": "1852-3",
+              "display": "Bering Straits Inupiat",
+              "definition": "Bering Straits Inupiat"
+            },
+            {
+              "code": "1853-1",
+              "display": "Brevig Mission",
+              "definition": "Brevig Mission"
+            },
+            {
+              "code": "1854-9",
+              "display": "Buckland",
+              "definition": "Buckland"
+            },
+            {
+              "code": "1855-6",
+              "display": "Chinik",
+              "definition": "Chinik"
+            },
+            {
+              "code": "1856-4",
+              "display": "Council",
+              "definition": "Council"
+            },
+            {
+              "code": "1857-2",
+              "display": "Deering",
+              "definition": "Deering"
+            },
+            {
+              "code": "1858-0",
+              "display": "Elim",
+              "definition": "Elim"
+            },
+            {
+              "code": "1859-8",
+              "display": "Golovin",
+              "definition": "Golovin"
+            },
+            {
+              "code": "1860-6",
+              "display": "Inalik Diomede",
+              "definition": "Inalik Diomede"
+            },
+            {
+              "code": "1861-4",
+              "display": "Inupiaq",
+              "definition": "Inupiaq"
+            },
+            {
+              "code": "1862-2",
+              "display": "Kaktovik",
+              "definition": "Kaktovik"
+            },
+            {
+              "code": "1863-0",
+              "display": "Kawerak",
+              "definition": "Kawerak"
+            },
+            {
+              "code": "1864-8",
+              "display": "Kiana",
+              "definition": "Kiana"
+            },
+            {
+              "code": "1865-5",
+              "display": "Kivalina",
+              "definition": "Kivalina"
+            },
+            {
+              "code": "1866-3",
+              "display": "Kobuk",
+              "definition": "Kobuk"
+            },
+            {
+              "code": "1867-1",
+              "display": "Kotzebue",
+              "definition": "Kotzebue"
+            },
+            {
+              "code": "1868-9",
+              "display": "Koyuk",
+              "definition": "Koyuk"
+            },
+            {
+              "code": "1869-7",
+              "display": "Kwiguk",
+              "definition": "Kwiguk"
+            },
+            {
+              "code": "1870-5",
+              "display": "Mauneluk Inupiat",
+              "definition": "Mauneluk Inupiat"
+            },
+            {
+              "code": "1871-3",
+              "display": "Nana Inupiat",
+              "definition": "Nana Inupiat"
+            },
+            {
+              "code": "1872-1",
+              "display": "Noatak",
+              "definition": "Noatak"
+            },
+            {
+              "code": "1873-9",
+              "display": "Nome",
+              "definition": "Nome"
+            },
+            {
+              "code": "1874-7",
+              "display": "Noorvik",
+              "definition": "Noorvik"
+            },
+            {
+              "code": "1875-4",
+              "display": "Nuiqsut",
+              "definition": "Nuiqsut"
+            },
+            {
+              "code": "1876-2",
+              "display": "Point Hope",
+              "definition": "Point Hope"
+            },
+            {
+              "code": "1877-0",
+              "display": "Point Lay",
+              "definition": "Point Lay"
+            },
+            {
+              "code": "1878-8",
+              "display": "Selawik",
+              "definition": "Selawik"
+            },
+            {
+              "code": "1879-6",
+              "display": "Shaktoolik",
+              "definition": "Shaktoolik"
+            },
+            {
+              "code": "1880-4",
+              "display": "Shishmaref",
+              "definition": "Shishmaref"
+            },
+            {
+              "code": "1881-2",
+              "display": "Shungnak",
+              "definition": "Shungnak"
+            },
+            {
+              "code": "1882-0",
+              "display": "Solomon",
+              "definition": "Solomon"
+            },
+            {
+              "code": "1883-8",
+              "display": "Teller",
+              "definition": "Teller"
+            },
+            {
+              "code": "1884-6",
+              "display": "Unalakleet",
+              "definition": "Unalakleet"
+            },
+            {
+              "code": "1885-3",
+              "display": "Wainwright",
+              "definition": "Wainwright"
+            },
+            {
+              "code": "1886-1",
+              "display": "Wales",
+              "definition": "Wales"
+            },
+            {
+              "code": "1887-9",
+              "display": "White Mountain",
+              "definition": "White Mountain"
+            },
+            {
+              "code": "1888-7",
+              "display": "White Mountain Inupiat",
+              "definition": "White Mountain Inupiat"
+            },
+            {
+              "code": "1889-5",
+              "display": "Mary's Igloo",
+              "definition": "Mary's Igloo"
+            },
+            {
+              "code": "1892-9",
+              "display": "Gambell",
+              "definition": "Gambell"
+            },
+            {
+              "code": "1893-7",
+              "display": "Savoonga",
+              "definition": "Savoonga"
+            },
+            {
+              "code": "1894-5",
+              "display": "Siberian Yupik",
+              "definition": "Siberian Yupik"
+            },
+            {
+              "code": "1897-8",
+              "display": "Akiachak",
+              "definition": "Akiachak"
+            },
+            {
+              "code": "1898-6",
+              "display": "Akiak",
+              "definition": "Akiak"
+            },
+            {
+              "code": "1899-4",
+              "display": "Alakanuk",
+              "definition": "Alakanuk"
+            },
+            {
+              "code": "1900-0",
+              "display": "Aleknagik",
+              "definition": "Aleknagik"
+            },
+            {
+              "code": "1901-8",
+              "display": "Andreafsky",
+              "definition": "Andreafsky"
+            },
+            {
+              "code": "1902-6",
+              "display": "Aniak",
+              "definition": "Aniak"
+            },
+            {
+              "code": "1903-4",
+              "display": "Atmautluak",
+              "definition": "Atmautluak"
+            },
+            {
+              "code": "1904-2",
+              "display": "Bethel",
+              "definition": "Bethel"
+            },
+            {
+              "code": "1905-9",
+              "display": "Bill Moore's Slough",
+              "definition": "Bill Moore's Slough"
+            },
+            {
+              "code": "1906-7",
+              "display": "Bristol Bay Yupik",
+              "definition": "Bristol Bay Yupik"
+            },
+            {
+              "code": "1907-5",
+              "display": "Calista Yupik",
+              "definition": "Calista Yupik"
+            },
+            {
+              "code": "1908-3",
+              "display": "Chefornak",
+              "definition": "Chefornak"
+            },
+            {
+              "code": "1909-1",
+              "display": "Chevak",
+              "definition": "Chevak"
+            },
+            {
+              "code": "1910-9",
+              "display": "Chuathbaluk",
+              "definition": "Chuathbaluk"
+            },
+            {
+              "code": "1911-7",
+              "display": "Clark's Point",
+              "definition": "Clark's Point"
+            },
+            {
+              "code": "1912-5",
+              "display": "Crooked Creek",
+              "definition": "Crooked Creek"
+            },
+            {
+              "code": "1913-3",
+              "display": "Dillingham",
+              "definition": "Dillingham"
+            },
+            {
+              "code": "1914-1",
+              "display": "Eek",
+              "definition": "Eek"
+            },
+            {
+              "code": "1915-8",
+              "display": "Ekuk",
+              "definition": "Ekuk"
+            },
+            {
+              "code": "1916-6",
+              "display": "Ekwok",
+              "definition": "Ekwok"
+            },
+            {
+              "code": "1917-4",
+              "display": "Emmonak",
+              "definition": "Emmonak"
+            },
+            {
+              "code": "1918-2",
+              "display": "Goodnews Bay",
+              "definition": "Goodnews Bay"
+            },
+            {
+              "code": "1919-0",
+              "display": "Hooper Bay",
+              "definition": "Hooper Bay"
+            },
+            {
+              "code": "1920-8",
+              "display": "Iqurmuit (Russian Mission)",
+              "definition": "Iqurmuit (Russian Mission)"
+            },
+            {
+              "code": "1921-6",
+              "display": "Kalskag",
+              "definition": "Kalskag"
+            },
+            {
+              "code": "1922-4",
+              "display": "Kasigluk",
+              "definition": "Kasigluk"
+            },
+            {
+              "code": "1923-2",
+              "display": "Kipnuk",
+              "definition": "Kipnuk"
+            },
+            {
+              "code": "1924-0",
+              "display": "Koliganek",
+              "definition": "Koliganek"
+            },
+            {
+              "code": "1925-7",
+              "display": "Kongiganak",
+              "definition": "Kongiganak"
+            },
+            {
+              "code": "1926-5",
+              "display": "Kotlik",
+              "definition": "Kotlik"
+            },
+            {
+              "code": "1927-3",
+              "display": "Kwethluk",
+              "definition": "Kwethluk"
+            },
+            {
+              "code": "1928-1",
+              "display": "Kwigillingok",
+              "definition": "Kwigillingok"
+            },
+            {
+              "code": "1929-9",
+              "display": "Levelock",
+              "definition": "Levelock"
+            },
+            {
+              "code": "1930-7",
+              "display": "Lower Kalskag",
+              "definition": "Lower Kalskag"
+            },
+            {
+              "code": "1931-5",
+              "display": "Manokotak",
+              "definition": "Manokotak"
+            },
+            {
+              "code": "1932-3",
+              "display": "Marshall",
+              "definition": "Marshall"
+            },
+            {
+              "code": "1933-1",
+              "display": "Mekoryuk",
+              "definition": "Mekoryuk"
+            },
+            {
+              "code": "1934-9",
+              "display": "Mountain Village",
+              "definition": "Mountain Village"
+            },
+            {
+              "code": "1935-6",
+              "display": "Naknek",
+              "definition": "Naknek"
+            },
+            {
+              "code": "1936-4",
+              "display": "Napaumute",
+              "definition": "Napaumute"
+            },
+            {
+              "code": "1937-2",
+              "display": "Napakiak",
+              "definition": "Napakiak"
+            },
+            {
+              "code": "1938-0",
+              "display": "Napaskiak",
+              "definition": "Napaskiak"
+            },
+            {
+              "code": "1939-8",
+              "display": "Newhalen",
+              "definition": "Newhalen"
+            },
+            {
+              "code": "1940-6",
+              "display": "New Stuyahok",
+              "definition": "New Stuyahok"
+            },
+            {
+              "code": "1941-4",
+              "display": "Newtok",
+              "definition": "Newtok"
+            },
+            {
+              "code": "1942-2",
+              "display": "Nightmute",
+              "definition": "Nightmute"
+            },
+            {
+              "code": "1943-0",
+              "display": "Nunapitchukv",
+              "definition": "Nunapitchukv"
+            },
+            {
+              "code": "1944-8",
+              "display": "Oscarville",
+              "definition": "Oscarville"
+            },
+            {
+              "code": "1945-5",
+              "display": "Pilot Station",
+              "definition": "Pilot Station"
+            },
+            {
+              "code": "1946-3",
+              "display": "Pitkas Point",
+              "definition": "Pitkas Point"
+            },
+            {
+              "code": "1947-1",
+              "display": "Platinum",
+              "definition": "Platinum"
+            },
+            {
+              "code": "1948-9",
+              "display": "Portage Creek",
+              "definition": "Portage Creek"
+            },
+            {
+              "code": "1949-7",
+              "display": "Quinhagak",
+              "definition": "Quinhagak"
+            },
+            {
+              "code": "1950-5",
+              "display": "Red Devil",
+              "definition": "Red Devil"
+            },
+            {
+              "code": "1951-3",
+              "display": "St. Michael",
+              "definition": "St. Michael"
+            },
+            {
+              "code": "1952-1",
+              "display": "Scammon Bay",
+              "definition": "Scammon Bay"
+            },
+            {
+              "code": "1953-9",
+              "display": "Sheldon's Point",
+              "definition": "Sheldon's Point"
+            },
+            {
+              "code": "1954-7",
+              "display": "Sleetmute",
+              "definition": "Sleetmute"
+            },
+            {
+              "code": "1955-4",
+              "display": "Stebbins",
+              "definition": "Stebbins"
+            },
+            {
+              "code": "1956-2",
+              "display": "Togiak",
+              "definition": "Togiak"
+            },
+            {
+              "code": "1957-0",
+              "display": "Toksook",
+              "definition": "Toksook"
+            },
+            {
+              "code": "1958-8",
+              "display": "Tulukskak",
+              "definition": "Tulukskak"
+            },
+            {
+              "code": "1959-6",
+              "display": "Tuntutuliak",
+              "definition": "Tuntutuliak"
+            },
+            {
+              "code": "1960-4",
+              "display": "Tununak",
+              "definition": "Tununak"
+            },
+            {
+              "code": "1961-2",
+              "display": "Twin Hills",
+              "definition": "Twin Hills"
+            },
+            {
+              "code": "1962-0",
+              "display": "Georgetown (Yupik-Eskimo)",
+              "definition": "Georgetown (Yupik-Eskimo)"
+            },
+            {
+              "code": "1963-8",
+              "display": "St. Mary's",
+              "definition": "St. Mary's"
+            },
+            {
+              "code": "1964-6",
+              "display": "Umkumiate",
+              "definition": "Umkumiate"
+            },
+            {
+              "code": "1968-7",
+              "display": "Alutiiq Aleut",
+              "definition": "Alutiiq Aleut"
+            },
+            {
+              "code": "1972-9",
+              "display": "Bristol Bay Aleut",
+              "definition": "Bristol Bay Aleut"
+            },
+            {
+              "code": "1984-4",
+              "display": "Chugach Aleut",
+              "definition": "Chugach Aleut"
+            },
+            {
+              "code": "1990-1",
+              "display": "Eyak",
+              "definition": "Eyak"
+            },
+            {
+              "code": "1992-7",
+              "display": "Koniag Aleut",
+              "definition": "Koniag Aleut"
+            },
+            {
+              "code": "2002-4",
+              "display": "Sugpiaq",
+              "definition": "Sugpiaq"
+            },
+            {
+              "code": "2004-0",
+              "display": "Suqpigaq",
+              "definition": "Suqpigaq"
+            },
+            {
+              "code": "2006-5",
+              "display": "Unangan Aleut",
+              "definition": "Unangan Aleut"
+            },
+            {
+              "code": "1969-5",
+              "display": "Tatitlek",
+              "definition": "Tatitlek"
+            },
+            {
+              "code": "1970-3",
+              "display": "Ugashik",
+              "definition": "Ugashik"
+            },
+            {
+              "code": "1973-7",
+              "display": "Chignik",
+              "definition": "Chignik"
+            },
+            {
+              "code": "1974-5",
+              "display": "Chignik Lake",
+              "definition": "Chignik Lake"
+            },
+            {
+              "code": "1975-2",
+              "display": "Egegik",
+              "definition": "Egegik"
+            },
+            {
+              "code": "1976-0",
+              "display": "Igiugig",
+              "definition": "Igiugig"
+            },
+            {
+              "code": "1977-8",
+              "display": "Ivanof Bay",
+              "definition": "Ivanof Bay"
+            },
+            {
+              "code": "1978-6",
+              "display": "King Salmon",
+              "definition": "King Salmon"
+            },
+            {
+              "code": "1979-4",
+              "display": "Kokhanok",
+              "definition": "Kokhanok"
+            },
+            {
+              "code": "1980-2",
+              "display": "Perryville",
+              "definition": "Perryville"
+            },
+            {
+              "code": "1981-0",
+              "display": "Pilot Point",
+              "definition": "Pilot Point"
+            },
+            {
+              "code": "1982-8",
+              "display": "Port Heiden",
+              "definition": "Port Heiden"
+            },
+            {
+              "code": "1985-1",
+              "display": "Chenega",
+              "definition": "Chenega"
+            },
+            {
+              "code": "1986-9",
+              "display": "Chugach Corporation",
+              "definition": "Chugach Corporation"
+            },
+            {
+              "code": "1987-7",
+              "display": "English Bay",
+              "definition": "English Bay"
+            },
+            {
+              "code": "1988-5",
+              "display": "Port Graham",
+              "definition": "Port Graham"
+            },
+            {
+              "code": "1993-5",
+              "display": "Akhiok",
+              "definition": "Akhiok"
+            },
+            {
+              "code": "1994-3",
+              "display": "Agdaagux",
+              "definition": "Agdaagux"
+            },
+            {
+              "code": "1995-0",
+              "display": "Karluk",
+              "definition": "Karluk"
+            },
+            {
+              "code": "1996-8",
+              "display": "Kodiak",
+              "definition": "Kodiak"
+            },
+            {
+              "code": "1997-6",
+              "display": "Larsen Bay",
+              "definition": "Larsen Bay"
+            },
+            {
+              "code": "1998-4",
+              "display": "Old Harbor",
+              "definition": "Old Harbor"
+            },
+            {
+              "code": "1999-2",
+              "display": "Ouzinkie",
+              "definition": "Ouzinkie"
+            },
+            {
+              "code": "2000-8",
+              "display": "Port Lions",
+              "definition": "Port Lions"
+            },
+            {
+              "code": "2007-3",
+              "display": "Akutan",
+              "definition": "Akutan"
+            },
+            {
+              "code": "2008-1",
+              "display": "Aleut Corporation",
+              "definition": "Aleut Corporation"
+            },
+            {
+              "code": "2009-9",
+              "display": "Aleutian",
+              "definition": "Aleutian"
+            },
+            {
+              "code": "2010-7",
+              "display": "Aleutian Islander",
+              "definition": "Aleutian Islander"
+            },
+            {
+              "code": "2011-5",
+              "display": "Atka",
+              "definition": "Atka"
+            },
+            {
+              "code": "2012-3",
+              "display": "Belkofski",
+              "definition": "Belkofski"
+            },
+            {
+              "code": "2013-1",
+              "display": "Chignik Lagoon",
+              "definition": "Chignik Lagoon"
+            },
+            {
+              "code": "2014-9",
+              "display": "King Cove",
+              "definition": "King Cove"
+            },
+            {
+              "code": "2015-6",
+              "display": "False Pass",
+              "definition": "False Pass"
+            },
+            {
+              "code": "2016-4",
+              "display": "Nelson Lagoon",
+              "definition": "Nelson Lagoon"
+            },
+            {
+              "code": "2017-2",
+              "display": "Nikolski",
+              "definition": "Nikolski"
+            },
+            {
+              "code": "2018-0",
+              "display": "Pauloff Harbor",
+              "definition": "Pauloff Harbor"
+            },
+            {
+              "code": "2019-8",
+              "display": "Qagan Toyagungin",
+              "definition": "Qagan Toyagungin"
+            },
+            {
+              "code": "2020-6",
+              "display": "Qawalangin",
+              "definition": "Qawalangin"
+            },
+            {
+              "code": "2021-4",
+              "display": "St. George",
+              "definition": "St. George"
+            },
+            {
+              "code": "2022-2",
+              "display": "St. Paul",
+              "definition": "St. Paul"
+            },
+            {
+              "code": "2023-0",
+              "display": "Sand Point",
+              "definition": "Sand Point"
+            },
+            {
+              "code": "2024-8",
+              "display": "South Naknek",
+              "definition": "South Naknek"
+            },
+            {
+              "code": "2025-5",
+              "display": "Unalaska",
+              "definition": "Unalaska"
+            },
+            {
+              "code": "2026-3",
+              "display": "Unga",
+              "definition": "Unga"
+            }
+          ]
+        },
+        {
+          "code": "2028-9",
+          "display": "Asian",
+          "definition": "Asian",
+          "concept": [
+            {
+              "code": "2029-7",
+              "display": "Asian Indian",
+              "definition": "Asian Indian"
+            },
+            {
+              "code": "2030-5",
+              "display": "Bangladeshi",
+              "definition": "Bangladeshi"
+            },
+            {
+              "code": "2031-3",
+              "display": "Bhutanese",
+              "definition": "Bhutanese"
+            },
+            {
+              "code": "2032-1",
+              "display": "Burmese",
+              "definition": "Burmese"
+            },
+            {
+              "code": "2033-9",
+              "display": "Cambodian",
+              "definition": "Cambodian"
+            },
+            {
+              "code": "2034-7",
+              "display": "Chinese",
+              "definition": "Chinese"
+            },
+            {
+              "code": "2035-4",
+              "display": "Taiwanese",
+              "definition": "Taiwanese"
+            },
+            {
+              "code": "2036-2",
+              "display": "Filipino",
+              "definition": "Filipino"
+            },
+            {
+              "code": "2037-0",
+              "display": "Hmong",
+              "definition": "Hmong"
+            },
+            {
+              "code": "2038-8",
+              "display": "Indonesian",
+              "definition": "Indonesian"
+            },
+            {
+              "code": "2039-6",
+              "display": "Japanese",
+              "definition": "Japanese"
+            },
+            {
+              "code": "2040-4",
+              "display": "Korean",
+              "definition": "Korean"
+            },
+            {
+              "code": "2041-2",
+              "display": "Laotian",
+              "definition": "Laotian"
+            },
+            {
+              "code": "2042-0",
+              "display": "Malaysian",
+              "definition": "Malaysian"
+            },
+            {
+              "code": "2043-8",
+              "display": "Okinawan",
+              "definition": "Okinawan"
+            },
+            {
+              "code": "2044-6",
+              "display": "Pakistani",
+              "definition": "Pakistani"
+            },
+            {
+              "code": "2045-3",
+              "display": "Sri Lankan",
+              "definition": "Sri Lankan"
+            },
+            {
+              "code": "2046-1",
+              "display": "Thai",
+              "definition": "Thai"
+            },
+            {
+              "code": "2047-9",
+              "display": "Vietnamese",
+              "definition": "Vietnamese"
+            },
+            {
+              "code": "2048-7",
+              "display": "Iwo Jiman",
+              "definition": "Iwo Jiman"
+            },
+            {
+              "code": "2049-5",
+              "display": "Maldivian",
+              "definition": "Maldivian"
+            },
+            {
+              "code": "2050-3",
+              "display": "Nepalese",
+              "definition": "Nepalese"
+            },
+            {
+              "code": "2051-1",
+              "display": "Singaporean",
+              "definition": "Singaporean"
+            },
+            {
+              "code": "2052-9",
+              "display": "Madagascar",
+              "definition": "Madagascar"
+            }
+          ]
+        },
+        {
+          "code": "2054-5",
+          "display": "Black or African American",
+          "definition": "Black or African American",
+          "concept": [
+            {
+              "code": "2056-0",
+              "display": "Black",
+              "definition": "Black"
+            },
+            {
+              "code": "2058-6",
+              "display": "African American",
+              "definition": "African American"
+            },
+            {
+              "code": "2060-2",
+              "display": "African",
+              "definition": "African"
+            },
+            {
+              "code": "2067-7",
+              "display": "Bahamian",
+              "definition": "Bahamian"
+            },
+            {
+              "code": "2068-5",
+              "display": "Barbadian",
+              "definition": "Barbadian"
+            },
+            {
+              "code": "2069-3",
+              "display": "Dominican",
+              "definition": "Dominican"
+            },
+            {
+              "code": "2070-1",
+              "display": "Dominica Islander",
+              "definition": "Dominica Islander"
+            },
+            {
+              "code": "2071-9",
+              "display": "Haitian",
+              "definition": "Haitian"
+            },
+            {
+              "code": "2072-7",
+              "display": "Jamaican",
+              "definition": "Jamaican"
+            },
+            {
+              "code": "2073-5",
+              "display": "Tobagoan",
+              "definition": "Tobagoan"
+            },
+            {
+              "code": "2074-3",
+              "display": "Trinidadian",
+              "definition": "Trinidadian"
+            },
+            {
+              "code": "2075-0",
+              "display": "West Indian",
+              "definition": "West Indian"
+            },
+            {
+              "code": "2061-0",
+              "display": "Botswanan",
+              "definition": "Botswanan"
+            },
+            {
+              "code": "2062-8",
+              "display": "Ethiopian",
+              "definition": "Ethiopian"
+            },
+            {
+              "code": "2063-6",
+              "display": "Liberian",
+              "definition": "Liberian"
+            },
+            {
+              "code": "2064-4",
+              "display": "Namibian",
+              "definition": "Namibian"
+            },
+            {
+              "code": "2065-1",
+              "display": "Nigerian",
+              "definition": "Nigerian"
+            },
+            {
+              "code": "2066-9",
+              "display": "Zairean",
+              "definition": "Zairean"
+            }
+          ]
+        },
+        {
+          "code": "2076-8",
+          "display": "Native Hawaiian or Other Pacific Islander",
+          "definition": "Native Hawaiian or Other Pacific Islander",
+          "concept": [
+            {
+              "code": "2078-4",
+              "display": "Polynesian",
+              "definition": "Polynesian"
+            },
+            {
+              "code": "2085-9",
+              "display": "Micronesian",
+              "definition": "Micronesian"
+            },
+            {
+              "code": "2100-6",
+              "display": "Melanesian",
+              "definition": "Melanesian"
+            },
+            {
+              "code": "2500-7",
+              "display": "Other Pacific Islander",
+              "definition": "Other Pacific Islander"
+            },
+            {
+              "code": "2079-2",
+              "display": "Native Hawaiian",
+              "definition": "Native Hawaiian"
+            },
+            {
+              "code": "2080-0",
+              "display": "Samoan",
+              "definition": "Samoan"
+            },
+            {
+              "code": "2081-8",
+              "display": "Tahitian",
+              "definition": "Tahitian"
+            },
+            {
+              "code": "2082-6",
+              "display": "Tongan",
+              "definition": "Tongan"
+            },
+            {
+              "code": "2083-4",
+              "display": "Tokelauan",
+              "definition": "Tokelauan"
+            },
+            {
+              "code": "2086-7",
+              "display": "Guamanian or Chamorro",
+              "definition": "Guamanian or Chamorro"
+            },
+            {
+              "code": "2087-5",
+              "display": "Guamanian",
+              "definition": "Guamanian"
+            },
+            {
+              "code": "2088-3",
+              "display": "Chamorro",
+              "definition": "Chamorro"
+            },
+            {
+              "code": "2089-1",
+              "display": "Mariana Islander",
+              "definition": "Mariana Islander"
+            },
+            {
+              "code": "2090-9",
+              "display": "Marshallese",
+              "definition": "Marshallese"
+            },
+            {
+              "code": "2091-7",
+              "display": "Palauan",
+              "definition": "Palauan"
+            },
+            {
+              "code": "2092-5",
+              "display": "Carolinian",
+              "definition": "Carolinian"
+            },
+            {
+              "code": "2093-3",
+              "display": "Kosraean",
+              "definition": "Kosraean"
+            },
+            {
+              "code": "2094-1",
+              "display": "Pohnpeian",
+              "definition": "Pohnpeian"
+            },
+            {
+              "code": "2095-8",
+              "display": "Saipanese",
+              "definition": "Saipanese"
+            },
+            {
+              "code": "2096-6",
+              "display": "Kiribati",
+              "definition": "Kiribati"
+            },
+            {
+              "code": "2097-4",
+              "display": "Chuukese",
+              "definition": "Chuukese"
+            },
+            {
+              "code": "2098-2",
+              "display": "Yapese",
+              "definition": "Yapese"
+            },
+            {
+              "code": "2101-4",
+              "display": "Fijian",
+              "definition": "Fijian"
+            },
+            {
+              "code": "2102-2",
+              "display": "Papua New Guinean",
+              "definition": "Papua New Guinean"
+            },
+            {
+              "code": "2103-0",
+              "display": "Solomon Islander",
+              "definition": "Solomon Islander"
+            },
+            {
+              "code": "2104-8",
+              "display": "New Hebrides",
+              "definition": "New Hebrides"
+            }
+          ]
+        },
+        {
+          "code": "2106-3",
+          "display": "White",
+          "definition": "White",
+          "concept": [
+            {
+              "code": "2108-9",
+              "display": "European",
+              "definition": "European"
+            },
+            {
+              "code": "2118-8",
+              "display": "Middle Eastern or North African",
+              "definition": "Middle Eastern or North African"
+            },
+            {
+              "code": "2129-5",
+              "display": "Arab",
+              "definition": "Arab"
+            },
+            {
+              "code": "2109-7",
+              "display": "Armenian",
+              "definition": "Armenian"
+            },
+            {
+              "code": "2110-5",
+              "display": "English",
+              "definition": "English"
+            },
+            {
+              "code": "2111-3",
+              "display": "French",
+              "definition": "French"
+            },
+            {
+              "code": "2112-1",
+              "display": "German",
+              "definition": "German"
+            },
+            {
+              "code": "2113-9",
+              "display": "Irish",
+              "definition": "Irish"
+            },
+            {
+              "code": "2114-7",
+              "display": "Italian",
+              "definition": "Italian"
+            },
+            {
+              "code": "2115-4",
+              "display": "Polish",
+              "definition": "Polish"
+            },
+            {
+              "code": "2116-2",
+              "display": "Scottish",
+              "definition": "Scottish"
+            },
+            {
+              "code": "2119-6",
+              "display": "Assyrian",
+              "definition": "Assyrian"
+            },
+            {
+              "code": "2120-4",
+              "display": "Egyptian",
+              "definition": "Egyptian"
+            },
+            {
+              "code": "2121-2",
+              "display": "Iranian",
+              "definition": "Iranian"
+            },
+            {
+              "code": "2122-0",
+              "display": "Iraqi",
+              "definition": "Iraqi"
+            },
+            {
+              "code": "2123-8",
+              "display": "Lebanese",
+              "definition": "Lebanese"
+            },
+            {
+              "code": "2124-6",
+              "display": "Palestinian",
+              "definition": "Palestinian"
+            },
+            {
+              "code": "2125-3",
+              "display": "Syrian",
+              "definition": "Syrian"
+            },
+            {
+              "code": "2126-1",
+              "display": "Afghanistani",
+              "definition": "Afghanistani"
+            },
+            {
+              "code": "2127-9",
+              "display": "Israeili",
+              "definition": "Israeili"
+            }
+          ]
+        },
+        {
+          "code": "2131-1",
+          "display": "Other Race",
+          "definition": "Note that this term remains in the table for completeness, even though within HL7, the notion of Other code is deprecated."
+        }
+      ]
+    },
+    {
+      "code": "2133-7",
+      "display": "Ethnicity",
+      "definition": "Ethnicity",
+      "concept": [
+        {
+          "code": "2135-2",
+          "display": "Hispanic or Latino",
+          "definition": "Hispanic or Latino",
+          "concept": [
+            {
+              "code": "2137-8",
+              "display": "Spaniard",
+              "definition": "Spaniard"
+            },
+            {
+              "code": "2148-5",
+              "display": "Mexican",
+              "definition": "Mexican"
+            },
+            {
+              "code": "2155-0",
+              "display": "Central American",
+              "definition": "Central American"
+            },
+            {
+              "code": "2165-9",
+              "display": "South American",
+              "definition": "South American"
+            },
+            {
+              "code": "2178-2",
+              "display": "Latin American",
+              "definition": "Latin American"
+            },
+            {
+              "code": "2180-8",
+              "display": "Puerto Rican",
+              "definition": "Puerto Rican"
+            },
+            {
+              "code": "2182-4",
+              "display": "Cuban",
+              "definition": "Cuban"
+            },
+            {
+              "code": "2184-0",
+              "display": "Dominican",
+              "definition": "Dominican"
+            },
+            {
+              "code": "2138-6",
+              "display": "Andalusian",
+              "definition": "Andalusian"
+            },
+            {
+              "code": "2139-4",
+              "display": "Asturian",
+              "definition": "Asturian"
+            },
+            {
+              "code": "2140-2",
+              "display": "Castillian",
+              "definition": "Castillian"
+            },
+            {
+              "code": "2141-0",
+              "display": "Catalonian",
+              "definition": "Catalonian"
+            },
+            {
+              "code": "2142-8",
+              "display": "Belearic Islander",
+              "definition": "Belearic Islander"
+            },
+            {
+              "code": "2143-6",
+              "display": "Gallego",
+              "definition": "Gallego"
+            },
+            {
+              "code": "2144-4",
+              "display": "Valencian",
+              "definition": "Valencian"
+            },
+            {
+              "code": "2145-1",
+              "display": "Canarian",
+              "definition": "Canarian"
+            },
+            {
+              "code": "2146-9",
+              "display": "Spanish Basque",
+              "definition": "Spanish Basque"
+            },
+            {
+              "code": "2149-3",
+              "display": "Mexican American",
+              "definition": "Mexican American"
+            },
+            {
+              "code": "2150-1",
+              "display": "Mexicano",
+              "definition": "Mexicano"
+            },
+            {
+              "code": "2151-9",
+              "display": "Chicano",
+              "definition": "Chicano"
+            },
+            {
+              "code": "2152-7",
+              "display": "La Raza",
+              "definition": "La Raza"
+            },
+            {
+              "code": "2153-5",
+              "display": "Mexican American Indian",
+              "definition": "Mexican American Indian"
+            },
+            {
+              "code": "2156-8",
+              "display": "Costa Rican",
+              "definition": "Costa Rican"
+            },
+            {
+              "code": "2157-6",
+              "display": "Guatemalan",
+              "definition": "Guatemalan"
+            },
+            {
+              "code": "2158-4",
+              "display": "Honduran",
+              "definition": "Honduran"
+            },
+            {
+              "code": "2159-2",
+              "display": "Nicaraguan",
+              "definition": "Nicaraguan"
+            },
+            {
+              "code": "2160-0",
+              "display": "Panamanian",
+              "definition": "Panamanian"
+            },
+            {
+              "code": "2161-8",
+              "display": "Salvadoran",
+              "definition": "Salvadoran"
+            },
+            {
+              "code": "2162-6",
+              "display": "Central American Indian",
+              "definition": "Central American Indian"
+            },
+            {
+              "code": "2163-4",
+              "display": "Canal Zone",
+              "definition": "Canal Zone"
+            },
+            {
+              "code": "2166-7",
+              "display": "Argentinean",
+              "definition": "Argentinean"
+            },
+            {
+              "code": "2167-5",
+              "display": "Bolivian",
+              "definition": "Bolivian"
+            },
+            {
+              "code": "2168-3",
+              "display": "Chilean",
+              "definition": "Chilean"
+            },
+            {
+              "code": "2169-1",
+              "display": "Colombian",
+              "definition": "Colombian"
+            },
+            {
+              "code": "2170-9",
+              "display": "Ecuadorian",
+              "definition": "Ecuadorian"
+            },
+            {
+              "code": "2171-7",
+              "display": "Paraguayan",
+              "definition": "Paraguayan"
+            },
+            {
+              "code": "2172-5",
+              "display": "Peruvian",
+              "definition": "Peruvian"
+            },
+            {
+              "code": "2173-3",
+              "display": "Uruguayan",
+              "definition": "Uruguayan"
+            },
+            {
+              "code": "2174-1",
+              "display": "Venezuelan",
+              "definition": "Venezuelan"
+            },
+            {
+              "code": "2175-8",
+              "display": "South American Indian",
+              "definition": "South American Indian"
+            },
+            {
+              "code": "2176-6",
+              "display": "Criollo",
+              "definition": "Criollo"
+            }
+          ]
+        },
+        {
+          "code": "2186-5",
+          "display": "Not Hispanic or Latino",
+          "definition": "Note that this term remains in the table for completeness, even though within HL7, the notion of \"not otherwise coded\" term is deprecated."
+        }
+      ]
+    }
+  ]
+}
diff --git a/lib/resources/us_core/CodeSystem-condition-category.json b/lib/resources/us_core/CodeSystem-condition-category.json
index fa3f768..b649cb6 100755
--- a/lib/resources/us_core/CodeSystem-condition-category.json
+++ b/lib/resources/us_core/CodeSystem-condition-category.json
@@ -6,10 +6,11 @@
     "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>US Core Condition Category Extension Codes</h2><div><p>Set of codes that are needed for implementation of the US-Core profiles. These codes are used as extensions to the FHIR and US Core value sets.</p>\n</div><p>This code system http://hl7.org/fhir/us/core/CodeSystem/condition-category defines the following codes:</p><table class=\"codes\"><tr><td><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td>problem<a name=\"condition-category-problem\"> </a></td><td>Problem</td><td>The patients problems as identified by the provider(s). Items on the provider’s problem list</td></tr><tr><td>health-concern<a name=\"condition-category-health-concern\"> </a></td><td>Health Concern</td><td>Additional health concerns from other stakeholders which are outside the provider’s problem list.</td></tr></table></div>"
   },
   "url": "http://hl7.org/fhir/us/core/CodeSystem/condition-category",
+  "version": "1.0.0",
   "name": "US Core Condition Category Extension Codes",
   "status": "draft",
-  "publisher": "HL7 (FHIR Project)",
-  "date": "2016-12-06T22:13:05+11:00",
+  "date": "2017-03-21T11:28:08+11:00",
+  "publisher": "HL7 US Realm Steering Committee",
   "description": "Set of codes that are needed for implementation of the US-Core profiles. These codes are used as extensions to the FHIR and US Core value sets.\n",
   "caseSensitive": true,
   "valueSet": "http://hl7.org/fhir/us/core/ValueSet/condition-category",
@@ -26,4 +27,4 @@
       "definition": "Additional health concerns from other stakeholders which are outside the provider’s problem list."
     }
   ]
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/ConceptMap-ndc-cvx.json b/lib/resources/us_core/ConceptMap-ndc-cvx.json
new file mode 100755
index 0000000..a11d7d3
--- /dev/null
+++ b/lib/resources/us_core/ConceptMap-ndc-cvx.json
@@ -0,0 +1,2127 @@
+{
+  "resourceType": "ConceptMap",
+  "id": "ndc-cvx",
+  "text": {
+    "status": "generated",
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>US Core NDC to CVX Code Mapping (http://hl7.org/fhir/us/core/ConceptMap/ndc-cvx)</h2><p>Mapping from <a href=\"ValueSet-us-core-ndc-vaccine-codes.html\">http://hl7.org/fhir/us/core/ValueSet/us-core-ndc-vaccine-codes</a> to <a href=\"ValueSet-us-core-cvx.html\">http://hl7.org/fhir/us/core/ValueSet/us-core-cvx</a></p><p>ACTIVE. Published on 06/06/2016 by HL7 US Realm Steering Committee. </p><div><p>Unit of Use <a href=\"https://www2a.cdc.gov/vaccines/iis/iisstandards/ndc_crosswalk.asp\">NDC code</a> mapping  to the <a href=\"https://www2a.cdc.gov/vaccines/iis/iisstandards/vaccines.asp?rpt=cvx\">CVX Vaccine codes</a>.  Note: source = NDC and target = CVX</p>\n</div><br/><table class=\"grid\"><tr><td><b>Source Code</b></td><td><b>Equivalence</b></td><td><b>Destination Code</b></td></tr><tr><td>49281-0589-58</td><td>wider</td><td>114</td></tr><tr><td>49281-0623-78</td><td>wider</td><td>158</td></tr><tr><td>49281-0515-00</td><td>wider</td><td>161</td></tr><tr><td>49281-0415-88</td><td>wider</td><td>150</td></tr><tr><td>49281-0415-58</td><td>wider</td><td>150</td></tr><tr><td>33332-0115-11</td><td>wider</td><td>141</td></tr><tr><td>33332-0015-02</td><td>wider</td><td>140</td></tr><tr><td>66019-0302-01</td><td>wider</td><td>149</td></tr><tr><td>42874-0015-01</td><td>wider</td><td>155</td></tr><tr><td>66521-0118-12</td><td>wider</td><td>140</td></tr><tr><td>66521-0118-11</td><td>wider</td><td>141</td></tr><tr><td>58160-0883-41</td><td>wider</td><td>140</td></tr><tr><td>66521-0000-11</td><td>wider</td><td>168</td></tr><tr><td>69401-0000-01</td><td>wider</td><td>25</td></tr><tr><td>66019-0301-01</td><td>wider</td><td>149</td></tr><tr><td>33332-0014-02</td><td>wider</td><td>140</td></tr><tr><td>33332-0114-11</td><td>wider</td><td>141</td></tr><tr><td>63851-0613-11</td><td>wider</td><td>153</td></tr><tr><td>66521-0117-11</td><td>wider</td><td>141</td></tr><tr><td>66521-0117-12</td><td>wider</td><td>140</td></tr><tr><td>00006-4093-01</td><td>wider</td><td>8</td></tr><tr><td>00006-4094-01</td><td>wider</td><td>43</td></tr><tr><td>00006-4095-01</td><td>wider</td><td>83</td></tr><tr><td>00006-4096-01</td><td>wider</td><td>52</td></tr><tr><td>00006-4963-01</td><td>wider</td><td>121</td></tr><tr><td>00006-4963-01</td><td>wider</td><td>121</td></tr><tr><td>42874-0014-01</td><td>wider</td><td>155</td></tr><tr><td>49281-0414-88</td><td>wider</td><td>150</td></tr><tr><td>49281-0395-88</td><td>wider</td><td>135</td></tr><tr><td>49281-0709-48</td><td>wider</td><td>144</td></tr><tr><td>58160-0881-41</td><td>wider</td><td>140</td></tr><tr><td>58160-0809-01</td><td>wider</td><td>148</td></tr><tr><td>62577-0613-11</td><td>wider</td><td>153</td></tr><tr><td>19515-0893-02</td><td>wider</td><td>141</td></tr><tr><td>49281-0621-78</td><td>wider</td><td>158</td></tr><tr><td>00005-0100-01</td><td>wider</td><td>162</td></tr><tr><td>00005-0100-01</td><td>wider</td><td>162</td></tr><tr><td>00005-0100-01</td><td>wider</td><td>162</td></tr><tr><td>00006-4047-01</td><td>wider</td><td>116</td></tr><tr><td>00006-4109-01</td><td>wider</td><td>62</td></tr><tr><td>62577-0613-11</td><td>wider</td><td>153</td></tr><tr><td>00006-4121-01</td><td>wider</td><td>165</td></tr><tr><td>00006-4119-01</td><td>wider</td><td>165</td></tr><tr><td>00006-4119-01</td><td>wider</td><td>165</td></tr><tr><td>63851-0511-11</td><td>wider</td><td>18</td></tr><tr><td>49281-0562-58</td><td>wider</td><td>130</td></tr><tr><td>46028-0114-11</td><td>wider</td><td>163</td></tr><tr><td>46028-0114-11</td><td>wider</td><td>163</td></tr><tr><td>00006-4171-01</td><td>wider</td><td>94</td></tr><tr><td>13533-0131-00</td><td>wider</td><td>9</td></tr><tr><td>49281-0396-78</td><td>wider</td><td>141</td></tr><tr><td>49281-0397-88</td><td>wider</td><td>135</td></tr><tr><td>62577-0614-11</td><td>wider</td><td>153</td></tr><tr><td>58160-0903-41</td><td>wider</td><td>150</td></tr><tr><td>19515-0898-01</td><td>wider</td><td>158</td></tr><tr><td>19515-0901-41</td><td>wider</td><td>150</td></tr><tr><td>49281-0393-88</td><td>wider</td><td>135</td></tr><tr><td>58160-0810-43</td><td>wider</td><td>20</td></tr><tr><td>58160-0810-01</td><td>wider</td><td>20</td></tr><tr><td>49281-0790-38</td><td>wider</td><td>101</td></tr><tr><td>49281-0790-88</td><td>wider</td><td>101</td></tr><tr><td>49281-0640-15</td><td>wider</td><td>127</td></tr><tr><td>49281-0650-10</td><td>wider</td><td>126</td></tr><tr><td>49281-0650-90</td><td>wider</td><td>126</td></tr><tr><td>49281-0650-25</td><td>wider</td><td>126</td></tr><tr><td>49281-0650-70</td><td>wider</td><td>126</td></tr><tr><td>49281-0650-50</td><td>wider</td><td>126</td></tr><tr><td>49281-0707-48</td><td>wider</td><td>144</td></tr><tr><td>66019-0110-01</td><td>wider</td><td>111</td></tr><tr><td>00006-4681-01</td><td>wider</td><td>3</td></tr><tr><td>49281-0215-58</td><td>wider</td><td>113</td></tr><tr><td>49281-0215-88</td><td>wider</td><td>113</td></tr><tr><td>46028-0218-11</td><td>wider</td><td>136</td></tr><tr><td>49281-0387-65</td><td>wider</td><td>135</td></tr><tr><td>49281-0386-15</td><td>wider</td><td>141</td></tr><tr><td>49281-0010-10</td><td>wider</td><td>140</td></tr><tr><td>49281-0010-25</td><td>wider</td><td>140</td></tr><tr><td>49281-0010-50</td><td>wider</td><td>140</td></tr><tr><td>54868-0980-00</td><td>wider</td><td>3</td></tr><tr><td>58160-0830-43</td><td>wider</td><td>118</td></tr><tr><td>58160-0830-05</td><td>wider</td><td>118</td></tr><tr><td>00005-1971-01</td><td>wider</td><td>133</td></tr><tr><td>00005-1971-01</td><td>wider</td><td>133</td></tr><tr><td>00005-1971-01</td><td>wider</td><td>133</td></tr><tr><td>17478-0131-00</td><td>wider</td><td>9</td></tr><tr><td>58160-0812-43</td><td>wider</td><td>130</td></tr><tr><td>58160-0812-01</td><td>wider</td><td>130</td></tr><tr><td>66019-0108-01</td><td>wider</td><td>111</td></tr><tr><td>00006-4898-01</td><td>wider</td><td>51</td></tr><tr><td>58160-0809-01</td><td>wider</td><td>148</td></tr><tr><td>63851-0612-11</td><td>wider</td><td>153</td></tr><tr><td>00006-4992-01</td><td>wider</td><td>44</td></tr><tr><td>00006-4981-01</td><td>wider</td><td>8</td></tr><tr><td>00006-4980-00</td><td>wider</td><td>8</td></tr><tr><td>00006-4093-01</td><td>wider</td><td>8</td></tr><tr><td>00006-4094-01</td><td>wider</td><td>43</td></tr><tr><td>00006-4109-01</td><td>wider</td><td>62</td></tr><tr><td>66521-0112-02</td><td>wider</td><td>140</td></tr><tr><td>66521-0112-10</td><td>wider</td><td>141</td></tr><tr><td>66019-0107-01</td><td>wider</td><td>111</td></tr><tr><td>49281-0225-58</td><td>wider</td><td>28</td></tr><tr><td>49281-0705-55</td><td>wider</td><td>144</td></tr><tr><td>42515-0001-00</td><td>wider</td><td>134</td></tr><tr><td>58160-0879-41</td><td>wider</td><td>140</td></tr><tr><td>58160-0880-41</td><td>wider</td><td>140</td></tr><tr><td>58160-0820-01</td><td>wider</td><td>8</td></tr><tr><td>58160-0820-43</td><td>wider</td><td>8</td></tr><tr><td>58160-0821-01</td><td>wider</td><td>43</td></tr><tr><td>58160-0821-43</td><td>wider</td><td>43</td></tr><tr><td>58160-0821-05</td><td>wider</td><td>43</td></tr><tr><td>42874-0012-01</td><td>wider</td><td>155</td></tr><tr><td>49281-0278-10</td><td>wider</td><td>28</td></tr><tr><td>66019-0109-01</td><td>wider</td><td>111</td></tr><tr><td>19515-0890-02</td><td>wider</td><td>141</td></tr><tr><td>19515-0889-02</td><td>wider</td><td>141</td></tr><tr><td>58160-0900-41</td><td>wider</td><td>150</td></tr><tr><td>49281-0860-78</td><td>wider</td><td>10</td></tr><tr><td>49281-0860-88</td><td>wider</td><td>10</td></tr><tr><td>49281-0389-65</td><td>wider</td><td>135</td></tr><tr><td>49281-0388-15</td><td>wider</td><td>141</td></tr><tr><td>49281-0011-10</td><td>wider</td><td>140</td></tr><tr><td>49281-0011-50</td><td>wider</td><td>140</td></tr><tr><td>49281-0703-55</td><td>wider</td><td>144</td></tr><tr><td>49281-0111-25</td><td>wider</td><td>140</td></tr><tr><td>66521-0200-10</td><td>wider</td><td>126</td></tr><tr><td>66521-0200-02</td><td>wider</td><td>127</td></tr><tr><td>49281-0298-10</td><td>wider</td><td>20</td></tr><tr><td>58160-0806-01</td><td>wider</td><td>48</td></tr><tr><td>33332-0013-02</td><td>wider</td><td>140</td></tr><tr><td>33332-0113-11</td><td>wider</td><td>141</td></tr><tr><td>49281-0391-65</td><td>wider</td><td>135</td></tr><tr><td>49281-0012-50</td><td>wider</td><td>140</td></tr><tr><td>49281-0012-10</td><td>wider</td><td>140</td></tr><tr><td>49281-0112-25</td><td>wider</td><td>140</td></tr><tr><td>49281-0390-15</td><td>wider</td><td>141</td></tr><tr><td>00006-4897-01</td><td>wider</td><td>49</td></tr><tr><td>49281-0291-83</td><td>wider</td><td>113</td></tr><tr><td>49281-0291-10</td><td>wider</td><td>113</td></tr><tr><td>49281-0413-88</td><td>wider</td><td>150</td></tr><tr><td>49281-0413-58</td><td>wider</td><td>150</td></tr><tr><td>49281-0513-00</td><td>wider</td><td>161</td></tr><tr><td>66521-0113-02</td><td>wider</td><td>140</td></tr><tr><td>66521-0113-10</td><td>wider</td><td>141</td></tr><tr><td>00005-1970-49</td><td>wider</td><td>100</td></tr><tr><td>00006-4047-01</td><td>wider</td><td>116</td></tr><tr><td>58160-0811-43</td><td>wider</td><td>110</td></tr><tr><td>58160-0811-41</td><td>wider</td><td>110</td></tr><tr><td>00006-4827-01</td><td>wider</td><td>21</td></tr><tr><td>00006-4826-01</td><td>wider</td><td>21</td></tr><tr><td>58160-0842-41</td><td>wider</td><td>115</td></tr><tr><td>58160-0842-01</td><td>wider</td><td>115</td></tr><tr><td>58160-0842-43</td><td>wider</td><td>115</td></tr><tr><td>58160-0842-05</td><td>wider</td><td>115</td></tr><tr><td>66019-0300-01</td><td>wider</td><td>149</td></tr><tr><td>49281-0589-58</td><td>wider</td><td>114</td></tr><tr><td>00006-4095-01</td><td>wider</td><td>83</td></tr><tr><td>00006-4096-01</td><td>wider</td><td>52</td></tr><tr><td>00006-4831-01</td><td>wider</td><td>83</td></tr><tr><td>63851-0511-11</td><td>wider</td><td>18</td></tr><tr><td>66019-0200-01</td><td>wider</td><td>125</td></tr><tr><td>14362-0111-03</td><td>wider</td><td>9</td></tr><tr><td>33332-0519-01</td><td>wider</td><td>126</td></tr><tr><td>33332-0519-25</td><td>wider</td><td>126</td></tr><tr><td>33332-0629-10</td><td>wider</td><td>127</td></tr><tr><td>58160-0825-43</td><td>wider</td><td>83</td></tr><tr><td>58160-0825-01</td><td>wider</td><td>83</td></tr><tr><td>58160-0826-43</td><td>wider</td><td>52</td></tr><tr><td>58160-0826-05</td><td>wider</td><td>52</td></tr><tr><td>58160-0826-01</td><td>wider</td><td>52</td></tr><tr><td>33332-0010-01</td><td>wider</td><td>140</td></tr><tr><td>33332-0110-10</td><td>wider</td><td>141</td></tr><tr><td>66521-0115-10</td><td>wider</td><td>141</td></tr><tr><td>66521-0115-02</td><td>wider</td><td>140</td></tr><tr><td>00006-4133-01</td><td>wider</td><td>9</td></tr><tr><td>54868-4320-09</td><td>wider</td><td>33</td></tr><tr><td>54868-3339-09</td><td>wider</td><td>33</td></tr><tr><td>00052-0603-01</td><td>wider</td><td>19</td></tr><tr><td>64678-0211-05</td><td>wider</td><td>24</td></tr><tr><td>00006-4739-01</td><td>wider</td><td>33</td></tr><tr><td>00006-4943-01</td><td>wider</td><td>33</td></tr><tr><td>49281-0013-58</td><td>wider</td><td>140</td></tr><tr><td>49281-0013-88</td><td>wider</td><td>140</td></tr><tr><td>49281-0392-78</td><td>wider</td><td>141</td></tr><tr><td>49281-0113-00</td><td>wider</td><td>140</td></tr><tr><td>49281-0820-10</td><td>wider</td><td>35</td></tr><tr><td>49281-0800-83</td><td>wider</td><td>35</td></tr><tr><td>49281-0400-88</td><td>wider</td><td>115</td></tr><tr><td>49281-0286-58</td><td>wider</td><td>106</td></tr><tr><td>49281-0286-58</td><td>wider</td><td>106</td></tr><tr><td>49281-0286-58</td><td>wider</td><td>106</td></tr><tr><td>58160-0815-41</td><td>wider</td><td>104</td></tr><tr><td>58160-0815-43</td><td>wider</td><td>104</td></tr><tr><td>58160-0815-05</td><td>wider</td><td>104</td></tr><tr><td>58160-0815-43</td><td>wider</td><td>104</td></tr><tr><td>58160-0815-01</td><td>wider</td><td>104</td></tr><tr><td>66521-0114-10</td><td>wider</td><td>141</td></tr><tr><td>76420-0482-01</td><td>wider</td><td>140</td></tr><tr><td>19515-0895-01</td><td>wider</td><td>158</td></tr><tr><td>00006-4999-01</td><td>wider</td><td>94</td></tr><tr><td>49281-0545-15</td><td>wider</td><td>120</td></tr><tr><td>51285-0174-02</td><td>wider</td><td>143</td></tr><tr><td>49281-0248-58</td><td>wider</td><td>18</td></tr><tr><td>49281-0487-58</td><td>wider</td><td>32</td></tr><tr><td>49281-0915-58</td><td>wider</td><td>37</td></tr><tr><td>49281-0547-58</td><td>wider</td><td>48</td></tr><tr><td>58160-0851-01</td><td>wider</td><td>119</td></tr><tr><td>49281-0915-68</td><td>wider</td><td>37</td></tr><tr><td>49281-0488-78</td><td>wider</td><td>32</td></tr><tr><td>46028-0219-11</td><td>wider</td><td>136</td></tr><tr><td>51285-0175-02</td><td>wider</td><td>143</td></tr><tr><td>49281-0560-05</td><td>wider</td><td>120</td></tr><tr><td>49281-0400-58</td><td>wider</td><td>115</td></tr><tr><td>49281-0400-58</td><td>wider</td><td>115</td></tr><tr><td>42874-0013-01</td><td>wider</td><td>155</td></tr><tr><td>66521-0116-11</td><td>wider</td><td>141</td></tr><tr><td>66521-0116-12</td><td>wider</td><td>140</td></tr><tr><td>00006-4045-01</td><td>wider</td><td>62</td></tr><tr><td>00006-4045-01</td><td>wider</td><td>62</td></tr><tr><td>00006-4995-01</td><td>wider</td><td>43</td></tr><tr><td>00006-4995-01</td><td>wider</td><td>43</td></tr><tr><td>00006-4841-01</td><td>wider</td><td>52</td></tr><tr><td>00006-4841-01</td><td>wider</td><td>52</td></tr><tr><td>58160-0804-01</td><td>wider</td><td>160</td></tr><tr><td>58160-0802-02</td><td>wider</td><td>160</td></tr><tr><td>58160-0901-41</td><td>wider</td><td>150</td></tr><tr><td>00006-4837-01</td><td>wider</td><td>33</td></tr><tr><td>19515-0891-01</td><td>wider</td><td>158</td></tr><tr><td>19515-0893-02</td><td>wider</td><td>141</td></tr><tr><td>19515-0894-41</td><td>wider</td><td>150</td></tr><tr><td>49281-0514-00</td><td>wider</td><td>161</td></tr><tr><td>49281-0394-78</td><td>wider</td><td>141</td></tr><tr><td>49281-0014-88</td><td>wider</td><td>140</td></tr><tr><td>49281-0414-58</td><td>wider</td><td>150</td></tr></table></div>"
+  },
+  "url": "http://hl7.org/fhir/us/core/ConceptMap/ndc-cvx",
+  "version": "1.0.0",
+  "name": "US Core NDC to CVX Code Mapping",
+  "status": "active",
+  "date": "2016-06-06",
+  "publisher": "HL7 US Realm Steering Committee",
+  "description": "Unit of Use [NDC code] (https://www2a.cdc.gov/vaccines/iis/iisstandards/ndc_crosswalk.asp) mapping  to the [CVX Vaccine codes](https://www2a.cdc.gov/vaccines/iis/iisstandards/vaccines.asp?rpt=cvx).  Note: source = NDC and target = CVX",
+  "purpose": "Based upon the 2015 Edition Certification Requirements, the NDC vaccine codes SHOULD be supported as translations to the CVX vaccine codes.",
+  "sourceReference": {
+    "reference": "http://hl7.org/fhir/us/core/ValueSet/us-core-ndc-vaccine-codes",
+    "display": "Vaccine National Drug Code (NDC)"
+  },
+  "targetReference": {
+    "reference": "http://hl7.org/fhir/us/core/ValueSet/us-core-cvx",
+    "display": "Vaccine Administered Value Set (CVX)"
+  },
+  "group": [
+    {
+      "element": [
+        {
+          "code": "49281-0589-58",
+          "target": [
+            {
+              "code": "114",
+              "equivalence": "wider"
+            }
+          ]
+        },
+        {
+          "code": "49281-0623-78",
+          "target": [
+            {
+              "code": "158",
+              "equivalence": "wider"
+            }
+          ]
+        },
+        {
+          "code": "49281-0515-00",
+          "target": [
+            {
+              "code": "161",
+              "equivalence": "wider"
+            }
+          ]
+        },
+        {
+          "code": "49281-0415-88",
+          "target": [
+            {
+              "code": "150",
+              "equivalence": "wider"
+            }
+          ]
+        },
+        {
+          "code": "49281-0415-58",
+          "target": [
+            {
+              "code": "150",
+              "equivalence": "wider"
+            }
+          ]
+        },
+        {
+          "code": "33332-0115-11",
+          "target": [
+            {
+              "code": "141",
+              "equivalence": "wider"
+            }
+          ]
+        },
+        {
+          "code": "33332-0015-02",
+          "target": [
+            {
+              "code": "140",
+              "equivalence": "wider"
+            }
+          ]
+        },
+        {
+          "code": "66019-0302-01",
+          "target": [
+            {
+              "code": "149",
+              "equivalence": "wider"
+            }
+          ]
+        },
+        {
+          "code": "42874-0015-01",
+          "target": [
+            {
+              "code": "155",
+              "equivalence": "wider"
+            }
+          ]
+        },
+        {
+          "code": "66521-0118-12",
+          "target": [
+            {
+              "code": "140",
+              "equivalence": "wider"
+            }
+          ]
+        },
+        {
+          "code": "66521-0118-11",
+          "target": [
+            {
+              "code": "141",
+              "equivalence": "wider"
+            }
+          ]
+        },
+        {
+          "code": "58160-0883-41",
+          "target": [
+            {
+              "code": "140",
+              "equivalence": "wider"
+            }
+          ]
+        },
+        {
+          "code": "66521-0000-11",
+          "target": [
+            {
+              "code": "168",
+              "equivalence": "wider"
+            }
+          ]
+        },
+        {
+          "code": "69401-0000-01",
+          "target": [
+            {
+              "code": "25",
+              "equivalence": "wider"
+            }
+          ]
+        },
+        {
+          "code": "66019-0301-01",
+          "target": [
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+              "equivalence": "wider"
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+              "equivalence": "wider"
+            }
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+        {
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+          "target": [
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+              "equivalence": "wider"
+            }
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+          "code": "00006-4133-01",
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+              "equivalence": "wider"
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+          ]
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+          "code": "54868-4320-09",
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+              "equivalence": "wider"
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+              "equivalence": "wider"
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+              "equivalence": "wider"
+            }
+          ]
+        },
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+              "equivalence": "wider"
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+        {
+          "code": "00006-4943-01",
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+              "equivalence": "wider"
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+              "equivalence": "wider"
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+              "equivalence": "wider"
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+              "equivalence": "wider"
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+        {
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+              "equivalence": "wider"
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+              "equivalence": "wider"
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+              "equivalence": "wider"
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+          "target": [
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+              "equivalence": "wider"
+            }
+          ]
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+              "equivalence": "wider"
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+        {
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+          "target": [
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+              "equivalence": "wider"
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+          ]
+        },
+        {
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+          "target": [
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+              "equivalence": "wider"
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+          ]
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+        {
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+          "target": [
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+              "equivalence": "wider"
+            }
+          ]
+        },
+        {
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+          "target": [
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+              "equivalence": "wider"
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+          "target": [
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+              "equivalence": "wider"
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+        {
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+          "target": [
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+            }
+          ]
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+        {
+          "code": "51285-0175-02",
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+              "equivalence": "wider"
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+          ]
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+              "equivalence": "wider"
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+              "equivalence": "wider"
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+          "code": "49281-0400-58",
+          "target": [
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+              "equivalence": "wider"
+            }
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+        {
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+          ]
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+              "equivalence": "wider"
+            }
+          ]
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+          "target": [
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+              "equivalence": "wider"
+            }
+          ]
+        },
+        {
+          "code": "00006-4995-01",
+          "target": [
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+              "equivalence": "wider"
+            }
+          ]
+        },
+        {
+          "code": "00006-4995-01",
+          "target": [
+            {
+              "code": "43",
+              "equivalence": "wider"
+            }
+          ]
+        },
+        {
+          "code": "00006-4841-01",
+          "target": [
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+              "code": "52",
+              "equivalence": "wider"
+            }
+          ]
+        },
+        {
+          "code": "00006-4841-01",
+          "target": [
+            {
+              "code": "52",
+              "equivalence": "wider"
+            }
+          ]
+        },
+        {
+          "code": "58160-0804-01",
+          "target": [
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+              "equivalence": "wider"
+            }
+          ]
+        },
+        {
+          "code": "58160-0802-02",
+          "target": [
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+              "equivalence": "wider"
+            }
+          ]
+        },
+        {
+          "code": "58160-0901-41",
+          "target": [
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+              "equivalence": "wider"
+            }
+          ]
+        },
+        {
+          "code": "00006-4837-01",
+          "target": [
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+              "code": "33",
+              "equivalence": "wider"
+            }
+          ]
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+        {
+          "code": "19515-0891-01",
+          "target": [
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+              "code": "158",
+              "equivalence": "wider"
+            }
+          ]
+        },
+        {
+          "code": "19515-0893-02",
+          "target": [
+            {
+              "code": "141",
+              "equivalence": "wider"
+            }
+          ]
+        },
+        {
+          "code": "19515-0894-41",
+          "target": [
+            {
+              "code": "150",
+              "equivalence": "wider"
+            }
+          ]
+        },
+        {
+          "code": "49281-0514-00",
+          "target": [
+            {
+              "code": "161",
+              "equivalence": "wider"
+            }
+          ]
+        },
+        {
+          "code": "49281-0394-78",
+          "target": [
+            {
+              "code": "141",
+              "equivalence": "wider"
+            }
+          ]
+        },
+        {
+          "code": "49281-0014-88",
+          "target": [
+            {
+              "code": "140",
+              "equivalence": "wider"
+            }
+          ]
+        },
+        {
+          "code": "49281-0414-58",
+          "target": [
+            {
+              "code": "150",
+              "equivalence": "wider"
+            }
+          ]
+        }
+      ]
+    }
+  ]
+}
diff --git a/lib/resources/us_core/ImplementationGuide.json b/lib/resources/us_core/ImplementationGuide-ig.json
similarity index 92%
rename from lib/resources/us_core/ImplementationGuide.json
rename to lib/resources/us_core/ImplementationGuide-ig.json
index e1590f0..a8bfcd4 100755
--- a/lib/resources/us_core/ImplementationGuide.json
+++ b/lib/resources/us_core/ImplementationGuide-ig.json
@@ -502,6 +502,18 @@
             "reference": "Procedure/rehab"
           }
         },
+        {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
+              "valueUri": "Practitioner-practitioner-2.html"
+            }
+          ],
+          "example": true,
+          "sourceReference": {
+            "reference": "Practitioner/practitioner-2"
+          }
+        },
         {
           "extension": [
             {
@@ -694,6 +706,18 @@
             "reference": "Observation/erythrocytes"
           }
         },
+        {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
+              "valueUri": "Encounter-1036.html"
+            }
+          ],
+          "example": true,
+          "sourceReference": {
+            "reference": "Encounter/1036"
+          }
+        },
         {
           "extension": [
             {
@@ -710,7 +734,7 @@
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "Careplan-colonoscopy.html"
+              "valueUri": "CarePlan-colonoscopy.html"
             }
           ],
           "example": true,
@@ -734,7 +758,7 @@
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "Careteam-example.html"
+              "valueUri": "CareTeam-example.html"
             }
           ],
           "example": true,
@@ -746,12 +770,12 @@
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "Observation-BUN.html"
+              "valueUri": "Observation-bun.html"
             }
           ],
           "example": true,
           "sourceReference": {
-            "reference": "Observation/BUN"
+            "reference": "Observation/bun"
           }
         },
         {
@@ -826,18 +850,6 @@
             "reference": "Organization/acme-lab"
           }
         },
-        {
-          "extension": [
-            {
-              "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "ValueSet-us-core-ucum.html"
-            }
-          ],
-          "example": false,
-          "sourceReference": {
-            "reference": "ValueSet/us-core-ucum"
-          }
-        },
         {
           "extension": [
             {
@@ -914,24 +926,24 @@
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "ValueSet-us-core-procedure-type.html"
+              "valueUri": "ValueSet-us-core-procedure-icd10pcs.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "ValueSet/us-core-procedure-type"
+            "reference": "ValueSet/us-core-procedure-icd10pcs"
           }
         },
         {
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "ValueSet-us-core-procedure-icd10pcs.html"
+              "valueUri": "ValueSet-us-core-procedure-code.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "ValueSet/us-core-procedure-icd10pcs"
+            "reference": "ValueSet/us-core-procedure-code"
           }
         },
         {
@@ -962,180 +974,216 @@
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "ValueSet-us-core-observation-ccdavitalsignresult.html"
+              "valueUri": "ValueSet-us-core-observation-ccdasmokingstatus.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "ValueSet/us-core-observation-ccdavitalsignresult"
+            "reference": "ValueSet/us-core-observation-ccdasmokingstatus"
           }
         },
         {
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "ValueSet-us-core-observation-ccdasmokingstatus.html"
+              "valueUri": "ValueSet-us-core-ndc-vaccine-codes.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "ValueSet/us-core-observation-ccdasmokingstatus"
+            "reference": "ValueSet/us-core-ndc-vaccine-codes"
           }
         },
         {
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "ValueSet-us-core-ndc-vaccine-codes.html"
+              "valueUri": "ValueSet-us-core-narrative-status.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "ValueSet/us-core-ndc-vaccine-codes"
+            "reference": "ValueSet/us-core-narrative-status"
           }
         },
         {
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "ValueSet-us-core-narrative-status.html"
+              "valueUri": "ValueSet-us-core-medication-codes.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "ValueSet/us-core-narrative-status"
+            "reference": "ValueSet/us-core-medication-codes"
           }
         },
         {
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "ValueSet-us-core-medication-codes.html"
+              "valueUri": "ValueSet-us-core-cvx.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "ValueSet/us-core-medication-codes"
+            "reference": "ValueSet/us-core-cvx"
           }
         },
         {
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "ValueSet-us-core-immunization-status.html"
+              "valueUri": "ValueSet-us-core-condition-category.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "ValueSet/us-core-immunization-status"
+            "reference": "ValueSet/us-core-condition-category"
           }
         },
         {
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "ValueSet-us-core-cvx.html"
+              "valueUri": "ValueSet-us-core-careteam-provider-roles.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "ValueSet/us-core-cvx"
+            "reference": "ValueSet/us-core-careteam-provider-roles"
           }
         },
         {
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "ValueSet-us-core-condition-category.html"
+              "valueUri": "ValueSet-us-core-birthsex.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "ValueSet/us-core-condition-category"
+            "reference": "ValueSet/us-core-birthsex"
           }
         },
         {
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "ValueSet-us-core-careteam-status.html"
+              "valueUri": "ValueSet-simple-language.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "ValueSet/us-core-careteam-status"
+            "reference": "ValueSet/simple-language"
           }
         },
         {
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "ValueSet-us-core-careteam-provider-roles.html"
+              "valueUri": "ValueSet-omb-race-category.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "ValueSet/us-core-careteam-provider-roles"
+            "reference": "ValueSet/omb-race-category"
           }
         },
         {
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "ValueSet-us-core-birthsex.html"
+              "valueUri": "ValueSet-omb-ethnicity-category.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "ValueSet/us-core-birthsex"
+            "reference": "ValueSet/omb-ethnicity-category"
+          }
+        },
+        {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
+              "valueUri": "ValueSet-detailed-race.html"
+            }
+          ],
+          "example": false,
+          "sourceReference": {
+            "reference": "ValueSet/detailed-race"
           }
         },
         {
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "ValueSet-omb-race.html"
+              "valueUri": "ValueSet-detailed-ethnicity.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "ValueSet/omb-race"
+            "reference": "ValueSet/detailed-ethnicity"
           }
         },
         {
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "ValueSet-omb-ethnicity.html"
+              "valueUri": "StructureDefinition-us-core-race.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "ValueSet/omb-ethnicity"
+            "reference": "StructureDefinition/us-core-race"
           }
         },
         {
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "ValueSet-detailed-race.html"
+              "valueUri": "StructureDefinition-us-core-profile-link.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "ValueSet/detailed-race"
+            "reference": "StructureDefinition/us-core-profile-link"
           }
         },
         {
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "ValueSet-detailed-ethnicity.html"
+              "valueUri": "StructureDefinition-us-core-ethnicity.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "ValueSet/detailed-ethnicity"
+            "reference": "StructureDefinition/us-core-ethnicity"
+          }
+        },
+        {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
+              "valueUri": "StructureDefinition-us-core-direct.html"
+            }
+          ],
+          "example": false,
+          "sourceReference": {
+            "reference": "StructureDefinition/us-core-direct"
+          }
+        },
+        {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
+              "valueUri": "StructureDefinition-us-core-birthsex.html"
+            }
+          ],
+          "example": false,
+          "sourceReference": {
+            "reference": "StructureDefinition/us-core-birthsex"
           }
         },
         {
@@ -1162,6 +1210,18 @@
             "reference": "SearchParameter/us-core-ethnicity"
           }
         },
+        {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
+              "valueUri": "ConceptMap-ndc-cvx.html"
+            }
+          ],
+          "example": false,
+          "sourceReference": {
+            "reference": "ConceptMap/ndc-cvx"
+          }
+        },
         {
           "extension": [
             {
@@ -1178,12 +1238,12 @@
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "CodeSystem-careteam-status.html"
+              "valueUri": "CodeSystem-cdcrec.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "CodeSystem/careteam-status"
+            "reference": "CodeSystem/cdcrec"
           }
         },
         {
@@ -1225,7 +1285,7 @@
       ]
     },
     {
-      "name": "U.S.  Core AllergyIntolerance Profile",
+      "name": "US  Core AllergyIntolerance Profile",
       "resource": [
         {
           "extension": [
@@ -1235,7 +1295,7 @@
             }
           ],
           "example": false,
-          "name": "US Core Allergies Profile",
+          "name": "US  Core AllergyIntolerance Profile",
           "sourceReference": {
             "reference": "StructureDefinition/us-core-allergyintolerance"
           }
@@ -1243,7 +1303,7 @@
       ]
     },
     {
-      "name": "U.S.  Core CarePlan Profile",
+      "name": "US Core CarePlan Profile",
       "resource": [
         {
           "extension": [
@@ -1261,7 +1321,7 @@
       ]
     },
     {
-      "name": "U.S.  Core CareTeam Profile",
+      "name": "US  Core CareTeam Profile",
       "resource": [
         {
           "extension": [
@@ -1271,7 +1331,7 @@
             }
           ],
           "example": false,
-          "name": "US Core CareTeam Profile",
+          "name": "US  Core CareTeam Profile",
           "sourceReference": {
             "reference": "StructureDefinition/us-core-careteam"
           }
@@ -1279,7 +1339,7 @@
       ]
     },
     {
-      "name": "U.S.  Core Condition (a.k.a Problem) Profile",
+      "name": "US  Core Condition (a.k.a Problem) Profile",
       "resource": [
         {
           "extension": [
@@ -1289,7 +1349,7 @@
             }
           ],
           "example": false,
-          "name": "US Core Condition Profile",
+          "name": "US  Core Condition (a.k.a Problem) Profile",
           "sourceReference": {
             "reference": "StructureDefinition/us-core-condition"
           }
@@ -1297,7 +1357,7 @@
       ]
     },
     {
-      "name": "U.S.  Core Device Profile",
+      "name": "US  Core Device Profile",
       "resource": [
         {
           "extension": [
@@ -1307,7 +1367,7 @@
             }
           ],
           "example": false,
-          "name": "US Core Implanted Device Profile",
+          "name": "US  Core Device Profile",
           "sourceReference": {
             "reference": "StructureDefinition/us-core-device"
           }
@@ -1315,7 +1375,7 @@
       ]
     },
     {
-      "name": "U.S.  Core DiagnosticReport Profile",
+      "name": "US  Core DiagnosticReport Profile",
       "resource": [
         {
           "extension": [
@@ -1325,7 +1385,7 @@
             }
           ],
           "example": false,
-          "name": "US Core Diagnostic Report Profile",
+          "name": "US  Core DiagnosticReport Profile",
           "sourceReference": {
             "reference": "StructureDefinition/us-core-diagnosticreport"
           }
@@ -1333,7 +1393,7 @@
       ]
     },
     {
-      "name": "U.S.  Core Goal Profile",
+      "name": "US  Core Goal Profile",
       "resource": [
         {
           "extension": [
@@ -1343,7 +1403,7 @@
             }
           ],
           "example": false,
-          "name": "US Core Goal Profile",
+          "name": "US  Core Goal Profile",
           "sourceReference": {
             "reference": "StructureDefinition/us-core-goal"
           }
@@ -1351,7 +1411,7 @@
       ]
     },
     {
-      "name": "U.S.  Core Immunization Profile",
+      "name": "US  Core Immunization Profile",
       "resource": [
         {
           "extension": [
@@ -1361,7 +1421,7 @@
             }
           ],
           "example": false,
-          "name": "US Core Immunization Profile",
+          "name": "US  Core Immunization Profile",
           "sourceReference": {
             "reference": "StructureDefinition/us-core-immunization"
           }
@@ -1369,7 +1429,7 @@
       ]
     },
     {
-      "name": "U.S.  Core Location Profile",
+      "name": "US  Core Location Profile",
       "resource": [
         {
           "extension": [
@@ -1379,7 +1439,7 @@
             }
           ],
           "example": false,
-          "name": "US Core Location Profile",
+          "name": "US  Core Location Profile",
           "sourceReference": {
             "reference": "StructureDefinition/us-core-location"
           }
@@ -1387,7 +1447,7 @@
       ]
     },
     {
-      "name": "U.S.  Core Medication Profile",
+      "name": "US  Core Medication Profile",
       "resource": [
         {
           "extension": [
@@ -1397,7 +1457,7 @@
             }
           ],
           "example": false,
-          "name": "US Core Medication Profile",
+          "name": "US  Core Medication Profile",
           "sourceReference": {
             "reference": "StructureDefinition/us-core-medication"
           }
@@ -1405,7 +1465,7 @@
       ]
     },
     {
-      "name": "U.S.  Core MedicationRequest Profile",
+      "name": "US  Core MedicationRequest Profile",
       "resource": [
         {
           "extension": [
@@ -1415,7 +1475,7 @@
             }
           ],
           "example": false,
-          "name": "US Core Medication Request Profile",
+          "name": "US  Core MedicationRequest Profile",
           "sourceReference": {
             "reference": "StructureDefinition/us-core-medicationrequest"
           }
@@ -1423,7 +1483,7 @@
       ]
     },
     {
-      "name": "U.S.  Core MedicationStatement Profile",
+      "name": "US  Core MedicationStatement Profile",
       "resource": [
         {
           "extension": [
@@ -1433,7 +1493,7 @@
             }
           ],
           "example": false,
-          "name": "US Core Medication Statement Profile",
+          "name": "US  Core MedicationStatement Profile",
           "sourceReference": {
             "reference": "StructureDefinition/us-core-medicationstatement"
           }
@@ -1441,7 +1501,7 @@
       ]
     },
     {
-      "name": "U.S.  Core Results Profile",
+      "name": "US  Core Results Profile",
       "resource": [
         {
           "extension": [
@@ -1451,7 +1511,7 @@
             }
           ],
           "example": false,
-          "name": "US Core Result Observation",
+          "name": "US  Core Results Profile",
           "sourceReference": {
             "reference": "StructureDefinition/us-core-observationresults"
           }
@@ -1459,7 +1519,7 @@
       ]
     },
     {
-      "name": "U.S.  Core Smoking Status Profile",
+      "name": "US  Core Smoking Status Profile",
       "resource": [
         {
           "extension": [
@@ -1469,7 +1529,7 @@
             }
           ],
           "example": false,
-          "name": "US Core Smoking Status Observation Profile",
+          "name": "US  Core Smoking Status Profile",
           "sourceReference": {
             "reference": "StructureDefinition/us-core-smokingstatus"
           }
@@ -1477,25 +1537,7 @@
       ]
     },
     {
-      "name": "U.S.  Core Vital Signs Profile",
-      "resource": [
-        {
-          "extension": [
-            {
-              "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "StructureDefinition-us-core-vitalsigns.html"
-            }
-          ],
-          "example": false,
-          "name": "US Core Vital Signs Profile",
-          "sourceReference": {
-            "reference": "StructureDefinition/us-core-vitalsigns"
-          }
-        }
-      ]
-    },
-    {
-      "name": "U.S. US Core Organization Core Profile",
+      "name": "US Core Organization Core Profile",
       "resource": [
         {
           "extension": [
@@ -1505,7 +1547,7 @@
             }
           ],
           "example": false,
-          "name": "US Core Organization Profile",
+          "name": "US Core Organization Core Profile",
           "sourceReference": {
             "reference": "StructureDefinition/us-core-organization"
           }
@@ -1513,60 +1555,8 @@
       ]
     },
     {
-      "name": "U.S.  Core Patient Profile",
+      "name": "US Core Patient Profile",
       "resource": [
-        {
-          "extension": [
-            {
-              "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "StructureDefinition-us-core-direct.html"
-            }
-          ],
-          "example": false,
-          "name": "Email is a \"direct\" email",
-          "sourceReference": {
-            "reference": "StructureDefinition/us-core-direct"
-          }
-        },
-        {
-          "extension": [
-            {
-              "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "StructureDefinition-us-core-birthsex.html"
-            }
-          ],
-          "example": false,
-          "name": "US Core Birth Sex Extension",
-          "sourceReference": {
-            "reference": "StructureDefinition/us-core-birthsex"
-          }
-        },
-        {
-          "extension": [
-            {
-              "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "StructureDefinition-us-core-race.html"
-            }
-          ],
-          "example": false,
-          "name": "US Core Race Extension",
-          "sourceReference": {
-            "reference": "StructureDefinition/us-core-race"
-          }
-        },
-        {
-          "extension": [
-            {
-              "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "StructureDefinition-us-core-ethnicity.html"
-            }
-          ],
-          "example": false,
-          "name": "US Core ethnicity Extension",
-          "sourceReference": {
-            "reference": "StructureDefinition/us-core-ethnicity"
-          }
-        },
         {
           "extension": [
             {
@@ -1583,25 +1573,25 @@
       ]
     },
     {
-      "name": "U.S.  Core Practitioner Profile",
+      "name": "US  Core Practitioner Profile",
       "resource": [
         {
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "StructureDefinition-us-core-pract.html"
+              "valueUri": "StructureDefinition-us-core-practitioner.html"
             }
           ],
           "example": false,
-          "name": "US Core Practitioner",
+          "name": "US  Core Practitioner Profile",
           "sourceReference": {
-            "reference": "StructureDefinition/us-core-pract"
+            "reference": "StructureDefinition/us-core-practitioner"
           }
         }
       ]
     },
     {
-      "name": "U.S.  Core Procedure Profile",
+      "name": "US  Core Procedure Profile",
       "resource": [
         {
           "extension": [
@@ -1611,7 +1601,7 @@
             }
           ],
           "example": false,
-          "name": "US Core Procedure Profile",
+          "name": "US  Core Procedure Profile",
           "sourceReference": {
             "reference": "StructureDefinition/us-core-procedure"
           }
@@ -1621,7 +1611,7 @@
   ],
   "page": {
     "source": "index.html",
-    "title": "blah",
+    "title": "US Core Homepage",
     "kind": "page"
   }
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/StructureDefinition-us-core-allergyintolerance.json b/lib/resources/us_core/StructureDefinition-us-core-allergyintolerance.json
index 68fa705..ab45a9d 100755
--- a/lib/resources/us_core/StructureDefinition-us-core-allergyintolerance.json
+++ b/lib/resources/us_core/StructureDefinition-us-core-allergyintolerance.json
@@ -3,12 +3,14 @@
   "id": "us-core-allergyintolerance",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance</a></p><p><b>name</b>: US Core Allergies Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: Health Level Seven International (FHIR - Infrastructure)</p><p><b>contact</b>: </p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance</a></p><p><b>name</b>: US Core Allergies Profile</p><p><b>status</b>: DRAFT</p><p><b>publisher</b>: Health Level Seven International (FHIR - Infrastructure)</p><p><b>contact</b>: </p><p><b>date</b>: 01/08/2016</p><blockquote><p><b>mapping</b></p><p><b>identity</b>: rim</p><p><b>uri</b>: <a href=\"http://hl7.org/v3\">http://hl7.org/v3</a></p><p><b>name</b>: RIM Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: w5</p><p><b>uri</b>: <a href=\"http://hl7.org/fhir/w5\">http://hl7.org/fhir/w5</a></p><p><b>name</b>: W5 Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: v2</p><p><b>uri</b>: <a href=\"http://hl7.org/v2\">http://hl7.org/v2</a></p><p><b>name</b>: HL7 v2 Mapping</p></blockquote><p><b>kind</b>: RESOURCE</p><p><b>abstract</b>: false</p><p><b>type</b>: AllergyIntolerance</p><p><b>baseDefinition</b>: <a href=\"http://hl7.org/fhir/StructureDefinition/AllergyIntolerance\">http://hl7.org/fhir/StructureDefinition/AllergyIntolerance</a></p><p><b>derivation</b>: CONSTRAINT</p><h3>Snapshots</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table><h3>Differentials</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table></div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: US  Core AllergyIntolerance Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: HL7 US Realm Steering Committee</p><p><b>contact</b>: </p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: US  Core AllergyIntolerance Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: HL7 US Realm Steering Committee</p><p><b>contact</b>: </p><p><b>fhirVersion</b>: 3.0.0</p><blockquote><p><b>mapping</b></p><p><b>identity</b>: argonaut-dq-dstu2</p><p><b>uri</b>: <a href=\"http://unknown.org/Argonaut DQ DSTU2\">http://unknown.org/Argonaut DQ DSTU2</a></p><p><b>name</b>: Argonaut DQ DSTU2</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: rim</p><p><b>uri</b>: <a href=\"http://hl7.org/v3\">http://hl7.org/v3</a></p><p><b>name</b>: RIM Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: w5</p><p><b>uri</b>: <a href=\"http://hl7.org/fhir/w5\">http://hl7.org/fhir/w5</a></p><p><b>name</b>: W5 Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: v2</p><p><b>uri</b>: <a href=\"http://hl7.org/v2\">http://hl7.org/v2</a></p><p><b>name</b>: HL7 v2 Mapping</p></blockquote><p><b>kind</b>: RESOURCE</p><p><b>abstract</b>: false</p><p><b>type</b>: AllergyIntolerance</p><p><b>baseDefinition</b>: <a href=\"http://hl7.org/fhir/StructureDefinition/AllergyIntolerance\">http://hl7.org/fhir/StructureDefinition/AllergyIntolerance</a></p><p><b>derivation</b>: CONSTRAINT</p><h3>Snapshots</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table><h3>Differentials</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table></div>"
   },
   "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance",
-  "name": "US Core Allergies Profile",
+  "version": "1.0.0",
+  "name": "US  Core AllergyIntolerance Profile",
   "status": "draft",
-  "publisher": "Health Level Seven International (FHIR - Infrastructure)",
+  "date": "2016-08-01",
+  "publisher": "HL7 US Realm Steering Committee",
   "contact": [
     {
       "telecom": [
@@ -19,8 +21,13 @@
       ]
     }
   ],
-  "date": "2016-08-01",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "argonaut-dq-dstu2",
+      "uri": "http://unknown.org/Argonaut DQ DSTU2",
+      "name": "Argonaut DQ DSTU2"
+    },
     {
       "identity": "rim",
       "uri": "http://hl7.org/v3",
@@ -50,7 +57,7 @@
         "sliceName": "USCoreAllergyIntolerance",
         "short": "US Core Allergies Profile",
         "definition": "The US Core Allergies Profile is based upon the core FHIR AllergyIntolerance Resource and created to meet the 2015 Edition Common Clinical Data Set 'Medical allergies' requirements.",
-        "comments": "Substances include, but are not limited to: a therapeutic substance administered correctly at an appropriate dosage for the individual; food; material derived from plants or animals; or venom from insect stings.",
+        "comment": "Substances include, but are not limited to: a therapeutic substance administered correctly at an appropriate dosage for the individual; food; material derived from plants or animals; or venom from insect stings.",
         "alias": [
           "Allergy",
           "Intolerance",
@@ -114,7 +121,6 @@
           }
         ],
         "mustSupport": false,
-        "isSummary": false,
         "mapping": [
           {
             "identity": "rim",
@@ -127,6 +133,10 @@
           {
             "identity": "w5",
             "map": "clinical.general"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "AllergyIntolerance"
           }
         ]
       },
@@ -135,7 +145,7 @@
         "path": "AllergyIntolerance.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -174,7 +184,7 @@
         "path": "AllergyIntolerance.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -195,7 +205,7 @@
         "path": "AllergyIntolerance.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -215,6 +225,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -229,7 +247,7 @@
         "path": "AllergyIntolerance.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -263,7 +281,7 @@
         "path": "AllergyIntolerance.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -293,7 +311,7 @@
         "path": "AllergyIntolerance.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -322,7 +340,7 @@
         "path": "AllergyIntolerance.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -385,6 +403,7 @@
         "path": "AllergyIntolerance.clinicalStatus",
         "short": "active | inactive | resolved",
         "definition": "The clinical status of the allergy or intolerance.",
+        "comment": "This element is labeled as a modifier because the status contains the codes inactive and resolved that mark the AllergyIntolerance as not currently valid.",
         "min": 0,
         "max": "1",
         "base": {
@@ -397,9 +416,13 @@
             "code": "code"
           }
         ],
+        "condition": [
+          "ait-1",
+          "ait-2"
+        ],
         "mustSupport": true,
         "isModifier": true,
-        "isSummary": false,
+        "isSummary": true,
         "binding": {
           "strength": "required",
           "valueSetReference": {
@@ -407,9 +430,17 @@
           }
         },
         "mapping": [
+          {
+            "identity": "rim",
+            "map": "Observation ACT\n.inboundRelationship[typeCode=COMP].source[classCode=OBS, code=\"clinicalStatus\", moodCode=EVN].value"
+          },
           {
             "identity": "w5",
             "map": "status"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "AllergyIntolerance.status"
           }
         ]
       },
@@ -418,7 +449,7 @@
         "path": "AllergyIntolerance.verificationStatus",
         "short": "unconfirmed | confirmed | refuted | entered-in-error",
         "definition": "Assertion about certainty associated with the propensity, or potential risk, of a reaction to the identified substance (including pharmaceutical product).",
-        "comments": "Decision support would typically raise alerts for 'confirmed' and 'unconfirmed' and ignore a 'refuted' reaction. In particular, 'refuted' may be useful for reconciliation of the Adverse Reaction List.",
+        "comment": "This element is labeled as a modifier because the status contains the codes refuted and entered-in-error that mark the AllergyIntolerance as not currently valid.",
         "min": 1,
         "max": "1",
         "base": {
@@ -431,9 +462,13 @@
             "code": "code"
           }
         ],
+        "condition": [
+          "ait-1",
+          "ait-2"
+        ],
         "mustSupport": true,
         "isModifier": true,
-        "isSummary": false,
+        "isSummary": true,
         "binding": {
           "strength": "required",
           "valueSetReference": {
@@ -441,9 +476,17 @@
           }
         },
         "mapping": [
+          {
+            "identity": "rim",
+            "map": "Observation ACT\n.inboundRelationship[typeCode=COMP].source[classCode=OBS, code=\"verificationStatus\", moodCode=EVN].value"
+          },
           {
             "identity": "w5",
             "map": "status"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "AllergyIntolerance.status"
           }
         ]
       },
@@ -452,7 +495,7 @@
         "path": "AllergyIntolerance.type",
         "short": "allergy | intolerance - Underlying mechanism (if known)",
         "definition": "Identification of the underlying physiological mechanism for the reaction risk.",
-        "comments": "Allergic (typically immune-mediated) reactions have been traditionally regarded as an indicator for potential escalation to significant future risk. Contemporary knowledge suggests that some reactions previously thought to be immune-mediated are, in fact, non-immune, but in some cases can still pose a life threatening risk. It is acknowledged that many clinicians may not be in a position to distinguish the mechanism of a particular reaction. Often the term \"allergy\" is used rather generically and may overlap with the use of \"intolerance\" - in practice the boundaries between these two concepts may not be well-defined or understood. This data element is included nevertheless, because many legacy systems have captured this attribute. Immunologic testing may provide supporting evidence for the basis of the reaction and the causative substance, but no tests are 100% sensitive or specific for sensitivity to a particular substance. If, as is commonly the case, it is unclear whether the reaction is due to an allergy or an intolerance, then the type element should be omitted from the resource.",
+        "comment": "Allergic (typically immune-mediated) reactions have been traditionally regarded as an indicator for potential escalation to significant future risk. Contemporary knowledge suggests that some reactions previously thought to be immune-mediated are, in fact, non-immune, but in some cases can still pose a life threatening risk. It is acknowledged that many clinicians may not be in a position to distinguish the mechanism of a particular reaction. Often the term \"allergy\" is used rather generically and may overlap with the use of \"intolerance\" - in practice the boundaries between these two concepts may not be well-defined or understood. This data element is included nevertheless, because many legacy systems have captured this attribute. Immunologic testing may provide supporting evidence for the basis of the reaction and the causative substance, but no tests are 100% sensitive or specific for sensitivity to a particular substance. If, as is commonly the case, it is unclear whether the reaction is due to an allergy or an intolerance, then the type element should be omitted from the resource.",
         "alias": [
           "Category",
           "Class"
@@ -471,6 +514,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AllergyIntoleranceType"
+            }
+          ],
           "strength": "required",
           "description": "Identification of the underlying physiological mechanism for a Reaction Risk.",
           "valueSetReference": {
@@ -495,9 +544,9 @@
       {
         "id": "AllergyIntolerance:uscoreallergyintolerance.category",
         "path": "AllergyIntolerance.category",
-        "short": "food | medication | biologic | environment",
+        "short": "food | medication | environment | biologic",
         "definition": "Category of the identified substance.",
-        "comments": "This data element has been included because it is currently being captured in some clinical systems. This data can be derived from the substance where coding systems are used, and is effectively redundant in that situation.  When searching on category, consider the implications of AllergyIntolerance resources without a category.  For example, when searching on category = medication, medication allergies that don't have a category valued will not be returned.  Refer to [search](search.html) for more information on how to search category with a :missing modifier to get allergies that don't have a category.",
+        "comment": "This data element has been included because it is currently being captured in some clinical systems. This data can be derived from the substance where coding systems are used, and is effectively redundant in that situation.  When searching on category, consider the implications of AllergyIntolerance resources without a category.  For example, when searching on category = medication, medication allergies that don't have a category valued will not be returned.  Refer to [search](search.html) for more information on how to search category with a :missing modifier to get allergies that don't have a category.  Additionally, category should be used with caution because category can be subjective based on the sender.",
         "alias": [
           "Category",
           "Type",
@@ -518,6 +567,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AllergyIntoleranceCategory"
+            }
+          ],
           "strength": "required",
           "description": "Category of an identified substance.",
           "valueSetReference": {
@@ -544,7 +599,7 @@
         "path": "AllergyIntolerance.criticality",
         "short": "low | high | unable-to-assess",
         "definition": "Estimate of the potential clinical harm, or seriousness, of the reaction to the identified substance.",
-        "comments": "The default criticality value for any propensity to an adverse reaction should be 'Low Risk', indicating at the very least a relative contraindication to deliberate or voluntary exposure to the substance. 'High Risk' is flagged if the clinician has identified a propensity for a more serious or potentially life-threatening reaction, such as anaphylaxis, and implies an absolute contraindication to deliberate or voluntary exposure to the substance. If this element is missing, the criticality is unknown (though it may be known elsewhere).",
+        "comment": "The default criticality value for any propensity to an adverse reaction should be 'Low Risk', indicating at the very least a relative contraindication to deliberate or voluntary exposure to the substance. 'High Risk' is flagged if the clinician has identified a propensity for a more serious or potentially life-threatening reaction, such as anaphylaxis, and implies an absolute contraindication to deliberate or voluntary exposure to the substance. If this element is missing, the criticality is unknown (though it may be known elsewhere).\n\nSystems that capture a severity at the condition level are actually representing the concept of criticality whereas the severity documented at the reaction level is representing the true reaction severity.  Existing systems that are capturing both condition criticality and reaction severity may use the term \"severity\" to represent both.  Criticality is the worst it could be in the future (i.e. situation-agnostic) whereas severity is situation-dependent.",
         "alias": [
           "Severity",
           "Seriousness",
@@ -565,6 +620,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AllergyIntoleranceCriticality"
+            }
+          ],
           "strength": "required",
           "description": "Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.",
           "valueSetReference": {
@@ -589,9 +650,9 @@
       {
         "id": "AllergyIntolerance:uscoreallergyintolerance.code",
         "path": "AllergyIntolerance.code",
-        "short": "Allergy or intolerance code",
+        "short": "Code that identifies the allergy or intolerance",
         "definition": "Code for an allergy or intolerance statement (either a positive or a negated/excluded statement).  This may be a code for a substance or pharmaceutical product that is considered to be responsible for the adverse reaction risk (e.g., \"Latex\"), an allergy or intolerance condition (e.g., \"Latex allergy\"), or a negated/excluded code for a specific substance or class (e.g., \"No latex allergy\") or a general or categorical negated statement (e.g.,  \"No known allergy\", \"No known drug allergies\").",
-        "comments": "It is strongly recommended that this element be populated using a terminology, where possible. For example, some terminologies used include RxNorm, SNOMED CT, DM+D, NDFRT, ICD-9, IDC-10, UNI, ATC and CPT. Plain text should only be used if there is no appropriate terminology available. Additional details can be specified in the text.  When a substance or product code is specified for the 'code' element, the \"default\" semantic context is that this is a positive statement of an allergy or intolerance (depending on the value of the 'type' element, if present) condition to the specified substance/product.  In the corresponding SNOMED CT allergy model, the specified substance/product is the target (destination) of the \"Causative agent\" relationship.  The 'substanceExposureRisk' extension is available as a structured and more flexible alternative to the 'code' element for making positive or negative allergy or intolerance statements.  This extension provides the capability to make \"no known allergy\" (or \"no risk of adverse reaction\") statements regarding any coded substance/product (including cases when a pre-coordinated \"no allergy to x\" concept for that substance/product does not exist).  If the 'substanceExposureRisk' extension is present, the AllergyIntolerance.code element SHALL be omitted.",
+        "comment": "It is strongly recommended that this element be populated using a terminology, where possible. For example, some terminologies used include RxNorm, SNOMED CT, DM+D, NDFRT, ICD-9, IDC-10, UNI, ATC and CPT. Plain text should only be used if there is no appropriate terminology available. Additional details can be specified in the text.\r\rWhen a substance or product code is specified for the 'code' element, the \"default\" semantic context is that this is a positive statement of an allergy or intolerance (depending on the value of the 'type' element, if present) condition to the specified substance/product.  In the corresponding SNOMED CT allergy model, the specified substance/product is the target (destination) of the \"Causative agent\" relationship.\r\rThe 'substanceExposureRisk' extension is available as a structured and more flexible alternative to the 'code' element for making positive or negative allergy or intolerance statements.  This extension provides the capability to make \"no known allergy\" (or \"no risk of adverse reaction\") statements regarding any coded substance/product (including cases when a pre-coordinated \"no allergy to x\" concept for that substance/product does not exist).  If the 'substanceExposureRisk' extension is present, the AllergyIntolerance.code element SHALL be omitted.",
         "alias": [
           "Code"
         ],
@@ -608,7 +669,7 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "binding": {
           "strength": "extensible",
           "valueSetReference": {
@@ -622,11 +683,15 @@
           },
           {
             "identity": "rim",
-            "map": "substance/product:  .participation[typeCode=CAGNT].role[classCode=ADMM].player[classCode=MAT, determinerCode=KIND, code <= ExposureAgentEntityType]  negated/excluded substance/product:  .participation[typeCode=CAGNT, negationInd=true].role[classCode=ADMM].player[classCode=MAT, determinerCode=KIND, code <= ExposureAgentEntityType]  positive or negated/excluded condition/situation:  Observation.code=ASSERTION; Observation.value"
+            "map": "substance/product:\r\r.participation[typeCode=CAGNT].role[classCode=ADMM].player[classCode=MAT, determinerCode=KIND, code <= ExposureAgentEntityType]\r\rnegated/excluded substance/product:\r\r.participation[typeCode=CAGNT, negationInd=true].role[classCode=ADMM].player[classCode=MAT, determinerCode=KIND, code <= ExposureAgentEntityType]\r\rpositive or negated/excluded condition/situation:\r\rObservation.code=ASSERTION; Observation.value"
           },
           {
             "identity": "w5",
             "map": "what"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "AllergyIntolerance.substance"
           }
         ]
       },
@@ -652,7 +717,7 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -665,6 +730,10 @@
           {
             "identity": "w5",
             "map": "who.focus"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "AllergyIntolerance.patient"
           }
         ]
       },
@@ -781,7 +850,7 @@
         "path": "AllergyIntolerance.asserter",
         "short": "Source of the information about the allergy",
         "definition": "The source of the information about the allergy that is recorded.",
-        "comments": "The recorder takes repsonsibility for the content, but can reference the source from where they got it.",
+        "comment": "The recorder takes repsonsibility for the content, but can reference the source from where they got it.",
         "alias": [
           "Source",
           "Informant"
@@ -828,7 +897,7 @@
         "path": "AllergyIntolerance.lastOccurrence",
         "short": "Date(/time) of last known occurrence of a reaction",
         "definition": "Represents the date and/or time of the last known occurrence of a reaction event.",
-        "comments": "This date may be replicated by one of the Onset of Reaction dates. Where a textual representation of the date of last occurrence is required e.g. 'In Childhood, '10 years ago' the Comment element should be used.",
+        "comment": "This date may be replicated by one of the Onset of Reaction dates. Where a textual representation of the date of last occurrence is required e.g. 'In Childhood, '10 years ago' the Comment element should be used.",
         "min": 0,
         "max": "1",
         "base": {
@@ -853,7 +922,7 @@
         "path": "AllergyIntolerance.note",
         "short": "Additional text not captured in other fields",
         "definition": "Additional narrative about the propensity for the Adverse Reaction, not captured in other fields.",
-        "comments": "For example: including reason for flagging a seriousness of 'High Risk'; and instructions related to future exposure or administration of the substance, such as administration within an Intensive Care Unit or under corticosteroid cover. The notes should be related to an allergy or intolerance as a condition in general and not related to any particular episode of it. For episode notes and descriptions, use AllergyIntolerance.event.description and  AllergyIntolerance.event.notes.",
+        "comment": "For example: including reason for flagging a seriousness of 'High Risk'; and instructions related to future exposure or administration of the substance, such as administration within an Intensive Care Unit or under corticosteroid cover. The notes should be related to an allergy or intolerance as a condition in general and not related to any particular episode of it. For episode notes and descriptions, use AllergyIntolerance.event.description and  AllergyIntolerance.event.notes.",
         "min": 0,
         "max": "*",
         "base": {
@@ -939,7 +1008,7 @@
         "path": "AllergyIntolerance.reaction.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -968,7 +1037,7 @@
         "path": "AllergyIntolerance.reaction.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1000,7 +1069,7 @@
         "path": "AllergyIntolerance.reaction.substance",
         "short": "Specific substance or pharmaceutical product considered to be responsible for event",
         "definition": "Identification of the specific substance (or pharmaceutical product) considered to be responsible for the Adverse Reaction event. Note: the substance for a specific reaction may be different from the substance identified as the cause of the risk, but it must be consistent with it. For instance, it may be a more specific substance (e.g. a brand medication) or a composite product that includes the identified substance. It must be clinically safe to only process the 'code' and ignore the 'reaction.substance'.",
-        "comments": "Coding of the specific substance (or pharmaceutical product) with a terminology capable of triggering decision support should be used wherever possible.  The 'code' element allows for the use of a specific substance or pharmaceutical product, or a group or class of substances. In the case of an allergy or intolerance to a class of substances, (for example, \"penicillins\"), the 'reaction.substance' element could be used to code the specific substance that was identifed as having caused the reaction (for example, \"amoxycillin\"). Duplication of the value in the 'code' and 'reaction.substance' elements is acceptable when a specific substance has been recorded in 'code'.",
+        "comment": "Coding of the specific substance (or pharmaceutical product) with a terminology capable of triggering decision support should be used wherever possible.  The 'code' element allows for the use of a specific substance or pharmaceutical product, or a group or class of substances. In the case of an allergy or intolerance to a class of substances, (for example, \"penicillins\"), the 'reaction.substance' element could be used to code the specific substance that was identifed as having caused the reaction (for example, \"amoxycillin\"). Duplication of the value in the 'code' and 'reaction.substance' elements is acceptable when a specific substance has been recorded in 'code'.",
         "min": 0,
         "max": "1",
         "base": {
@@ -1014,6 +1083,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "SubstanceCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes defining the type of the substance (including pharmaceutical products).",
           "valueSetReference": {
@@ -1027,47 +1102,12 @@
           }
         ]
       },
-      {
-        "id": "AllergyIntolerance:uscoreallergyintolerance.reaction.certainty",
-        "path": "AllergyIntolerance.reaction.certainty",
-        "short": "unlikely | likely | confirmed | unknown",
-        "definition": "Statement about the degree of clinical certainty that the specific substance was the cause of the manifestation in this reaction event.",
-        "comments": "When certainty is missing, it means no information exists (although it could be in narrative).  By contrast, the unknown code is used when there is an explicit assertion that certainty is not known, such as when a patient eats a meal and it is unknown which food caused the reaction.",
-        "alias": [
-          "Cause"
-        ],
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "AllergyIntolerance.reaction.certainty",
-          "min": 0,
-          "max": "1"
-        },
-        "type": [
-          {
-            "code": "code"
-          }
-        ],
-        "binding": {
-          "strength": "required",
-          "description": "Statement about the degree of clinical certainty that a specific substance was the cause of the manifestation in an reaction event.",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/reaction-event-certainty"
-          }
-        },
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "uncertaintyCode"
-          }
-        ]
-      },
       {
         "id": "AllergyIntolerance:uscoreallergyintolerance.reaction.manifestation",
         "path": "AllergyIntolerance.reaction.manifestation",
         "short": "Clinical symptoms/signs associated with the Event",
         "definition": "Clinical symptoms and/or signs that are observed or associated with the adverse reaction event.",
-        "comments": "Manifestation can be expressed as a single word, phrase or brief description. For example: nausea, rash or no reaction. It is preferable that manifestation should be coded with a terminology, where possible. The values entered here may be used to display on an application screen as part of a list of adverse reactions, as recommended in the UK NHS CUI guidelines.  Terminologies commonly used include, but are not limited to, SNOMED CT or ICD10.",
+        "comment": "Manifestation can be expressed as a single word, phrase or brief description. For example: nausea, rash or no reaction. It is preferable that manifestation should be coded with a terminology, where possible. The values entered here may be used to display on an application screen as part of a list of adverse reactions, as recommended in the UK NHS CUI guidelines.  Terminologies commonly used include, but are not limited to, SNOMED CT or ICD10.",
         "alias": [
           "Symptoms",
           "Signs"
@@ -1085,10 +1125,16 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Manifestation"
+            }
+          ],
           "strength": "example",
           "description": "Clinical symptoms and/or signs that are observed or associated with an Adverse Reaction Event.",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/manifestation-codes"
+            "reference": "http://hl7.org/fhir/ValueSet/clinical-findings"
           }
         },
         "mapping": [
@@ -1107,7 +1153,7 @@
         "path": "AllergyIntolerance.reaction.description",
         "short": "Description of the event as a whole",
         "definition": "Text description about the reaction as a whole, including details of the manifestation if required.",
-        "comments": "Use the description to provide any details of a particular event of the occurred reaction such as circumstances, reaction specifics, what happened before/after. Information, related to the event, but not describing a particular care should be captured in the comment field. For example: at the age of four, the patient was given penicillin for strep throat and subsequently developed severe hives.",
+        "comment": "Use the description to provide any details of a particular event of the occurred reaction such as circumstances, reaction specifics, what happened before/after. Information, related to the event, but not describing a particular care should be captured in the comment field. For example: at the age of four, the patient was given penicillin for strep throat and subsequently developed severe hives.",
         "alias": [
           "Narrative",
           "Text"
@@ -1164,7 +1210,7 @@
         "path": "AllergyIntolerance.reaction.severity",
         "short": "mild | moderate | severe (of event as a whole)",
         "definition": "Clinical assessment of the severity of the reaction event as a whole, potentially considering multiple different manifestations.",
-        "comments": "It is acknowledged that this assessment is very subjective. There may be some some specific practice domains where objective scales have been applied. Objective scales can be included in this model as extensions.",
+        "comment": "It is acknowledged that this assessment is very subjective. There may be some some specific practice domains where objective scales have been applied. Objective scales can be included in this model as extensions.",
         "min": 0,
         "max": "1",
         "base": {
@@ -1178,6 +1224,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AllergyIntoleranceSeverity"
+            }
+          ],
           "strength": "required",
           "description": "Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations.",
           "valueSetReference": {
@@ -1196,7 +1248,7 @@
         "path": "AllergyIntolerance.reaction.exposureRoute",
         "short": "How the subject was exposed to the substance",
         "definition": "Identification of the route by which the subject was exposed to the substance.",
-        "comments": "Coding of the route of exposure with a terminology should be used wherever possible.",
+        "comment": "Coding of the route of exposure with a terminology should be used wherever possible.",
         "min": 0,
         "max": "1",
         "base": {
@@ -1210,6 +1262,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "RouteOfAdministration"
+            }
+          ],
           "strength": "example",
           "description": "A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.",
           "valueSetReference": {
@@ -1228,7 +1286,7 @@
         "path": "AllergyIntolerance.reaction.note",
         "short": "Text about event not captured in other fields",
         "definition": "Additional text about the adverse reaction event not captured in other fields.",
-        "comments": "Use this field to record information indirectly related to a particular event and not captured in the description. For example: Clinical records are no longer available, recorded based on information provided to the patient by her mother and her mother is deceased.",
+        "comment": "Use this field to record information indirectly related to a particular event and not captured in the description. For example: Clinical records are no longer available, recorded based on information provided to the patient by her mother and her mother is deceased.",
         "min": 0,
         "max": "*",
         "base": {
@@ -1260,7 +1318,12 @@
         "definition": "The US Core Allergies Profile is based upon the core FHIR AllergyIntolerance Resource and created to meet the 2015 Edition Common Clinical Data Set 'Medical allergies' requirements.",
         "mustSupport": false,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "AllergyIntolerance"
+          }
+        ]
       },
       {
         "id": "AllergyIntolerance:uscoreallergyintolerance.clinicalStatus",
@@ -1274,13 +1337,18 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false,
         "binding": {
           "strength": "required",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/allergy-clinical-status"
           }
-        }
+        },
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "AllergyIntolerance.status"
+          }
+        ]
       },
       {
         "id": "AllergyIntolerance:uscoreallergyintolerance.verificationStatus",
@@ -1294,13 +1362,18 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false,
         "binding": {
           "strength": "required",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/allergy-verification-status"
           }
-        }
+        },
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "AllergyIntolerance.status"
+          }
+        ]
       },
       {
         "id": "AllergyIntolerance:uscoreallergyintolerance.code",
@@ -1314,13 +1387,18 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false,
         "binding": {
           "strength": "extensible",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/us/core/ValueSet/us-core-substance"
           }
-        }
+        },
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "AllergyIntolerance.substance"
+          }
+        ]
       },
       {
         "id": "AllergyIntolerance:uscoreallergyintolerance.patient",
@@ -1335,8 +1413,13 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "AllergyIntolerance.patient"
+          }
+        ]
       }
     ]
   }
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/StructureDefinition-us-core-birthsex.json b/lib/resources/us_core/StructureDefinition-us-core-birthsex.json
index ce4c41b..25ed182 100755
--- a/lib/resources/us_core/StructureDefinition-us-core-birthsex.json
+++ b/lib/resources/us_core/StructureDefinition-us-core-birthsex.json
@@ -3,13 +3,15 @@
   "id": "us-core-birthsex",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex</a></p><p><b>name</b>: US Core Birth Sex Extension</p><p><b>title</b>: US Core Birth Sex Extension</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: Health Level Seven International (FHIR-Infrastructure)</p><p><b>contact</b>: </p><p><b>description</b>: A code classifying the person's sex assigned at birth  as specified by the [Office of the National Coordinator for Health IT (ONC)](https://www.healthit.gov/newsroom/about-onc).</p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex</a></p><p><b>name</b>: US Core Birth Sex Extension</p><p><b>title</b>: US Core Birth Sex Extension</p><p><b>status</b>: DRAFT</p><p><b>publisher</b>: Health Level Seven International (FHIR-Infrastructure)</p><p><b>contact</b>: </p><p><b>date</b>: 01/08/2016</p><p><b>description</b>: A code classifying the person's sex assigned at birth  as specified by the [Office of the National Coordinator for Health IT (ONC)](https://www.healthit.gov/newsroom/about-onc).</p><p><b>fhirVersion</b>: 1.8.0</p><h3>Mappings</h3><table class=\"grid\"><tr><td>-</td><td><b>Identity</b></td><td><b>Uri</b></td><td><b>Name</b></td></tr><tr><td>*</td><td>rim</td><td><a href=\"http://hl7.org/v3\">http://hl7.org/v3</a></td><td>RIM Mapping</td></tr></table><p><b>kind</b>: COMPLEXTYPE</p><p><b>abstract</b>: false</p><p><b>contextType</b>: RESOURCE</p><p><b>context</b>: Patient</p><p><b>type</b>: Extension</p><p><b>baseDefinition</b>: <a href=\"http://hl7.org/fhir/StructureDefinition/Extension\">http://hl7.org/fhir/StructureDefinition/Extension</a></p><p><b>derivation</b>: CONSTRAINT</p><h3>Snapshots</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table><h3>Differentials</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table></div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: US Core Birth Sex Extension</p><p><b>title</b>: US Core Birth Sex Extension</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: HL7 US Realm Steering Committee</p><p><b>contact</b>: </p><p><b>description</b>: A code classifying the person's sex assigned at birth  as specified by the [Office of the National Coordinator for Health IT (ONC)](https://www.healthit.gov/newsroom/about-onc). This extension aligns with the C-CDA Birth Sex Observation (LOINC 76689-9).</p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: US Core Birth Sex Extension</p><p><b>title</b>: US Core Birth Sex Extension</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: HL7 US Realm Steering Committee</p><p><b>contact</b>: </p><p><b>description</b>: A code classifying the person's sex assigned at birth  as specified by the [Office of the National Coordinator for Health IT (ONC)](https://www.healthit.gov/newsroom/about-onc). This extension aligns with the C-CDA Birth Sex Observation (LOINC 76689-9).</p><p><b>fhirVersion</b>: 3.0.0</p><h3>Mappings</h3><table class=\"grid\"><tr><td>-</td><td><b>Identity</b></td><td><b>Uri</b></td><td><b>Name</b></td></tr><tr><td>*</td><td>rim</td><td><a href=\"http://hl7.org/v3\">http://hl7.org/v3</a></td><td>RIM Mapping</td></tr></table><p><b>kind</b>: COMPLEXTYPE</p><p><b>abstract</b>: false</p><p><b>contextType</b>: RESOURCE</p><p><b>context</b>: Patient</p><p><b>type</b>: Extension</p><p><b>baseDefinition</b>: <a href=\"http://hl7.org/fhir/StructureDefinition/Extension\">http://hl7.org/fhir/StructureDefinition/Extension</a></p><p><b>derivation</b>: CONSTRAINT</p><h3>Snapshots</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table><h3>Differentials</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table></div>"
   },
   "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex",
+  "version": "1.0.0",
   "name": "US Core Birth Sex Extension",
   "title": "US Core Birth Sex Extension",
   "status": "draft",
-  "publisher": "Health Level Seven International (FHIR-Infrastructure)",
+  "date": "2016-08-01",
+  "publisher": "HL7 US Realm Steering Committee",
   "contact": [
     {
       "telecom": [
@@ -20,9 +22,8 @@
       ]
     }
   ],
-  "date": "2016-08-01",
-  "description": "A code classifying the person's sex assigned at birth  as specified by the [Office of the National Coordinator for Health IT (ONC)](https://www.healthit.gov/newsroom/about-onc).",
-  "fhirVersion": "1.8.0",
+  "description": "A code classifying the person's sex assigned at birth  as specified by the [Office of the National Coordinator for Health IT (ONC)](https://www.healthit.gov/newsroom/about-onc). This extension aligns with the C-CDA Birth Sex Observation (LOINC 76689-9).",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "rim",
@@ -47,7 +48,7 @@
         "sliceName": "birthsex",
         "short": "Extension",
         "definition": "A code classifying the person's sex assigned at birth  as specified by the [Office of the National Coordinator for Health IT (ONC)](https://www.healthit.gov/newsroom/about-onc).",
-        "comments": "The codes required are intended to present birth sex (i.e., the sex recorded on the patient’s birth certificate) and not gender identity or reassigned sex.",
+        "comment": "The codes required are intended to present birth sex (i.e., the sex recorded on the patient’s birth certificate) and not gender identity or reassigned sex.",
         "min": 0,
         "max": "1",
         "base": {
@@ -78,10 +79,6 @@
         ],
         "isModifier": false,
         "mapping": [
-          {
-            "identity": "v2",
-            "map": "PID-8"
-          },
           {
             "identity": "rim",
             "map": "player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender"
@@ -124,7 +121,7 @@
         "path": "Extension.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -156,7 +153,7 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
+        "comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -217,15 +214,11 @@
         "path": "Extension",
         "sliceName": "birthsex",
         "definition": "A code classifying the person's sex assigned at birth  as specified by the [Office of the National Coordinator for Health IT (ONC)](https://www.healthit.gov/newsroom/about-onc).",
-        "comments": "The codes required are intended to present birth sex (i.e., the sex recorded on the patient’s birth certificate) and not gender identity or reassigned sex.",
+        "comment": "The codes required are intended to present birth sex (i.e., the sex recorded on the patient’s birth certificate) and not gender identity or reassigned sex.",
         "min": 0,
         "max": "1",
         "isModifier": false,
         "mapping": [
-          {
-            "identity": "v2",
-            "map": "PID-8"
-          },
           {
             "identity": "rim",
             "map": "player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender"
@@ -242,8 +235,10 @@
         "fixedUri": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex"
       },
       {
-        "id": "Extension:birthsex.value[x]",
-        "path": "Extension.value[x]",
+        "id": "Extension:birthsex.valueCode",
+        "path": "Extension.valueCode",
+        "min": 0,
+        "max": "1",
         "type": [
           {
             "code": "code"
@@ -259,4 +254,4 @@
       }
     ]
   }
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/StructureDefinition-us-core-careplan.json b/lib/resources/us_core/StructureDefinition-us-core-careplan.json
index 05ed327..c4bf807 100755
--- a/lib/resources/us_core/StructureDefinition-us-core-careplan.json
+++ b/lib/resources/us_core/StructureDefinition-us-core-careplan.json
@@ -3,12 +3,14 @@
   "id": "us-core-careplan",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-careplan\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-careplan</a></p><p><b>name</b>: US Core CarePlan Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: Health Level Seven International (FHIR-Infrastructure)</p><p><b>contact</b>: </p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-careplan\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-careplan</a></p><p><b>name</b>: US Core CarePlan Profile</p><p><b>status</b>: DRAFT</p><p><b>publisher</b>: Health Level Seven International (FHIR-Infrastructure)</p><p><b>contact</b>: </p><p><b>date</b>: 01/08/2016</p><blockquote><p><b>mapping</b></p><p><b>identity</b>: rim</p><p><b>uri</b>: <a href=\"http://hl7.org/v3\">http://hl7.org/v3</a></p><p><b>name</b>: RIM Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: w5</p><p><b>uri</b>: <a href=\"http://hl7.org/fhir/w5\">http://hl7.org/fhir/w5</a></p><p><b>name</b>: W5 Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: v2</p><p><b>uri</b>: <a href=\"http://hl7.org/v2\">http://hl7.org/v2</a></p><p><b>name</b>: HL7 v2 Mapping</p></blockquote><p><b>kind</b>: RESOURCE</p><p><b>abstract</b>: false</p><p><b>type</b>: CarePlan</p><p><b>baseDefinition</b>: <a href=\"http://hl7.org/fhir/StructureDefinition/CarePlan\">http://hl7.org/fhir/StructureDefinition/CarePlan</a></p><p><b>derivation</b>: CONSTRAINT</p><h3>Snapshots</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table><h3>Differentials</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table></div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-careplan\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-careplan</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: US Core CarePlan Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: HL7 US Realm Steering Committee</p><p><b>contact</b>: </p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-careplan\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-careplan</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: US Core CarePlan Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: HL7 US Realm Steering Committee</p><p><b>contact</b>: </p><p><b>fhirVersion</b>: 3.0.0</p><blockquote><p><b>mapping</b></p><p><b>identity</b>: argonaut-dq-dstu2</p><p><b>uri</b>: <a href=\"http://unknown.org/Argonaut DQ DSTU2\">http://unknown.org/Argonaut DQ DSTU2</a></p><p><b>name</b>: Argonaut DQ DSTU2</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: workflow</p><p><b>uri</b>: <a href=\"http://hl7.org/fhir/workflow\">http://hl7.org/fhir/workflow</a></p><p><b>name</b>: Workflow Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: rim</p><p><b>uri</b>: <a href=\"http://hl7.org/v3\">http://hl7.org/v3</a></p><p><b>name</b>: RIM Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: w5</p><p><b>uri</b>: <a href=\"http://hl7.org/fhir/w5\">http://hl7.org/fhir/w5</a></p><p><b>name</b>: W5 Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: v2</p><p><b>uri</b>: <a href=\"http://hl7.org/v2\">http://hl7.org/v2</a></p><p><b>name</b>: HL7 v2 Mapping</p></blockquote><p><b>kind</b>: RESOURCE</p><p><b>abstract</b>: false</p><p><b>type</b>: CarePlan</p><p><b>baseDefinition</b>: <a href=\"http://hl7.org/fhir/StructureDefinition/CarePlan\">http://hl7.org/fhir/StructureDefinition/CarePlan</a></p><p><b>derivation</b>: CONSTRAINT</p><h3>Snapshots</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table><h3>Differentials</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table></div>"
   },
   "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-careplan",
+  "version": "1.0.0",
   "name": "US Core CarePlan Profile",
   "status": "draft",
-  "publisher": "Health Level Seven International (FHIR-Infrastructure)",
+  "date": "2016-08-01",
+  "publisher": "HL7 US Realm Steering Committee",
   "contact": [
     {
       "telecom": [
@@ -19,8 +21,18 @@
       ]
     }
   ],
-  "date": "2016-08-01",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "argonaut-dq-dstu2",
+      "uri": "http://unknown.org/Argonaut DQ DSTU2",
+      "name": "Argonaut DQ DSTU2"
+    },
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
     {
       "identity": "rim",
       "uri": "http://hl7.org/v3",
@@ -95,12 +107,15 @@
           }
         ],
         "mustSupport": false,
-        "isSummary": false,
         "mapping": [
           {
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Request"
+          },
           {
             "identity": "rim",
             "map": "Act[classCode=PCPR, moodCode=INT]"
@@ -108,6 +123,10 @@
           {
             "identity": "w5",
             "map": "clinical.careprovision"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "CarePlan"
           }
         ]
       },
@@ -116,7 +135,7 @@
         "path": "CarePlan.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -155,7 +174,7 @@
         "path": "CarePlan.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -176,7 +195,7 @@
         "path": "CarePlan.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -196,6 +215,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -210,7 +237,7 @@
         "path": "CarePlan.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -233,11 +260,14 @@
           "dom-1"
         ],
         "mustSupport": true,
-        "isSummary": false,
         "mapping": [
           {
             "identity": "rim",
             "map": "Act.text?"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "CarePlan.text"
           }
         ]
       },
@@ -271,9 +301,19 @@
       {
         "id": "CarePlan:uscorecareplan.text.extension",
         "path": "CarePlan.text.extension",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -315,7 +355,6 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
         "binding": {
           "strength": "required",
           "description": "Constrained value set of narrative statuses.",
@@ -327,6 +366,10 @@
           {
             "identity": "rim",
             "map": "N/A"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "CarePlan.text.status"
           }
         ]
       },
@@ -335,7 +378,7 @@
         "path": "CarePlan.text.div",
         "short": "Limited xhtml content",
         "definition": "The actual narrative content, a stripped down version of XHTML.",
-        "comments": "The contents of the html element are an XHTML fragment containing only the basic html formatting elements described in chapters 7-11 and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained stylesheets. The XHTML content may not contain a head, a body, external stylesheet references, scripts, forms, base/link/xlink, frames, iframes and objects.",
+        "comment": "The contents of the html element are an XHTML fragment containing only the basic html formatting elements described in chapters 7-11 and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained stylesheets. The XHTML content may not contain a head, a body, external stylesheet references, scripts, forms, base/link/xlink, frames, iframes and objects.",
         "min": 1,
         "max": "1",
         "base": {
@@ -376,7 +419,7 @@
         "path": "CarePlan.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -406,7 +449,7 @@
         "path": "CarePlan.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -435,7 +478,7 @@
         "path": "CarePlan.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -480,6 +523,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.identifier"
+          },
           {
             "identity": "v2",
             "map": "PTH-3"
@@ -494,12 +541,124 @@
           }
         ]
       },
+      {
+        "id": "CarePlan:uscorecareplan.definition",
+        "path": "CarePlan.definition",
+        "short": "Protocol or definition",
+        "definition": "Identifies the protocol, questionnaire, guideline or other specification the care plan should be conducted in accordance with.",
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "CarePlan.definition",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/PlanDefinition"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Questionnaire"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.definition"
+          }
+        ]
+      },
+      {
+        "id": "CarePlan:uscorecareplan.basedOn",
+        "path": "CarePlan.basedOn",
+        "short": "Fulfills care plan",
+        "definition": "A care plan that is fulfilled in whole or in part by this care plan.",
+        "requirements": "Allows tracing of the care plan and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "CarePlan.basedOn",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.basedOn"
+          }
+        ]
+      },
+      {
+        "id": "CarePlan:uscorecareplan.replaces",
+        "path": "CarePlan.replaces",
+        "short": "CarePlan replaced by this CarePlan",
+        "definition": "Completed or terminated care plan whose function is taken by this new care plan.",
+        "comment": "The replacement could be because the initial care plan was immediately rejected (due to an issue) or because the previous care plan was completed, but the need for the action described by the care plan remains ongoing.",
+        "requirements": "Allows tracing the continuation of a therapy or administrative process instantiated through multiple care plans.",
+        "alias": [
+          "supersedes"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "CarePlan.replaces",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.replaces"
+          }
+        ]
+      },
+      {
+        "id": "CarePlan:uscorecareplan.partOf",
+        "path": "CarePlan.partOf",
+        "short": "Part of referenced CarePlan",
+        "definition": "A larger care plan of which this particular care plan is a component or step.",
+        "comment": "Each care plan is an independent request, such that having a care plan be part of another care plan can cause issues with cascading statuses.  As such, this element is still being discussed.",
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "CarePlan.partOf",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          }
+        ],
+        "isSummary": true
+      },
       {
         "id": "CarePlan:uscorecareplan.status",
         "path": "CarePlan.status",
-        "short": "proposed | draft | active | suspended | completed | entered-in-error | cancelled | unknown",
+        "short": "draft | active | suspended | completed | entered-in-error | cancelled | unknown",
         "definition": "Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record.",
-        "comments": "The unknown code is not to be used to convey other statuses.  The unknown code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the care plan.",
+        "comment": "The unknown code is not to be used to convey other statuses.  The unknown code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the care plan.\n\nThis element is labeled as a modifier because the status contains the code entered-in-error] that marks the plan as not currently valid.",
         "requirements": "Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record.",
         "min": 1,
         "max": "1",
@@ -515,7 +674,7 @@
         ],
         "mustSupport": true,
         "isModifier": true,
-        "isSummary": false,
+        "isSummary": true,
         "binding": {
           "strength": "required",
           "description": "Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record.",
@@ -524,6 +683,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.status (uses different ValueSet)"
+          },
           {
             "identity": "v2",
             "map": "PTH-5"
@@ -535,154 +698,120 @@
           {
             "identity": "w5",
             "map": "status"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "CarePlan.status"
           }
         ]
       },
       {
-        "id": "CarePlan:uscorecareplan.category",
-        "path": "CarePlan.category",
-        "short": "Type of plan",
-        "definition": "Type of plan.",
-        "comments": "There may be multiple axis of categorization and one plan may serve multiple purposes.  In some cases, this may be redundant with references to CarePlan.concern.",
-        "requirements": "Identifies what \"kind\" of plan this is to support differentiation between multiple co-existing plans; e.g. \"Home health\", \"psychiatric\", \"asthma\", \"disease management\", \"wellness plan\", etc.",
+        "id": "CarePlan:uscorecareplan.intent",
+        "path": "CarePlan.intent",
+        "short": "proposal | plan | order | option",
+        "definition": "Indicates the level of authority/intentionality associated with the care plan and where the care plan fits into the workflow chain.",
+        "comment": "This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.",
+        "requirements": "Proposals/recommendations, plans and orders all use the same structure and can exist in the same fulfillment chain.",
         "min": 1,
         "max": "1",
         "base": {
-          "path": "CarePlan.category",
-          "min": 0,
-          "max": "*"
+          "path": "CarePlan.intent",
+          "min": 1,
+          "max": "1"
         },
         "type": [
           {
-            "code": "CodeableConcept"
+            "code": "code"
           }
         ],
-        "patternCodeableConcept": {
-          "coding": [
-            {
-              "system": "http://hl7.org/fhir/us/core/CodeSystem/careplan-category",
-              "code": "assess-plan"
-            }
-          ]
-        },
         "mustSupport": true,
-        "isSummary": false,
+        "isModifier": true,
+        "isSummary": true,
         "binding": {
-          "strength": "example",
-          "description": "Identifies what \"kind\" of plan this is to support differentiation between multiple co-existing plans; e.g. \"Home health\", \"psychiatric\", \"asthma\", \"disease management\", etc.",
+          "strength": "required",
+          "description": "Codes indicating the degree of authority/intentionality associated with a care plan",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/care-plan-category"
+            "reference": "http://hl7.org/fhir/ValueSet/care-plan-intent"
           }
         },
         "mapping": [
           {
-            "identity": "w5",
-            "map": "class"
-          }
-        ]
-      },
-      {
-        "id": "CarePlan:uscorecareplan.category.id",
-        "path": "CarePlan.category.id",
-        "representation": [
-          "xmlAttr"
-        ],
-        "short": "xml:id (or equivalent in JSON)",
-        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "Element.id",
-          "min": 0,
-          "max": "1"
-        },
-        "type": [
-          {
-            "code": "string"
-          }
-        ],
-        "mapping": [
+            "identity": "workflow",
+            "map": "Request.intent"
+          },
           {
-            "identity": "rim",
-            "map": "n/a"
+            "identity": "argonaut-dq-dstu2",
+            "map": "NA (new element in STU3)"
           }
         ]
       },
       {
-        "id": "CarePlan:uscorecareplan.category.extension",
-        "path": "CarePlan.category.extension",
-        "short": "Additional Content defined by implementations",
-        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
-        "alias": [
-          "extensions",
-          "user content"
-        ],
-        "min": 0,
+        "id": "CarePlan:uscorecareplan.category",
+        "path": "CarePlan.category",
+        "short": "Type of plan",
+        "definition": "Type of plan.",
+        "comment": "There may be multiple axis of categorization and one plan may serve multiple purposes.  In some cases, this may be redundant with references to CarePlan.concern.",
+        "requirements": "Identifies what \"kind\" of plan this is to support differentiation between multiple co-existing plans; e.g. \"Home health\", \"psychiatric\", \"asthma\", \"disease management\", \"wellness plan\", etc.",
+        "min": 1,
         "max": "*",
         "base": {
-          "path": "Element.extension",
+          "path": "CarePlan.category",
           "min": 0,
           "max": "*"
         },
         "type": [
           {
-            "code": "Extension"
+            "code": "CodeableConcept"
           }
         ],
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "n/a"
-          }
-        ]
-      },
-      {
-        "id": "CarePlan:uscorecareplan.category.coding",
-        "path": "CarePlan.category.coding",
-        "short": "Code defined by a terminology system",
-        "definition": "A reference to a code defined by a terminology system.",
-        "comments": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true.",
-        "requirements": "Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings.",
-        "min": 0,
-        "max": "*",
-        "base": {
-          "path": "CodeableConcept.coding",
-          "min": 0,
-          "max": "*"
-        },
-        "type": [
+        "constraint": [
           {
-            "code": "Coding"
+            "key": "us-core-1",
+            "severity": "error",
+            "human": "Must have a category of 'assess-plan' and a code system 'http://hl7.org/fhir/us/core/CodeSystem/careplan-category'",
+            "expression": "where(coding.system='http://hl7.org/fhir/us/core/CodeSystem/careplan-category' and coding.code='assess-plan').exists()",
+            "xpath": "exists(f:coding/code[@value='assess-plan']) and exists(f:coding/system[@value='http://hl7.org/fhir/us/core/CodeSystem/careplan-category'])"
           }
         ],
+        "mustSupport": true,
         "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "CarePlanCategory"
+            }
+          ],
+          "strength": "example",
+          "description": "Identifies what \"kind\" of plan this is to support differentiation between multiple co-existing plans; e.g. \"Home health\", \"psychiatric\", \"asthma\", \"disease management\", etc.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/care-plan-category"
+          }
+        },
         "mapping": [
           {
-            "identity": "v2",
-            "map": "C*E.1-8, C*E.10-22"
+            "identity": "workflow",
+            "map": "Request.supportingInfo"
           },
           {
-            "identity": "rim",
-            "map": "union(., ./translation)"
+            "identity": "w5",
+            "map": "class"
           },
           {
-            "identity": "orim",
-            "map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"
+            "identity": "argonaut-dq-dstu2",
+            "map": "CarePlan.category"
           }
         ]
       },
       {
-        "id": "CarePlan:uscorecareplan.category.text",
-        "path": "CarePlan.category.text",
-        "short": "Plain text representation of the concept",
-        "definition": "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.",
-        "comments": "Very often the text is the same as a displayName of one of the codings.",
-        "requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.",
+        "id": "CarePlan:uscorecareplan.title",
+        "path": "CarePlan.title",
+        "short": "Human-friendly name for the CarePlan",
+        "definition": "Human-friendly name for the CarePlan.",
         "min": 0,
         "max": "1",
         "base": {
-          "path": "CodeableConcept.text",
+          "path": "CarePlan.title",
           "min": 0,
           "max": "1"
         },
@@ -691,21 +820,7 @@
             "code": "string"
           }
         ],
-        "isSummary": true,
-        "mapping": [
-          {
-            "identity": "v2",
-            "map": "C*E.9. But note many systems use C*E.2 for this"
-          },
-          {
-            "identity": "rim",
-            "map": "./originalText[mediaType/code=\"text/plain\"]/data"
-          },
-          {
-            "identity": "orim",
-            "map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"
-          }
-        ]
+        "isSummary": true
       },
       {
         "id": "CarePlan:uscorecareplan.description",
@@ -739,6 +854,9 @@
         "short": "Who care plan is for",
         "definition": "Who care plan is for.",
         "requirements": "Identifies the patient or group whose intended care is described by the plan.",
+        "alias": [
+          "patient"
+        ],
         "min": 1,
         "max": "1",
         "base": {
@@ -753,8 +871,12 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -766,6 +888,10 @@
           {
             "identity": "w5",
             "map": "who.focus"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "CarePlan.subject"
           }
         ]
       },
@@ -774,7 +900,10 @@
         "path": "CarePlan.context",
         "short": "Created in context of",
         "definition": "Identifies the original context in which this particular CarePlan was created.",
-        "comments": "Activities conducted as a result of the care plan may well occur as part of other encounters/episodes.",
+        "comment": "Activities conducted as a result of the care plan may well occur as part of other encounters/episodes.",
+        "alias": [
+          "encounter"
+        ],
         "min": 0,
         "max": "1",
         "base": {
@@ -794,6 +923,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.context"
+          },
           {
             "identity": "v2",
             "map": "Associated PV1"
@@ -813,8 +946,11 @@
         "path": "CarePlan.period",
         "short": "Time period plan covers",
         "definition": "Indicates when the plan did (or is intended to) come into effect and end.",
-        "comments": "Any activities scheduled as part of the plan should be constrained to the specified period regardless of whether the activities are planned within a single encounter/episode or across multiple encounters/episodes (e.g. the longitudinal management of a chronic condition).",
+        "comment": "Any activities scheduled as part of the plan should be constrained to the specified period regardless of whether the activities are planned within a single encounter/episode or across multiple encounters/episodes (e.g. the longitudinal management of a chronic condition).",
         "requirements": "Allows tracking what plan(s) are in effect at a particular time.",
+        "alias": [
+          "timing"
+        ],
         "min": 0,
         "max": "1",
         "base": {
@@ -829,6 +965,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.occurrencePeriod"
+          },
           {
             "identity": "v2",
             "map": "GOL-7 / GOL-8"
@@ -843,46 +983,12 @@
           }
         ]
       },
-      {
-        "id": "CarePlan:uscorecareplan.modified",
-        "path": "CarePlan.modified",
-        "short": "When last updated",
-        "definition": "Identifies the most recent date on which the plan has been revised.",
-        "requirements": "Indicates how current the plan is.",
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "CarePlan.modified",
-          "min": 0,
-          "max": "1"
-        },
-        "type": [
-          {
-            "code": "dateTime"
-          }
-        ],
-        "isSummary": true,
-        "mapping": [
-          {
-            "identity": "v2",
-            "map": "PTH-6"
-          },
-          {
-            "identity": "rim",
-            "map": ".participation[typeCode=AUT].time"
-          },
-          {
-            "identity": "w5",
-            "map": "when.recorded"
-          }
-        ]
-      },
       {
         "id": "CarePlan:uscorecareplan.author",
         "path": "CarePlan.author",
         "short": "Who is responsible for contents of the plan",
         "definition": "Identifies the individual(s) or ogranization who is responsible for the content of the care plan.",
-        "comments": "Collaborative care plans may have multiple authors.",
+        "comment": "Collaborative care plans may have multiple authors.",
         "min": 0,
         "max": "*",
         "base": {
@@ -906,280 +1012,117 @@
           {
             "code": "Reference",
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
-          }
-        ],
-        "isSummary": true,
-        "mapping": [
-          {
-            "identity": "w5",
-            "map": "who.source"
-          }
-        ]
-      },
-      {
-        "id": "CarePlan:uscorecareplan.careTeam",
-        "path": "CarePlan.careTeam",
-        "short": "Who's involved in plan?",
-        "definition": "Identifies all people and organizations who are expected to be involved in the care envisioned by this plan.",
-        "requirements": "Allows representation of care teams, helps scope care plan.  In some cases may be a determiner of access permissions.",
-        "min": 0,
-        "max": "*",
-        "base": {
-          "path": "CarePlan.careTeam",
-          "min": 0,
-          "max": "*"
-        },
-        "type": [
+          },
           {
             "code": "Reference",
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/CareTeam"
           }
         ],
-        "mapping": [
-          {
-            "identity": "w5",
-            "map": "who.actor"
-          }
-        ]
-      },
-      {
-        "id": "CarePlan:uscorecareplan.addresses",
-        "path": "CarePlan.addresses",
-        "short": "Health issues this plan addresses",
-        "definition": "Identifies the conditions/problems/concerns/diagnoses/etc. whose management and/or mitigation are handled by this plan.",
-        "requirements": "Links plan to the conditions it manages.  The element can identify risks addressed by the plan as well as active conditions.  (The Condition resource can include things like \"at risk for hypertension\" or \"fall risk\".)  Also scopes plans - multiple plans may exist addressing different concerns.",
-        "min": 0,
-        "max": "*",
-        "base": {
-          "path": "CarePlan.addresses",
-          "min": 0,
-          "max": "*"
-        },
-        "type": [
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Condition"
-          }
-        ],
         "isSummary": true,
         "mapping": [
           {
-            "identity": "v2",
-            "map": "PRB-4"
-          },
-          {
-            "identity": "rim",
-            "map": ".actRelationship[typeCode=SUBJ].target[classCode=CONC, moodCode=EVN]"
+            "identity": "workflow",
+            "map": "Request.requester.agent (if only one author)"
           },
           {
             "identity": "w5",
-            "map": "why"
-          }
-        ]
-      },
-      {
-        "id": "CarePlan:uscorecareplan.support",
-        "path": "CarePlan.support",
-        "short": "Information considered as part of plan",
-        "definition": "Identifies portions of the patient's record that specifically influenced the formation of the plan.  These might include co-morbidities, recent procedures, limitations, recent assessments, etc.",
-        "comments": "Use \"concern\" to identify specific conditions addressed by the care plan.",
-        "requirements": "Identifies barriers and other considerations associated with the care plan.",
-        "min": 0,
-        "max": "*",
-        "base": {
-          "path": "CarePlan.support",
-          "min": 0,
-          "max": "*"
-        },
-        "type": [
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Resource"
-          }
-        ]
-      },
-      {
-        "id": "CarePlan:uscorecareplan.definition",
-        "path": "CarePlan.definition",
-        "short": "Protocol or definition",
-        "definition": "Identifies the protocol, questionnaire, guideline or other specification the care plan should be conducted in accordance with.",
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "CarePlan.definition",
-          "min": 0,
-          "max": "1"
-        },
-        "type": [
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/PlanDefinition"
-          },
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Questionnaire"
-          }
-        ]
-      },
-      {
-        "id": "CarePlan:uscorecareplan.relatedPlan",
-        "path": "CarePlan.relatedPlan",
-        "short": "Plans related to this one",
-        "definition": "Identifies CarePlans with some sort of formal relationship to the current plan.",
-        "comments": "Relationships are uni-directional with the \"newer\" plan pointing to the older one.",
-        "min": 0,
-        "max": "*",
-        "base": {
-          "path": "CarePlan.relatedPlan",
-          "min": 0,
-          "max": "*"
-        },
-        "type": [
-          {
-            "code": "BackboneElement"
-          }
-        ],
-        "constraint": [
-          {
-            "key": "ele-1",
-            "severity": "error",
-            "human": "All FHIR elements must have a @value or children",
-            "expression": "children().count() > id.count()",
-            "xpath": "@value|f:*|h:div",
-            "source": "Element"
-          }
-        ]
-      },
-      {
-        "id": "CarePlan:uscorecareplan.relatedPlan.id",
-        "path": "CarePlan.relatedPlan.id",
-        "representation": [
-          "xmlAttr"
-        ],
-        "short": "xml:id (or equivalent in JSON)",
-        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "Element.id",
-          "min": 0,
-          "max": "1"
-        },
-        "type": [
-          {
-            "code": "string"
-          }
-        ],
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "n/a"
+            "map": "who.source"
           }
         ]
       },
       {
-        "id": "CarePlan:uscorecareplan.relatedPlan.extension",
-        "path": "CarePlan.relatedPlan.extension",
-        "short": "Additional Content defined by implementations",
-        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
-        "alias": [
-          "extensions",
-          "user content"
-        ],
+        "id": "CarePlan:uscorecareplan.careTeam",
+        "path": "CarePlan.careTeam",
+        "short": "Who's involved in plan?",
+        "definition": "Identifies all people and organizations who are expected to be involved in the care envisioned by this plan.",
+        "requirements": "Allows representation of care teams, helps scope care plan.  In some cases may be a determiner of access permissions.",
         "min": 0,
         "max": "*",
         "base": {
-          "path": "Element.extension",
+          "path": "CarePlan.careTeam",
           "min": 0,
           "max": "*"
         },
         "type": [
           {
-            "code": "Extension"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CareTeam"
           }
         ],
         "mapping": [
           {
-            "identity": "rim",
-            "map": "n/a"
+            "identity": "workflow",
+            "map": "Request.performer (similar but does not entail CareTeam)"
+          },
+          {
+            "identity": "w5",
+            "map": "who.actor"
           }
         ]
       },
       {
-        "id": "CarePlan:uscorecareplan.relatedPlan.modifierExtension",
-        "path": "CarePlan.relatedPlan.modifierExtension",
-        "short": "Extensions that cannot be ignored",
-        "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
-        "alias": [
-          "extensions",
-          "user content",
-          "modifiers"
-        ],
+        "id": "CarePlan:uscorecareplan.addresses",
+        "path": "CarePlan.addresses",
+        "short": "Health issues this plan addresses",
+        "definition": "Identifies the conditions/problems/concerns/diagnoses/etc. whose management and/or mitigation are handled by this plan.",
+        "requirements": "Links plan to the conditions it manages.  The element can identify risks addressed by the plan as well as active conditions.  (The Condition resource can include things like \"at risk for hypertension\" or \"fall risk\".)  Also scopes plans - multiple plans may exist addressing different concerns.",
         "min": 0,
         "max": "*",
         "base": {
-          "path": "BackboneElement.modifierExtension",
+          "path": "CarePlan.addresses",
           "min": 0,
           "max": "*"
         },
         "type": [
           {
-            "code": "Extension"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Condition"
           }
         ],
-        "isModifier": true,
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.reasonReference"
+          },
+          {
+            "identity": "v2",
+            "map": "PRB-4"
+          },
           {
             "identity": "rim",
-            "map": "N/A"
+            "map": ".actRelationship[typeCode=SUBJ].target[classCode=CONC, moodCode=EVN]"
+          },
+          {
+            "identity": "w5",
+            "map": "why"
           }
         ]
       },
       {
-        "id": "CarePlan:uscorecareplan.relatedPlan.code",
-        "path": "CarePlan.relatedPlan.code",
-        "short": "includes | replaces | fulfills",
-        "definition": "Identifies the type of relationship this plan has to the target plan.",
-        "comments": "Read the relationship as \"this plan\" [relatedPlan.code] \"relatedPlan.plan\"; e.g. This plan includes Plan B.  Additional relationship types can be proposed for future releases or handled as extensions.",
+        "id": "CarePlan:uscorecareplan.supportingInfo",
+        "path": "CarePlan.supportingInfo",
+        "short": "Information considered as part of plan",
+        "definition": "Identifies portions of the patient's record that specifically influenced the formation of the plan.  These might include co-morbidities, recent procedures, limitations, recent assessments, etc.",
+        "comment": "Use \"concern\" to identify specific conditions addressed by the care plan.",
+        "requirements": "Identifies barriers and other considerations associated with the care plan.",
         "min": 0,
-        "max": "1",
+        "max": "*",
         "base": {
-          "path": "CarePlan.relatedPlan.code",
+          "path": "CarePlan.supportingInfo",
           "min": 0,
-          "max": "1"
+          "max": "*"
         },
         "type": [
           {
-            "code": "code"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Resource"
           }
         ],
-        "binding": {
-          "strength": "required",
-          "description": "Codes identifying the types of relationships between two plans.",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/care-plan-relationship"
-          }
-        }
-      },
-      {
-        "id": "CarePlan:uscorecareplan.relatedPlan.plan",
-        "path": "CarePlan.relatedPlan.plan",
-        "short": "Plan relationship exists with",
-        "definition": "A reference to the plan to which a relationship is asserted.",
-        "min": 1,
-        "max": "1",
-        "base": {
-          "path": "CarePlan.relatedPlan.plan",
-          "min": 1,
-          "max": "1"
-        },
-        "type": [
+        "mapping": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+            "identity": "workflow",
+            "map": "Request.supportingInfo"
           }
         ]
       },
@@ -1188,7 +1131,7 @@
         "path": "CarePlan.goal",
         "short": "Desired outcome of plan",
         "definition": "Describes the intended objective(s) of carrying out the care plan.",
-        "comments": "Goal can be achieving a particular change or merely maintaining a current state or even slowing a decline.",
+        "comment": "Goal can be achieving a particular change or merely maintaining a current state or even slowing a decline.",
         "requirements": "Provides context for plan.  Allows plan effectiveness to be evaluated by clinicians.",
         "min": 0,
         "max": "*",
@@ -1242,7 +1185,7 @@
             "source": "Element"
           },
           {
-            "key": "ctm-3",
+            "key": "cpl-3",
             "severity": "error",
             "human": "Provide a reference or detail, not both",
             "expression": "detail.empty() or reference.empty()",
@@ -1250,6 +1193,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "no mapping\nNOTE: This is a list of contained Request-Event tuples!"
+          },
           {
             "identity": "rim",
             "map": ".outboundRelationship[typeCode=COMP].target"
@@ -1288,7 +1235,7 @@
         "path": "CarePlan.activity.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1317,7 +1264,7 @@
         "path": "CarePlan.activity.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1345,59 +1292,74 @@
         ]
       },
       {
-        "id": "CarePlan:uscorecareplan.activity.actionResulting",
-        "path": "CarePlan.activity.actionResulting",
-        "short": "Appointments, orders, etc.",
-        "definition": "Resources that describe follow-on actions resulting from the plan, such as drug prescriptions, encounter records, appointments, etc.",
-        "requirements": "Links plan to resulting actions.",
+        "id": "CarePlan:uscorecareplan.activity.outcomeCodeableConcept",
+        "path": "CarePlan.activity.outcomeCodeableConcept",
+        "short": "Results of the activity",
+        "definition": "Identifies the outcome at the point when the status of the activity is assessed.  For example, the outcome of an education activity could be patient understands (or not).",
+        "comment": "Note that this should not duplicate the activity status (e.g. completed or in progress).",
         "min": 0,
         "max": "*",
         "base": {
-          "path": "CarePlan.activity.actionResulting",
+          "path": "CarePlan.activity.outcomeCodeableConcept",
           "min": 0,
           "max": "*"
         },
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Resource"
+            "code": "CodeableConcept"
           }
         ],
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": ".inboundRelationship[typeCode=FLFS].source"
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "CarePlanActivityOutcome"
+            }
+          ],
+          "strength": "example",
+          "description": "Identifies the results of the activity",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/care-plan-activity-outcome"
           }
-        ]
+        }
       },
       {
-        "id": "CarePlan:uscorecareplan.activity.outcome",
-        "path": "CarePlan.activity.outcome",
-        "short": "Results of the activity",
-        "definition": "Results of the careplan activity.",
+        "id": "CarePlan:uscorecareplan.activity.outcomeReference",
+        "path": "CarePlan.activity.outcomeReference",
+        "short": "Appointment, Encounter, Procedure, etc.",
+        "definition": "Details of the outcome or action resulting from the activity.  The reference to an \"event\" resource, such as Procedure or Encounter or Observation, is the result/outcome of the activity itself.  The activity can be conveyed using CarePlan.activity.detail OR using the CarePlan.activity.reference (a reference to a “request” resource).",
+        "comment": "The activity outcome is independent of the outcome of the related goal(s).  For example, if the goal is to achieve a target body weight of 150 lb and an activity is defined to diet, then the activity outcome could be calories consumed whereas the goal outcome is an observation for the actual body weight measured.",
+        "requirements": "Links plan to resulting actions.",
         "min": 0,
-        "max": "1",
+        "max": "*",
         "base": {
-          "path": "CarePlan.activity.outcome",
+          "path": "CarePlan.activity.outcomeReference",
           "min": 0,
-          "max": "1"
+          "max": "*"
         },
         "type": [
           {
-            "code": "CodeableConcept"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Resource"
           }
         ],
-        "binding": {
-          "strength": "example",
-          "description": "Identifies the results of the activity"
-        }
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event that is outcome of Request in activity.reference"
+          },
+          {
+            "identity": "rim",
+            "map": ".inboundRelationship[typeCode=FLFS].source"
+          }
+        ]
       },
       {
         "id": "CarePlan:uscorecareplan.activity.progress",
         "path": "CarePlan.activity.progress",
         "short": "Comments about the activity status/progress",
         "definition": "Notes about the adherence/status/progress of the activity.",
-        "comments": "This element should NOT be used to describe the activity to be performed - that occurs either within the resource pointed to by activity.detail.reference or in activity.detail.description.",
+        "comment": "This element should NOT be used to describe the activity to be performed - that occurs either within the resource pointed to by activity.detail.reference or in activity.detail.description.",
         "requirements": "Can be used to capture information about adherence, progress, concerns, etc.",
         "min": 0,
         "max": "*",
@@ -1412,6 +1374,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status (Annotation instead of CodableConcept)"
+          },
           {
             "identity": "v2",
             "map": "NTE?"
@@ -1427,7 +1393,7 @@
         "path": "CarePlan.activity.reference",
         "short": "Activity details defined in specific resource",
         "definition": "The details of the proposed activity represented in a specific resource.",
-        "comments": "Standard extension exists ([goal-pertainstogoal](extension-goal-pertainstogoal.html)) that allows goals to be referenced from any of the referenced resources in CarePlan.activity.reference.   The goal should be visible when the resource referenced by CarePlan.activity.reference is viewed indepedently from the CarePlan.  Requests that are pointed to by a CarePlan using this element should *not* point to this CarePlan using the \"basedOn\" element.  i.e. Requests that are part of a CarePlan are not \"based on\" the CarePlan.",
+        "comment": "Standard extension exists ([goal-pertainstogoal](extension-goal-pertainstogoal.html)) that allows goals to be referenced from any of the referenced resources in CarePlan.activity.reference.  \rThe goal should be visible when the resource referenced by CarePlan.activity.reference is viewed indepedently from the CarePlan.  Requests that are pointed to by a CarePlan using this element should *not* point to this CarePlan using the \"basedOn\" element.  i.e. Requests that are part of a CarePlan are not \"based on\" the CarePlan.",
         "requirements": "Details in a form consistent with other applications and contexts of use.",
         "min": 0,
         "max": "1",
@@ -1447,19 +1413,19 @@
           },
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceUseRequest"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
           },
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DiagnosticRequest"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
           },
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
           },
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionRequest"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Task"
           },
           {
             "code": "Reference",
@@ -1467,21 +1433,25 @@
           },
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcessRequest"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
           },
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/VisionPrescription"
           },
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/VisionPrescription"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/RequestGroup"
           }
         ],
         "condition": [
-          "ctm-3"
+          "cpl-3"
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request that resulted in Event in activity.actionResulting"
+          },
           {
             "identity": "rim",
             "map": ".outboundRelationship[typeCode=COMP].target"
@@ -1507,7 +1477,7 @@
           }
         ],
         "condition": [
-          "ctm-3"
+          "cpl-3"
         ],
         "constraint": [
           {
@@ -1558,7 +1528,7 @@
         "path": "CarePlan.activity.detail.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1587,7 +1557,7 @@
         "path": "CarePlan.activity.detail.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1633,6 +1603,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "CarePlanActivityCategory"
+            }
+          ],
           "strength": "example",
           "description": "High-level categorization of the type of activity in a care plan.",
           "valueSetReference": {
@@ -1640,6 +1616,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.supportingInformation"
+          },
           {
             "identity": "rim",
             "map": ".inboundRelationship[typeCode=COMP].source[classCode=LIST].code"
@@ -1664,10 +1644,20 @@
             "code": "Reference",
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/PlanDefinition"
           },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ActivityDefinition"
+          },
           {
             "code": "Reference",
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/Questionnaire"
           }
+        ],
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.definition"
+          }
         ]
       },
       {
@@ -1675,7 +1665,7 @@
         "path": "CarePlan.activity.detail.code",
         "short": "Detail type of activity",
         "definition": "Detailed description of the type of planned activity; e.g. What lab test, what procedure, what kind of encounter.",
-        "comments": "Tends to be less relevant for activities involving particular products.  Codes should not convey negation - use \"prohibited\" instead.",
+        "comment": "Tends to be less relevant for activities involving particular products.  Codes should not convey negation - use \"prohibited\" instead.",
         "requirements": "Allows matching performed to planned as well as validation against protocols.",
         "min": 0,
         "max": "1",
@@ -1690,6 +1680,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "CarePlanActivityType"
+            }
+          ],
           "strength": "example",
           "description": "Detailed description of the type of activity; e.g. What lab test, what procedure, what kind of encounter.",
           "valueSetReference": {
@@ -1697,6 +1693,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.code"
+          },
           {
             "identity": "v2",
             "map": "OBR-4 / RXE-2 / RXO-1  / RXD-2"
@@ -1712,7 +1712,7 @@
         "path": "CarePlan.activity.detail.reasonCode",
         "short": "Why activity should be done or why activity was prohibited",
         "definition": "Provides the rationale that drove the inclusion of this particular activity as part of the plan or the reason why the activity was prohibited.",
-        "comments": "This could be a diagnosis code.  If a full condition record exists or additional detail is needed, use reasonCondition instead.",
+        "comment": "This could be a diagnosis code.  If a full condition record exists or additional detail is needed, use reasonCondition instead.",
         "min": 0,
         "max": "*",
         "base": {
@@ -1726,19 +1726,31 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "CarePlanActivityReason"
+            }
+          ],
           "strength": "example",
           "description": "Identifies why a care plan activity is needed.  Can include any health condition codes as well as such concepts as \"general wellness\", prophylaxis, surgical preparation, etc.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/activity-reason"
           }
-        }
+        },
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.reasonCode"
+          }
+        ]
       },
       {
         "id": "CarePlan:uscorecareplan.activity.detail.reasonReference",
         "path": "CarePlan.activity.detail.reasonReference",
         "short": "Condition triggering need for activity",
         "definition": "Provides the health condition(s) that drove the inclusion of this particular activity as part of the plan.",
-        "comments": "Conditions can be identified at the activity level that are not identified as reasons for the overall plan.",
+        "comment": "Conditions can be identified at the activity level that are not identified as reasons for the overall plan.",
         "min": 0,
         "max": "*",
         "base": {
@@ -1751,6 +1763,12 @@
             "code": "Reference",
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/Condition"
           }
+        ],
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.reasonReference"
+          }
         ]
       },
       {
@@ -1773,6 +1791,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.goal"
+          },
           {
             "identity": "rim",
             "map": ".outboundRelationship[typeCode<=OBJ]."
@@ -1784,7 +1806,7 @@
         "path": "CarePlan.activity.detail.status",
         "short": "not-started | scheduled | in-progress | on-hold | completed | cancelled | unknown",
         "definition": "Identifies what progress is being made for the specific activity.",
-        "comments": "Some aspects of status can be inferred based on the resources linked in actionTaken.  Note that \"status\" is only as current as the plan was most recently updated.   The unknown code is not to be used to convey other statuses.  The unknown code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the activity.",
+        "comment": "Some aspects of status can be inferred based on the resources linked in actionTaken.  Note that \"status\" is only as current as the plan was most recently updated.  \nThe unknown code is not to be used to convey other statuses.  The unknown code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the activity.",
         "requirements": "Indicates progress against the plan, whether the activity is still relevant for the plan.",
         "min": 1,
         "max": "1",
@@ -1800,6 +1822,12 @@
         ],
         "isModifier": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "CarePlanActivityStatus"
+            }
+          ],
           "strength": "required",
           "description": "Indicates where the activity is at in its overall life cycle.",
           "valueSetReference": {
@@ -1807,6 +1835,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.status (uses different ValueSet)"
+          },
           {
             "identity": "v2",
             "map": "ORC-5?"
@@ -1822,7 +1854,7 @@
         "path": "CarePlan.activity.detail.statusReason",
         "short": "Reason for current status",
         "definition": "Provides reason why the activity isn't yet started, is on hold, was cancelled, etc.",
-        "comments": "Will generally not be present if status is \"complete\".  Be sure to prompt to update this (or at least remove the existing value) if the status is changed.",
+        "comment": "Will generally not be present if status is \"complete\".  Be sure to prompt to update this (or at least remove the existing value) if the status is changed.",
         "min": 0,
         "max": "1",
         "base": {
@@ -1832,22 +1864,16 @@
         },
         "type": [
           {
-            "code": "CodeableConcept"
-          }
-        ],
-        "binding": {
-          "strength": "example",
-          "description": "Describes why the current activity has the status it does; e.g. \"Recovering from injury\" as a reason for non-started or on-hold, \"Patient does not enjoy activity\" as a reason for cancelling a planned activity.",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/goal-status-reason"
+            "code": "string"
           }
-        }
+        ]
       },
       {
         "id": "CarePlan:uscorecareplan.activity.detail.prohibited",
         "path": "CarePlan.activity.detail.prohibited",
         "short": "Do NOT do",
         "definition": "If true, indicates that the described activity is one that must NOT be engaged in when following the plan.  If false, indicates that the described activity is one that should be engaged in when following the plan.",
+        "comment": "This element is labeled as a modifier because it marks an activity as an activity that is not to be performed.",
         "requirements": "Captures intention to not do something that may have been previously typical.",
         "min": 0,
         "max": "1",
@@ -1895,6 +1921,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.occurrence"
+          },
           {
             "identity": "v2",
             "map": "TQ1"
@@ -1910,7 +1940,7 @@
         "path": "CarePlan.activity.detail.location",
         "short": "Where it should happen",
         "definition": "Identifies the facility where the activity will occur; e.g. home, hospital, specific clinic, etc.",
-        "comments": "May reference a specific clinical location or may identify a type of location.",
+        "comment": "May reference a specific clinical location or may identify a type of location.",
         "requirements": "Helps in planning of activity.",
         "min": 0,
         "max": "1",
@@ -1941,7 +1971,7 @@
         "path": "CarePlan.activity.detail.performer",
         "short": "Who will be responsible?",
         "definition": "Identifies who's expected to be involved in the activity.",
-        "comments": "A performer MAY also be a participant in the care plan.",
+        "comment": "A performer MAY also be a participant in the care plan.",
         "requirements": "Helps in planning of activity.",
         "min": 0,
         "max": "*",
@@ -1966,9 +1996,17 @@
           {
             "code": "Reference",
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CareTeam"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.performer"
+          },
           {
             "identity": "v2",
             "map": "PRT-5 : ( PRV-4 e {provider participations} ) / PRT-5 : ( PRV-4 e {non-provider person participations} ) / PRT-5 : ( PRV-4 = (patient non-subject of care) ) / PRT-8"
@@ -2005,6 +2043,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "CarePlanProduct"
+            }
+          ],
           "strength": "example",
           "description": "A product supplied or administered as part of a care plan activity.",
           "valueSetReference": {
@@ -2102,6 +2146,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.note"
+          },
           {
             "identity": "v2",
             "map": "NTE?"
@@ -2119,11 +2167,11 @@
         "definition": "General notes about the care plan not covered elsewhere.",
         "requirements": "Used to capture information that applies to the plan as a whole that doesn't fit into discrete elements.",
         "min": 0,
-        "max": "1",
+        "max": "*",
         "base": {
           "path": "CarePlan.note",
           "min": 0,
-          "max": "1"
+          "max": "*"
         },
         "type": [
           {
@@ -2131,6 +2179,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.note"
+          },
           {
             "identity": "v2",
             "map": "NTE?"
@@ -2153,7 +2205,12 @@
         "definition": "The US Core CarePlan Profile is based upon the core FHIR CarePlan Resource and created to meet the 2015 Edition Common Clinical Data Set 'Assessment and Plan of Treatment requirements.",
         "mustSupport": false,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "CarePlan"
+          }
+        ]
       },
       {
         "id": "CarePlan:uscorecareplan.text",
@@ -2167,7 +2224,12 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "CarePlan.text"
+          }
+        ]
       },
       {
         "id": "CarePlan:uscorecareplan.text.status",
@@ -2180,14 +2242,19 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false,
         "binding": {
           "strength": "required",
           "description": "Constrained value set of narrative statuses.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/us/core/ValueSet/us-core-narrative-status"
           }
-        }
+        },
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "CarePlan.text.status"
+          }
+        ]
       },
       {
         "id": "CarePlan:uscorecareplan.status",
@@ -2202,66 +2269,75 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false,
         "binding": {
           "strength": "required",
           "description": "Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/care-plan-status"
           }
-        }
+        },
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "CarePlan.status"
+          }
+        ]
       },
       {
-        "id": "CarePlan:uscorecareplan.category",
-        "path": "CarePlan.category",
-        "definition": "Type of plan.",
-        "requirements": "Identifies what \"kind\" of plan this is to support differentiation between multiple co-existing plans; e.g. \"Home health\", \"psychiatric\", \"asthma\", \"disease management\", \"wellness plan\", etc.",
+        "id": "CarePlan:uscorecareplan.intent",
+        "path": "CarePlan.intent",
         "min": 1,
         "max": "1",
         "type": [
           {
-            "code": "CodeableConcept"
+            "code": "code"
           }
         ],
-        "patternCodeableConcept": {
-          "coding": [
-            {
-              "system": "http://hl7.org/fhir/us/core/CodeSystem/careplan-category",
-              "code": "assess-plan"
-            }
-          ]
-        },
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false
+        "binding": {
+          "strength": "required",
+          "description": "Codes indicating the degree of authority/intentionality associated with a care plan",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/care-plan-intent"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "NA (new element in STU3)"
+          }
+        ]
       },
       {
-        "id": "CarePlan:uscorecareplan.category.system",
-        "path": "CarePlan.category.coding.system",
+        "id": "CarePlan:uscorecareplan.category",
+        "path": "CarePlan.category",
+        "definition": "Type of plan.",
+        "requirements": "Identifies what \"kind\" of plan this is to support differentiation between multiple co-existing plans; e.g. \"Home health\", \"psychiatric\", \"asthma\", \"disease management\", \"wellness plan\", etc.",
         "min": 1,
-        "max": "1",
+        "max": "*",
         "type": [
           {
-            "code": "uri"
+            "code": "CodeableConcept"
           }
         ],
-        "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false
-      },
-      {
-        "id": "CarePlan:uscorecareplan.category.system.code",
-        "path": "CarePlan.category.coding.code",
-        "min": 1,
-        "max": "1",
-        "type": [
+        "constraint": [
           {
-            "code": "code"
+            "key": "us-core-1",
+            "severity": "error",
+            "human": "Must have a category of 'assess-plan' and a code system 'http://hl7.org/fhir/us/core/CodeSystem/careplan-category'",
+            "expression": "where(coding.system='http://hl7.org/fhir/us/core/CodeSystem/careplan-category' and coding.code='assess-plan').exists()",
+            "xpath": "exists(f:coding/code[@value='assess-plan']) and exists(f:coding/system[@value='http://hl7.org/fhir/us/core/CodeSystem/careplan-category'])"
           }
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "CarePlan.category"
+          }
+        ]
       },
       {
         "id": "CarePlan:uscorecareplan.subject",
@@ -2278,8 +2354,13 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "CarePlan.subject"
+          }
+        ]
       }
     ]
   }
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/StructureDefinition-us-core-careteam.json b/lib/resources/us_core/StructureDefinition-us-core-careteam.json
index 85b6c2a..04899e2 100755
--- a/lib/resources/us_core/StructureDefinition-us-core-careteam.json
+++ b/lib/resources/us_core/StructureDefinition-us-core-careteam.json
@@ -3,12 +3,14 @@
   "id": "us-core-careteam",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-careteam\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-careteam</a></p><p><b>name</b>: US Core CareTeam Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: Health Level Seven International (FHIR-Infrastructure)</p><p><b>contact</b>: </p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-careteam\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-careteam</a></p><p><b>name</b>: US Core CareTeam Profile</p><p><b>status</b>: DRAFT</p><p><b>publisher</b>: Health Level Seven International (FHIR-Infrastructure)</p><p><b>contact</b>: </p><p><b>date</b>: 01/08/2016</p><blockquote><p><b>mapping</b></p><p><b>identity</b>: w5</p><p><b>uri</b>: <a href=\"http://hl7.org/fhir/w5\">http://hl7.org/fhir/w5</a></p><p><b>name</b>: W5 Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: v2</p><p><b>uri</b>: <a href=\"http://hl7.org/v2\">http://hl7.org/v2</a></p><p><b>name</b>: HL7 v2 Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: rim</p><p><b>uri</b>: <a href=\"http://hl7.org/v3\">http://hl7.org/v3</a></p><p><b>name</b>: RIM Mapping</p></blockquote><p><b>kind</b>: RESOURCE</p><p><b>abstract</b>: false</p><p><b>type</b>: CareTeam</p><p><b>baseDefinition</b>: <a href=\"http://hl7.org/fhir/StructureDefinition/CareTeam\">http://hl7.org/fhir/StructureDefinition/CareTeam</a></p><p><b>derivation</b>: CONSTRAINT</p><h3>Snapshots</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table><h3>Differentials</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table></div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-careteam\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-careteam</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: US  Core CareTeam Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: HL7 US Realm Steering Committee</p><p><b>contact</b>: </p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-careteam\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-careteam</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: US  Core CareTeam Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: HL7 US Realm Steering Committee</p><p><b>contact</b>: </p><p><b>fhirVersion</b>: 3.0.0</p><blockquote><p><b>mapping</b></p><p><b>identity</b>: argonaut-dq-dstu2</p><p><b>uri</b>: <a href=\"http://unknown.org/Argonaut DQ DSTU2\">http://unknown.org/Argonaut DQ DSTU2</a></p><p><b>name</b>: Argonaut DQ DSTU2</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: w5</p><p><b>uri</b>: <a href=\"http://hl7.org/fhir/w5\">http://hl7.org/fhir/w5</a></p><p><b>name</b>: W5 Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: v2</p><p><b>uri</b>: <a href=\"http://hl7.org/v2\">http://hl7.org/v2</a></p><p><b>name</b>: HL7 v2 Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: rim</p><p><b>uri</b>: <a href=\"http://hl7.org/v3\">http://hl7.org/v3</a></p><p><b>name</b>: RIM Mapping</p></blockquote><p><b>kind</b>: RESOURCE</p><p><b>abstract</b>: false</p><p><b>type</b>: CareTeam</p><p><b>baseDefinition</b>: <a href=\"http://hl7.org/fhir/StructureDefinition/CareTeam\">http://hl7.org/fhir/StructureDefinition/CareTeam</a></p><p><b>derivation</b>: CONSTRAINT</p><h3>Snapshots</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table><h3>Differentials</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table></div>"
   },
   "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-careteam",
-  "name": "US Core CareTeam Profile",
+  "version": "1.0.0",
+  "name": "US  Core CareTeam Profile",
   "status": "draft",
-  "publisher": "Health Level Seven International (FHIR-Infrastructure)",
+  "date": "2016-08-01",
+  "publisher": "HL7 US Realm Steering Committee",
   "contact": [
     {
       "telecom": [
@@ -19,8 +21,13 @@
       ]
     }
   ],
-  "date": "2016-08-01",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "argonaut-dq-dstu2",
+      "uri": "http://unknown.org/Argonaut DQ DSTU2",
+      "name": "Argonaut DQ DSTU2"
+    },
     {
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
@@ -92,7 +99,6 @@
           }
         ],
         "mustSupport": false,
-        "isSummary": false,
         "mapping": [
           {
             "identity": "rim",
@@ -101,6 +107,10 @@
           {
             "identity": "w5",
             "map": "clinical.careprovision"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "CarePlan"
           }
         ]
       },
@@ -109,7 +119,7 @@
         "path": "CareTeam.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -148,7 +158,7 @@
         "path": "CareTeam.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -169,7 +179,7 @@
         "path": "CareTeam.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -189,6 +199,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -203,7 +221,7 @@
         "path": "CareTeam.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -237,7 +255,7 @@
         "path": "CareTeam.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -267,7 +285,7 @@
         "path": "CareTeam.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -296,7 +314,7 @@
         "path": "CareTeam.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -349,8 +367,9 @@
       {
         "id": "CareTeam:uscorecareteam.status",
         "path": "CareTeam.status",
-        "short": "active | suspended | inactive | entered in error",
-        "definition": "Indicates whether the care team is currently active, suspended, inactive, or entered in error.",
+        "short": "proposed | active | suspended | inactive | entered-in-error",
+        "definition": "Indicates the current state of the care team.",
+        "comment": "This element is labeled as a modifier because the status contains the code entered-in-error that marks the care team as not currently valid.",
         "min": 1,
         "max": "1",
         "base": {
@@ -360,23 +379,27 @@
         },
         "type": [
           {
-            "code": "CodeableConcept"
+            "code": "code"
           }
         ],
         "mustSupport": true,
         "isModifier": true,
-        "isSummary": false,
+        "isSummary": true,
         "binding": {
           "strength": "required",
           "description": "Indicates whether the team is current , represents future intentions or is now a historical record.",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/us/core/ValueSet/us-core-careteam-status"
+            "reference": "http://hl7.org/fhir/ValueSet/care-team-status"
           }
         },
         "mapping": [
           {
             "identity": "w5",
             "map": "status"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "CarePlan.status"
           }
         ]
       },
@@ -385,7 +408,7 @@
         "path": "CareTeam.category",
         "short": "Type of team",
         "definition": "Identifies what kind of team.  This is to support differentiation between multiple co-existing teams, such as care plan team, episode of care team, longitudinal care team.",
-        "comments": "There may be multiple axis of categorization and one team may serve multiple purposes.",
+        "comment": "There may be multiple axis of categorization and one team may serve multiple purposes.",
         "requirements": "Used for filtering what teams(s) are retrieved and displayed to different types of users.",
         "min": 0,
         "max": "*",
@@ -400,6 +423,19 @@
           }
         ],
         "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "CareTeamCategory"
+            }
+          ],
+          "strength": "example",
+          "description": "Indicates the type of care team.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/care-team-category"
+          }
+        },
         "mapping": [
           {
             "identity": "w5",
@@ -412,7 +448,7 @@
         "path": "CareTeam.name",
         "short": "Name of the team, such as crisis assessment team",
         "definition": "A label for human use intended to distinguish like teams.  E.g. the \"red\" vs. \"green\" trauma teams.",
-        "comments": "The meaning/purpose of the team is conveyed in CareTeam.category.  This element may also convey semantics of the team (e.g. \"Red trauma team\"), but it's primary purpose is to distinguish between identical teams in a human-friendly way.  (\"Team 18735\" isn't as friendly . ).",
+        "comment": "The meaning/purpose of the team is conveyed in CareTeam.category.  This element may also convey semantics of the team (e.g. \"Red trauma team\"), but its primary purpose is to distinguish between identical teams in a human-friendly way.  (\"Team 18735\" isn't as friendly . ).",
         "min": 0,
         "max": "1",
         "base": {
@@ -433,6 +469,9 @@
         "short": "Who care team is for",
         "definition": "Identifies the patient or group whose intended care is handled by the team.",
         "requirements": "Allows the team to care for a group (e.g. marriage) therapy.",
+        "alias": [
+          "patient"
+        ],
         "min": 1,
         "max": "1",
         "base": {
@@ -447,11 +486,48 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
           {
             "identity": "w5",
             "map": "who.focus"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "CarePlan.subject"
+          }
+        ]
+      },
+      {
+        "id": "CareTeam:uscorecareteam.context",
+        "path": "CareTeam.context",
+        "short": "Encounter or episode associated with CareTeam",
+        "definition": "The encounter or episode of care that establishes the context for this care team.",
+        "alias": [
+          "encounter"
+        ],
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "CareTeam.context",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "w5",
+            "map": "context"
           }
         ]
       },
@@ -498,6 +574,9 @@
             "code": "BackboneElement"
           }
         ],
+        "condition": [
+          "ctm-1"
+        ],
         "constraint": [
           {
             "key": "ele-1",
@@ -506,10 +585,17 @@
             "expression": "children().count() > id.count()",
             "xpath": "@value|f:*|h:div",
             "source": "Element"
+          },
+          {
+            "key": "ctm-1",
+            "severity": "error",
+            "human": "CareTeam.participant.onBehalfOf can only be populated when CareTeam.participant.member is a Practitioner",
+            "expression": "onBehalfOf.exists() implies (member.resolve() is Practitioner)",
+            "xpath": "contains(f:member, '/Practitioner') or not(exists(f:onBehalfOf))",
+            "source": "CareTeam.participant"
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
         "mapping": [
           {
             "identity": "v2",
@@ -517,7 +603,11 @@
           },
           {
             "identity": "rim",
-            "map": ".participation[typeCode=PFM]"
+            "map": ".participation[typeCode=PRF]"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "CarePlan.participant"
           }
         ]
       },
@@ -553,7 +643,7 @@
         "path": "CareTeam.participant.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -582,7 +672,7 @@
         "path": "CareTeam.participant.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -614,7 +704,7 @@
         "path": "CareTeam.participant.role",
         "short": "Type of involvement",
         "definition": "Indicates specific responsibility of an individual within the care team, such as \"Primary care physician\", \"Trained social worker counselor\", \"Caregiver\", etc.",
-        "comments": "Roles may sometimes be inferred by type of Practitioner.  These are relationships that hold only within the context of the care team.  General relationships should be handled as properties of the Patient resource directly.",
+        "comment": "Roles may sometimes be inferred by type of Practitioner.  These are relationships that hold only within the context of the care team.  General relationships should be handled as properties of the Patient resource directly.",
         "min": 1,
         "max": "1",
         "base": {
@@ -628,9 +718,17 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "binding": {
-          "strength": "required",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
+              "valueReference": {
+                "reference": "http://hl7.org/fhir/us/core/ValueSet/us-core-careteam-provider-roles"
+              }
+            }
+          ],
+          "strength": "extensible",
           "description": "Indicates specific responsibility of an individual within the care team, such as Primary physician, Team coordinator, Caregiver, etc.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/us/core/ValueSet/us-core-careteam-provider-roles"
@@ -644,6 +742,10 @@
           {
             "identity": "rim",
             "map": ".functionCode"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "CarePlan.participant.role"
           }
         ]
       },
@@ -652,7 +754,7 @@
         "path": "CareTeam.participant.member",
         "short": "Who is involved",
         "definition": "The specific person or organization who is participating/expected to participate in the care team.",
-        "comments": "Patient only needs to be listed if they have a role other than \"subject of care\".  Member is optional because some participants may be known only by their role, particularly in draft plans.",
+        "comment": "Patient only needs to be listed if they have a role other than \"subject of care\".\n\nMember is optional because some participants may be known only by their role, particularly in draft plans.",
         "min": 1,
         "max": "1",
         "base": {
@@ -663,15 +765,15 @@
         "type": [
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
+            "targetProfile": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"
           },
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
           },
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
           },
           {
             "code": "Reference",
@@ -679,7 +781,7 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -692,9 +794,34 @@
           {
             "identity": "w5",
             "map": "who.actor"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "CarePlan.participant.member"
           }
         ]
       },
+      {
+        "id": "CareTeam:uscorecareteam.participant.onBehalfOf",
+        "path": "CareTeam.participant.onBehalfOf",
+        "short": "Organization of the practitioner",
+        "definition": "The organization of the practitioner.",
+        "requirements": "Practitioners can be associated with multiple organizations.  This element indicates which organization they were acting on behalf of.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "CareTeam.participant.onBehalfOf",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
+          }
+        ],
+        "isSummary": true
+      },
       {
         "id": "CareTeam:uscorecareteam.participant.period",
         "path": "CareTeam.participant.period",
@@ -713,6 +840,68 @@
           }
         ]
       },
+      {
+        "id": "CareTeam:uscorecareteam.reasonCode",
+        "path": "CareTeam.reasonCode",
+        "short": "Why the care team exists",
+        "definition": "Describes why the care team exists.",
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "CareTeam.reasonCode",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "CareTeamReason"
+            }
+          ],
+          "strength": "example",
+          "description": "Indicates the reason for the care team.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/clinical-findings"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "w5",
+            "map": "why"
+          }
+        ]
+      },
+      {
+        "id": "CareTeam:uscorecareteam.reasonReference",
+        "path": "CareTeam.reasonReference",
+        "short": "Why the care team exists",
+        "definition": "Condition(s) that this care team addresses.",
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "CareTeam.reasonReference",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Condition"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "w5",
+            "map": "why"
+          }
+        ]
+      },
       {
         "id": "CareTeam:uscorecareteam.managingOrganization",
         "path": "CareTeam.managingOrganization",
@@ -733,6 +922,24 @@
           }
         ],
         "isSummary": true
+      },
+      {
+        "id": "CareTeam:uscorecareteam.note",
+        "path": "CareTeam.note",
+        "short": "Comments made about the CareTeam",
+        "definition": "Comments made about the CareTeam.",
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "CareTeam.note",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Annotation"
+          }
+        ]
       }
     ]
   },
@@ -746,7 +953,12 @@
         "definition": "The US Core CareTeam Profile is based upon the core FHIR CareTeam Resource and created to meet the 2015 Edition Common Clinical Data Set 'Care team member(s)' requirements.",
         "mustSupport": false,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "CarePlan"
+          }
+        ]
       },
       {
         "id": "CareTeam:uscorecareteam.status",
@@ -755,19 +967,24 @@
         "max": "1",
         "type": [
           {
-            "code": "CodeableConcept"
+            "code": "code"
           }
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false,
         "binding": {
           "strength": "required",
           "description": "Indicates whether the team is current , represents future intentions or is now a historical record.",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/us/core/ValueSet/us-core-careteam-status"
+            "reference": "http://hl7.org/fhir/ValueSet/care-team-status"
           }
-        }
+        },
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "CarePlan.status"
+          }
+        ]
       },
       {
         "id": "CareTeam:uscorecareteam.subject",
@@ -782,7 +999,12 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "CarePlan.subject"
+          }
+        ]
       },
       {
         "id": "CareTeam:uscorecareteam.participant",
@@ -791,7 +1013,12 @@
         "max": "*",
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "CarePlan.participant"
+          }
+        ]
       },
       {
         "id": "CareTeam:uscorecareteam.participant.role",
@@ -805,14 +1032,27 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false,
         "binding": {
-          "strength": "required",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
+              "valueReference": {
+                "reference": "http://hl7.org/fhir/us/core/ValueSet/us-core-careteam-provider-roles"
+              }
+            }
+          ],
+          "strength": "extensible",
           "description": "Indicates specific responsibility of an individual within the care team, such as Primary physician, Team coordinator, Caregiver, etc.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/us/core/ValueSet/us-core-careteam-provider-roles"
           }
-        }
+        },
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "CarePlan.participant.role"
+          }
+        ]
       },
       {
         "id": "CareTeam:uscorecareteam.participant.member",
@@ -822,15 +1062,15 @@
         "type": [
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
+            "targetProfile": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"
           },
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
           },
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
           },
           {
             "code": "Reference",
@@ -839,8 +1079,13 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "CarePlan.participant.member"
+          }
+        ]
       }
     ]
   }
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/StructureDefinition-us-core-condition.json b/lib/resources/us_core/StructureDefinition-us-core-condition.json
index 6acac5b..f3ba795 100755
--- a/lib/resources/us_core/StructureDefinition-us-core-condition.json
+++ b/lib/resources/us_core/StructureDefinition-us-core-condition.json
@@ -3,11 +3,13 @@
   "id": "us-core-condition",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition</a></p><p><b>name</b>: US Core Condition Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 21/08/2014</p><p><b>publisher</b>: Health Level Seven International (Infrastructure and Messaging - Data Access Framework)</p><p><b>contact</b>: </p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition</a></p><p><b>name</b>: US Core Condition Profile</p><p><b>status</b>: DRAFT</p><p><b>publisher</b>: Health Level Seven International (Infrastructure and Messaging - Data Access Framework)</p><p><b>contact</b>: </p><p><b>date</b>: 21/08/2014</p><blockquote><p><b>mapping</b></p><p><b>identity</b>: sct-concept</p><p><b>uri</b>: <a href=\"http://snomed.info/conceptdomain\">http://snomed.info/conceptdomain</a></p><p><b>name</b>: SNOMED CT Concept Domain Binding</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: v2</p><p><b>uri</b>: <a href=\"http://hl7.org/v2\">http://hl7.org/v2</a></p><p><b>name</b>: HL7 v2 Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: rim</p><p><b>uri</b>: <a href=\"http://hl7.org/v3\">http://hl7.org/v3</a></p><p><b>name</b>: RIM Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: w5</p><p><b>uri</b>: <a href=\"http://hl7.org/fhir/w5\">http://hl7.org/fhir/w5</a></p><p><b>name</b>: W5 Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: sct-attr</p><p><b>uri</b>: <a href=\"http://snomed.info/sct\">http://snomed.info/sct</a></p><p><b>name</b>: SNOMED CT Attribute Binding</p></blockquote><p><b>kind</b>: RESOURCE</p><p><b>abstract</b>: false</p><p><b>type</b>: Condition</p><p><b>baseDefinition</b>: <a href=\"http://hl7.org/fhir/StructureDefinition/Condition\">http://hl7.org/fhir/StructureDefinition/Condition</a></p><p><b>derivation</b>: CONSTRAINT</p><h3>Snapshots</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table><h3>Differentials</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table></div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: US  Core Condition (a.k.a Problem) Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 21/08/2014</p><p><b>publisher</b>: Health Level Seven International (Infrastructure and Messaging - Data Access Framework)</p><p><b>contact</b>: </p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: US  Core Condition (a.k.a Problem) Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 21/08/2014</p><p><b>publisher</b>: Health Level Seven International (Infrastructure and Messaging - Data Access Framework)</p><p><b>contact</b>: </p><p><b>fhirVersion</b>: 3.0.0</p><blockquote><p><b>mapping</b></p><p><b>identity</b>: argonaut-dq-dstu2</p><p><b>uri</b>: <a href=\"http://unknown.org/Argonaut DQ DSTU2\">http://unknown.org/Argonaut DQ DSTU2</a></p><p><b>name</b>: Argonaut DQ DSTU2</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: sct-concept</p><p><b>uri</b>: <a href=\"http://snomed.info/conceptdomain\">http://snomed.info/conceptdomain</a></p><p><b>name</b>: SNOMED CT Concept Domain Binding</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: v2</p><p><b>uri</b>: <a href=\"http://hl7.org/v2\">http://hl7.org/v2</a></p><p><b>name</b>: HL7 v2 Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: rim</p><p><b>uri</b>: <a href=\"http://hl7.org/v3\">http://hl7.org/v3</a></p><p><b>name</b>: RIM Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: w5</p><p><b>uri</b>: <a href=\"http://hl7.org/fhir/w5\">http://hl7.org/fhir/w5</a></p><p><b>name</b>: W5 Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: sct-attr</p><p><b>uri</b>: <a href=\"http://snomed.info/sct\">http://snomed.info/sct</a></p><p><b>name</b>: SNOMED CT Attribute Binding</p></blockquote><p><b>kind</b>: RESOURCE</p><p><b>abstract</b>: false</p><p><b>type</b>: Condition</p><p><b>baseDefinition</b>: <a href=\"http://hl7.org/fhir/StructureDefinition/Condition\">http://hl7.org/fhir/StructureDefinition/Condition</a></p><p><b>derivation</b>: CONSTRAINT</p><h3>Snapshots</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table><h3>Differentials</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table></div>"
   },
   "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition",
-  "name": "US Core Condition Profile",
+  "version": "1.0.0",
+  "name": "US  Core Condition (a.k.a Problem) Profile",
   "status": "draft",
+  "date": "2014-08-21",
   "publisher": "Health Level Seven International (Infrastructure and Messaging - Data Access Framework)",
   "contact": [
     {
@@ -19,8 +21,13 @@
       ]
     }
   ],
-  "date": "2014-08-21",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "argonaut-dq-dstu2",
+      "uri": "http://unknown.org/Argonaut DQ DSTU2",
+      "name": "Argonaut DQ DSTU2"
+    },
     {
       "identity": "sct-concept",
       "uri": "http://snomed.info/conceptdomain",
@@ -55,9 +62,9 @@
   "snapshot": {
     "element": [
       {
-        "id": "Condition:c",
+        "id": "Condition:uscorevitalsigns",
         "path": "Condition",
-        "sliceName": "c",
+        "sliceName": "USCoreVitalSigns",
         "short": "US Core Condition Profile",
         "definition": "The US Core Condition Profile is based upon the core FHIR Condition Resource and created to meet the 2015 Edition Common Clinical Data Set 'Problems' and 'Health Concerns' requirements.",
         "min": 0,
@@ -105,7 +112,7 @@
             "severity": "error",
             "human": "If condition is abated, then clinicalStatus must be either inactive, resolved, or remission",
             "expression": "abatement.empty() or (abatement as boolean).not()  or clinicalStatus='resolved' or clinicalStatus='remission' or clinicalStatus='inactive'",
-            "xpath": "xpath: not(f:abatementBoolean='true' or (not(exists(f:abatementBoolean)) and exists(*[starts-with(local-name(.), 'abatement')])) or f:clinicalStatus/@value=('resolved', 'remission', 'inactive')",
+            "xpath": "not(f:abatementBoolean='true' or (not(exists(f:abatementBoolean)) and exists(*[starts-with(local-name(.), 'abatement')])) or f:clinicalStatus/@value=('resolved', 'remission', 'inactive'))",
             "source": "Condition"
           },
           {
@@ -115,10 +122,22 @@
             "expression": "verificationStatus='entered-in-error' or clinicalStatus.exists()",
             "xpath": "f:verificationStatus/@value='entered-in-error' or exists(f:clinicalStatus)",
             "source": "Condition"
+          },
+          {
+            "extension": [
+              {
+                "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice",
+                "valueBoolean": true
+              }
+            ],
+            "key": "us-core-1",
+            "severity": "warning",
+            "human": "A code in Condition.category SHOULD be from US Core Condition Category Codes value set.",
+            "expression": "where(category in 'http://hl7.org/fhir/us/core/ValueSet/us-core-condition-category').exists()",
+            "xpath": "(no xpath equivalent)"
           }
         ],
         "mustSupport": false,
-        "isSummary": false,
         "mapping": [
           {
             "identity": "rim",
@@ -126,7 +145,7 @@
           },
           {
             "identity": "sct-concept",
-            "map": "< 243796009 |Situation with explicit context|: 246090004 |Associated finding| = ((< 404684003 |Clinical finding| MINUS << 420134006 |Propensity to adverse reactions| MINUS  << 473010000 |Hypersensitivity condition| MINUS  << 79899007 |Drug interaction| MINUS << 69449002 |Drug action| MINUS  << 441742003 |Evaluation finding| MINUS  << 307824009 |Administrative status| MINUS  << 385356007 |Tumor stage finding|) OR < 272379006 |Event|)"
+            "map": "< 243796009 |Situation with explicit context|:\n246090004 |Associated finding| =\n((< 404684003 |Clinical finding| MINUS\n<< 420134006 |Propensity to adverse reactions| MINUS \n<< 473010000 |Hypersensitivity condition| MINUS \n<< 79899007 |Drug interaction| MINUS\n<< 69449002 |Drug action| MINUS \n<< 441742003 |Evaluation finding| MINUS \n<< 307824009 |Administrative status| MINUS \n<< 385356007 |Tumor stage finding|) OR\n< 272379006 |Event|)"
           },
           {
             "identity": "v2",
@@ -139,15 +158,19 @@
           {
             "identity": "w5",
             "map": "clinical.general"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Condition"
           }
         ]
       },
       {
-        "id": "Condition:c.id",
+        "id": "Condition:uscorevitalsigns.id",
         "path": "Condition.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -163,7 +186,7 @@
         "isSummary": true
       },
       {
-        "id": "Condition:c.meta",
+        "id": "Condition:uscorevitalsigns.meta",
         "path": "Condition.meta",
         "short": "Metadata about the resource",
         "definition": "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.",
@@ -182,11 +205,11 @@
         "isSummary": true
       },
       {
-        "id": "Condition:c.implicitRules",
+        "id": "Condition:uscorevitalsigns.implicitRules",
         "path": "Condition.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -203,11 +226,11 @@
         "isSummary": true
       },
       {
-        "id": "Condition:c.language",
+        "id": "Condition:uscorevitalsigns.language",
         "path": "Condition.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -227,6 +250,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -237,11 +268,11 @@
         }
       },
       {
-        "id": "Condition:c.text",
+        "id": "Condition:uscorevitalsigns.text",
         "path": "Condition.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -271,11 +302,11 @@
         ]
       },
       {
-        "id": "Condition:c.contained",
+        "id": "Condition:uscorevitalsigns.contained",
         "path": "Condition.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -301,11 +332,11 @@
         ]
       },
       {
-        "id": "Condition:c.extension",
+        "id": "Condition:uscorevitalsigns.extension",
         "path": "Condition.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -330,11 +361,11 @@
         ]
       },
       {
-        "id": "Condition:c.modifierExtension",
+        "id": "Condition:uscorevitalsigns.modifierExtension",
         "path": "Condition.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -360,7 +391,7 @@
         ]
       },
       {
-        "id": "Condition:c.identifier",
+        "id": "Condition:uscorevitalsigns.identifier",
         "path": "Condition.identifier",
         "short": "External Ids for this condition",
         "definition": "This records identifiers associated with this condition that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate (e.g. in CDA documents, or in written / printed documentation).",
@@ -390,10 +421,11 @@
         ]
       },
       {
-        "id": "Condition:c.clinicalStatus",
+        "id": "Condition:uscorevitalsigns.clinicalStatus",
         "path": "Condition.clinicalStatus",
         "short": "active | recurrence | inactive | remission | resolved",
         "definition": "The clinical status of the condition.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the condition as not currently valid or of concern.",
         "min": 0,
         "max": "1",
         "base": {
@@ -406,9 +438,13 @@
             "code": "code"
           }
         ],
+        "condition": [
+          "con-3",
+          "con-4"
+        ],
         "mustSupport": true,
         "isModifier": true,
-        "isSummary": false,
+        "isSummary": true,
         "binding": {
           "strength": "required",
           "valueSetReference": {
@@ -424,18 +460,26 @@
             "identity": "v2",
             "map": "PRB-14 / DG1-6"
           },
+          {
+            "identity": "rim",
+            "map": "Observation ACT\n.inboundRelationship[typeCode=COMP].source[classCode=OBS, code=\"clinicalStatus\", moodCode=EVN].value"
+          },
           {
             "identity": "w5",
             "map": "status"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Condition.clinicalStatus"
           }
         ]
       },
       {
-        "id": "Condition:c.verificationStatus",
+        "id": "Condition:uscorevitalsigns.verificationStatus",
         "path": "Condition.verificationStatus",
         "short": "provisional | differential | confirmed | refuted | entered-in-error | unknown",
         "definition": "The verification status to support the clinical status of the condition.",
-        "comments": "verificationStatus is not required.  For example, when a patient has abdominal pain in the ED, there is not likely going to be a verification status.",
+        "comment": "verificationStatus is not required.  For example, when a patient has abdominal pain in the ED, there is not likely going to be a verification status.\n\nThis element is labeled as a modifier because the status contains the code refuted and entered-in-error that mark the Condition as not currently valid.",
         "min": 1,
         "max": "1",
         "base": {
@@ -449,9 +493,12 @@
           }
         ],
         "defaultValueCode": "unknown",
+        "condition": [
+          "con-3"
+        ],
         "mustSupport": true,
         "isModifier": true,
-        "isSummary": false,
+        "isSummary": true,
         "binding": {
           "strength": "required",
           "valueSetReference": {
@@ -469,7 +516,7 @@
           },
           {
             "identity": "rim",
-            "map": ".code (pre or post-coordinated in)  Can use valueNegationInd for refuted"
+            "map": "Observation ACT\n.inboundRelationship[typeCode=COMP].source[classCode=OBS, code=\"verificationStatus\", moodCode=EVN].value"
           },
           {
             "identity": "sct-attr",
@@ -478,15 +525,19 @@
           {
             "identity": "w5",
             "map": "status"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Condition.verificationStatus"
           }
         ]
       },
       {
-        "id": "Condition:c.category",
+        "id": "Condition:uscorevitalsigns.category",
         "path": "Condition.category",
         "short": "problem-list-item | encounter-diagnosis",
         "definition": "A category assigned to the condition.",
-        "comments": "The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts.",
+        "comment": "The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts.",
         "min": 1,
         "max": "*",
         "base": {
@@ -500,9 +551,8 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
         "binding": {
-          "strength": "required",
+          "strength": "preferred",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/us/core/ValueSet/us-core-condition-category"
           }
@@ -523,15 +573,19 @@
           {
             "identity": "w5",
             "map": "class"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Condition.category"
           }
         ]
       },
       {
-        "id": "Condition:c.severity",
+        "id": "Condition:uscorevitalsigns.severity",
         "path": "Condition.severity",
         "short": "Subjective severity of condition",
         "definition": "A subjective assessment of the severity of the condition as evaluated by the clinician.",
-        "comments": "Coding of the severity with a terminology is preferred, where possible.",
+        "comment": "Coding of the severity with a terminology is preferred, where possible.",
         "min": 0,
         "max": "1",
         "base": {
@@ -545,6 +599,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ConditionSeverity"
+            }
+          ],
           "strength": "preferred",
           "description": "A subjective assessment of the severity of the condition as evaluated by the clinician.",
           "valueSetReference": {
@@ -575,15 +635,19 @@
         ]
       },
       {
-        "id": "Condition:c.code",
+        "id": "Condition:uscorevitalsigns.code",
         "path": "Condition.code",
         "short": "Identification of the condition, problem or diagnosis",
         "definition": "Identification of the condition, problem or diagnosis.",
+        "requirements": "0..1 to account for primarily narrative only resources.",
+        "alias": [
+          "type"
+        ],
         "min": 1,
         "max": "1",
         "base": {
           "path": "Condition.code",
-          "min": 1,
+          "min": 0,
           "max": "1"
         },
         "type": [
@@ -592,7 +656,7 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "binding": {
           "strength": "extensible",
           "description": "Valueset to describe the actual problem experienced by the patient",
@@ -603,7 +667,7 @@
         "mapping": [
           {
             "identity": "sct-concept",
-            "map": "code 246090004 |Associated finding| (< 404684003 |Clinical finding| MINUS << 420134006 |Propensity to adverse reactions| MINUS  << 473010000 |Hypersensitivity condition| MINUS  << 79899007 |Drug interaction| MINUS << 69449002 |Drug action| MINUS  << 441742003 |Evaluation finding| MINUS  << 307824009 |Administrative status| MINUS  << 385356007 |Tumor stage finding|)  OR < 413350009 |Finding with explicit context| OR < 272379006 |Event|"
+            "map": "code 246090004 |Associated finding| (< 404684003 |Clinical finding| MINUS\n<< 420134006 |Propensity to adverse reactions| MINUS \n<< 473010000 |Hypersensitivity condition| MINUS \n<< 79899007 |Drug interaction| MINUS\n<< 69449002 |Drug action| MINUS \n<< 441742003 |Evaluation finding| MINUS \n<< 307824009 |Administrative status| MINUS \n<< 385356007 |Tumor stage finding|) \nOR < 413350009 |Finding with explicit context|\nOR < 272379006 |Event|"
           },
           {
             "identity": "v2",
@@ -620,15 +684,19 @@
           {
             "identity": "w5",
             "map": "what"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Condition.code"
           }
         ]
       },
       {
-        "id": "Condition:c.bodySite",
+        "id": "Condition:uscorevitalsigns.bodySite",
         "path": "Condition.bodySite",
         "short": "Anatomical location, if relevant",
         "definition": "The anatomical location where this condition manifests itself.",
-        "comments": "Only used if not implicit in code found in Condition.code. If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [body-site-instance](extension-body-site-instance.html).  May be a summary code, or a reference to a very precise definition of the location, or both.",
+        "comment": "Only used if not implicit in code found in Condition.code. If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [body-site-instance](extension-body-site-instance.html).  May be a summary code, or a reference to a very precise definition of the location, or both.",
         "min": 0,
         "max": "*",
         "base": {
@@ -643,6 +711,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -665,11 +739,14 @@
         ]
       },
       {
-        "id": "Condition:c.subject",
+        "id": "Condition:uscorevitalsigns.subject",
         "path": "Condition.subject",
         "short": "Who has the condition?",
         "definition": "Indicates the patient or group who the condition record is associated with.",
         "requirements": "Group is typically used for veterinary or public health use cases.",
+        "alias": [
+          "patient"
+        ],
         "min": 1,
         "max": "1",
         "base": {
@@ -684,7 +761,7 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -697,15 +774,22 @@
           {
             "identity": "w5",
             "map": "who.focus"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Condition.patient"
           }
         ]
       },
       {
-        "id": "Condition:c.context",
+        "id": "Condition:uscorevitalsigns.context",
         "path": "Condition.context",
-        "short": "Encounter when condition first asserted",
+        "short": "Encounter or episode when condition first asserted",
         "definition": "Encounter during which the condition was first asserted.",
-        "comments": "This record indicates the encounter this particular record is associated with.  In the case of a \"new\" diagnosis reflecting ongoing/revised information about the condition, this might be distinct from the first encounter in which the underlying condition was first \"known\".",
+        "comment": "This record indicates the encounter this particular record is associated with.  In the case of a \"new\" diagnosis reflecting ongoing/revised information about the condition, this might be distinct from the first encounter in which the underlying condition was first \"known\".",
+        "alias": [
+          "encounter"
+        ],
         "min": 0,
         "max": "1",
         "base": {
@@ -723,6 +807,7 @@
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -739,11 +824,11 @@
         ]
       },
       {
-        "id": "Condition:c.onset[x]",
+        "id": "Condition:uscorevitalsigns.onset[x]",
         "path": "Condition.onset[x]",
         "short": "Estimated or actual date,  date-time, or age",
         "definition": "Estimated or actual date or date-time  the condition began, in the opinion of the clinician.",
-        "comments": "Age is generally used when the patient reports an age at which the Condition began to occur.",
+        "comment": "Age is generally used when the patient reports an age at which the Condition began to occur.",
         "min": 0,
         "max": "1",
         "base": {
@@ -785,11 +870,11 @@
         ]
       },
       {
-        "id": "Condition:c.abatement[x]",
+        "id": "Condition:uscorevitalsigns.abatement[x]",
         "path": "Condition.abatement[x]",
         "short": "If/when in resolution/remission",
         "definition": "The date or estimated date that the condition resolved or went into remission. This is called \"abatement\" because of the many overloaded connotations associated with \"remission\" or \"resolution\" - Conditions are never really resolved, but they can abate.",
-        "comments": "There is no explicit distinction between resolution and remission because in many cases the distinction is not clear. Age is generally used when the patient reports an age at which the Condition abated.  If there is no abatement element, it is unknown whether the condition has resolved or entered remission; applications and users should generally assume that the condition is still valid.  When abatementString exists, it implies the condition is abated.",
+        "comment": "There is no explicit distinction between resolution and remission because in many cases the distinction is not clear. Age is generally used when the patient reports an age at which the Condition abated.  If there is no abatement element, it is unknown whether the condition has resolved or entered remission; applications and users should generally assume that the condition is still valid.  When abatementString exists, it implies the condition is abated.",
         "min": 0,
         "max": "1",
         "base": {
@@ -817,6 +902,9 @@
             "code": "string"
           }
         ],
+        "condition": [
+          "con-4"
+        ],
         "mapping": [
           {
             "identity": "rim",
@@ -829,11 +917,11 @@
         ]
       },
       {
-        "id": "Condition:c.assertedDate",
+        "id": "Condition:uscorevitalsigns.assertedDate",
         "path": "Condition.assertedDate",
         "short": "Date record was believed accurate",
         "definition": "The date on which the existance of the Condition was first asserted or acknowledged.",
-        "comments": "The assertedDate represents the date when this particular Condition record was created in the EHR, not the date of the most recent update in terms of when severity, abatement, etc. were specified.  The date of the last record modification can be retrieved from the resource metadata.",
+        "comment": "The assertedDate represents the date when this particular Condition record was created in the EHR, not the date of the most recent update in terms of when severity, abatement, etc. were specified.  The date of the last record modification can be retrieved from the resource metadata.",
         "min": 0,
         "max": "1",
         "base": {
@@ -843,9 +931,10 @@
         },
         "type": [
           {
-            "code": "date"
+            "code": "dateTime"
           }
         ],
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -862,7 +951,7 @@
         ]
       },
       {
-        "id": "Condition:c.asserter",
+        "id": "Condition:uscorevitalsigns.asserter",
         "path": "Condition.asserter",
         "short": "Person who asserts this condition",
         "definition": "Individual who is making the condition statement.",
@@ -904,7 +993,7 @@
         ]
       },
       {
-        "id": "Condition:c.stage",
+        "id": "Condition:uscorevitalsigns.stage",
         "path": "Condition.stage",
         "short": "Stage/grade, usually assessed formally",
         "definition": "Clinical stage or grade of a condition. May include formal severity assessments.",
@@ -945,7 +1034,7 @@
         ]
       },
       {
-        "id": "Condition:c.stage.id",
+        "id": "Condition:uscorevitalsigns.stage.id",
         "path": "Condition.stage.id",
         "representation": [
           "xmlAttr"
@@ -972,11 +1061,11 @@
         ]
       },
       {
-        "id": "Condition:c.stage.extension",
+        "id": "Condition:uscorevitalsigns.stage.extension",
         "path": "Condition.stage.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1001,11 +1090,11 @@
         ]
       },
       {
-        "id": "Condition:c.stage.modifierExtension",
+        "id": "Condition:uscorevitalsigns.stage.modifierExtension",
         "path": "Condition.stage.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1033,7 +1122,7 @@
         ]
       },
       {
-        "id": "Condition:c.stage.summary",
+        "id": "Condition:uscorevitalsigns.stage.summary",
         "path": "Condition.stage.summary",
         "short": "Simple summary (disease specific)",
         "definition": "A simple summary of the stage such as \"Stage 3\". The determination of the stage is disease-specific.",
@@ -1053,6 +1142,12 @@
           "con-1"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ConditionStage"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing condition stages (e.g. Cancer stages).",
           "valueSetReference": {
@@ -1075,7 +1170,7 @@
         ]
       },
       {
-        "id": "Condition:c.stage.assessment",
+        "id": "Condition:uscorevitalsigns.stage.assessment",
         "path": "Condition.stage.assessment",
         "short": "Formal record of assessment",
         "definition": "Reference to a formal record of the evidence on which the staging assessment is based.",
@@ -1111,11 +1206,11 @@
         ]
       },
       {
-        "id": "Condition:c.evidence",
+        "id": "Condition:uscorevitalsigns.evidence",
         "path": "Condition.evidence",
         "short": "Supporting evidence",
         "definition": "Supporting Evidence / manifestations that are the basis on which this condition is suspected or confirmed.",
-        "comments": "The evidence may be a simple list of coded symptoms/manifestations, or references to observations or formal assessments, or both.",
+        "comment": "The evidence may be a simple list of coded symptoms/manifestations, or references to observations or formal assessments, or both.",
         "min": 0,
         "max": "*",
         "base": {
@@ -1153,7 +1248,7 @@
         ]
       },
       {
-        "id": "Condition:c.evidence.id",
+        "id": "Condition:uscorevitalsigns.evidence.id",
         "path": "Condition.evidence.id",
         "representation": [
           "xmlAttr"
@@ -1180,11 +1275,11 @@
         ]
       },
       {
-        "id": "Condition:c.evidence.extension",
+        "id": "Condition:uscorevitalsigns.evidence.extension",
         "path": "Condition.evidence.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1209,11 +1304,11 @@
         ]
       },
       {
-        "id": "Condition:c.evidence.modifierExtension",
+        "id": "Condition:uscorevitalsigns.evidence.modifierExtension",
         "path": "Condition.evidence.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1241,16 +1336,16 @@
         ]
       },
       {
-        "id": "Condition:c.evidence.code",
+        "id": "Condition:uscorevitalsigns.evidence.code",
         "path": "Condition.evidence.code",
         "short": "Manifestation/symptom",
         "definition": "A manifestation or symptom that led to the recording of this condition.",
         "min": 0,
-        "max": "1",
+        "max": "*",
         "base": {
           "path": "Condition.evidence.code",
           "min": 0,
-          "max": "1"
+          "max": "*"
         },
         "type": [
           {
@@ -1260,7 +1355,14 @@
         "condition": [
           "con-2"
         ],
+        "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ManifestationOrSymptom"
+            }
+          ],
           "strength": "example",
           "description": "Codes that describe the manifestation or symptoms of a condition.",
           "valueSetReference": {
@@ -1275,11 +1377,15 @@
           {
             "identity": "rim",
             "map": "[code=\"diagnosis\"].value"
+          },
+          {
+            "identity": "w5",
+            "map": "why"
           }
         ]
       },
       {
-        "id": "Condition:c.evidence.detail",
+        "id": "Condition:uscorevitalsigns.evidence.detail",
         "path": "Condition.evidence.detail",
         "short": "Supporting information found elsewhere",
         "definition": "Links to other relevant information, including pathology reports.",
@@ -1299,15 +1405,20 @@
         "condition": [
           "con-2"
         ],
+        "isSummary": true,
         "mapping": [
           {
             "identity": "rim",
             "map": ".self"
+          },
+          {
+            "identity": "w5",
+            "map": "why"
           }
         ]
       },
       {
-        "id": "Condition:c.note",
+        "id": "Condition:uscorevitalsigns.note",
         "path": "Condition.note",
         "short": "Additional information about the Condition",
         "definition": "Additional information about the Condition. This is a general notes/comments entry  for description of the Condition, its diagnosis and prognosis.",
@@ -1339,17 +1450,37 @@
   "differential": {
     "element": [
       {
-        "id": "Condition:c",
+        "id": "Condition:uscorevitalsigns",
         "path": "Condition",
-        "sliceName": "c",
+        "sliceName": "USCoreVitalSigns",
         "short": "US Core Condition Profile",
         "definition": "The US Core Condition Profile is based upon the core FHIR Condition Resource and created to meet the 2015 Edition Common Clinical Data Set 'Problems' and 'Health Concerns' requirements.",
+        "constraint": [
+          {
+            "extension": [
+              {
+                "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice",
+                "valueBoolean": true
+              }
+            ],
+            "key": "us-core-1",
+            "severity": "warning",
+            "human": "A code in Condition.category SHOULD be from US Core Condition Category Codes value set.",
+            "expression": "where(category in 'http://hl7.org/fhir/us/core/ValueSet/us-core-condition-category').exists()",
+            "xpath": "(no xpath equivalent)"
+          }
+        ],
         "mustSupport": false,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Condition"
+          }
+        ]
       },
       {
-        "id": "Condition:c.clinicalStatus",
+        "id": "Condition:uscorevitalsigns.clinicalStatus",
         "path": "Condition.clinicalStatus",
         "min": 0,
         "max": "1",
@@ -1360,16 +1491,21 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false,
         "binding": {
           "strength": "required",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/condition-clinical"
           }
-        }
+        },
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Condition.clinicalStatus"
+          }
+        ]
       },
       {
-        "id": "Condition:c.verificationStatus",
+        "id": "Condition:uscorevitalsigns.verificationStatus",
         "path": "Condition.verificationStatus",
         "min": 1,
         "max": "1",
@@ -1380,16 +1516,21 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false,
         "binding": {
           "strength": "required",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/condition-ver-status"
           }
-        }
+        },
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Condition.verificationStatus"
+          }
+        ]
       },
       {
-        "id": "Condition:c.category",
+        "id": "Condition:uscorevitalsigns.category",
         "path": "Condition.category",
         "min": 1,
         "max": "*",
@@ -1400,16 +1541,21 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false,
         "binding": {
-          "strength": "required",
+          "strength": "preferred",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/us/core/ValueSet/us-core-condition-category"
           }
-        }
+        },
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Condition.category"
+          }
+        ]
       },
       {
-        "id": "Condition:c.code",
+        "id": "Condition:uscorevitalsigns.code",
         "path": "Condition.code",
         "min": 1,
         "max": "1",
@@ -1420,17 +1566,22 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false,
         "binding": {
           "strength": "extensible",
           "description": "Valueset to describe the actual problem experienced by the patient",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/us/core/ValueSet/us-core-problem"
           }
-        }
+        },
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Condition.code"
+          }
+        ]
       },
       {
-        "id": "Condition:c.subject",
+        "id": "Condition:uscorevitalsigns.subject",
         "path": "Condition.subject",
         "min": 1,
         "max": "1",
@@ -1442,8 +1593,13 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Condition.patient"
+          }
+        ]
       }
     ]
   }
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/StructureDefinition-us-core-device.json b/lib/resources/us_core/StructureDefinition-us-core-device.json
index 8819cb7..ea0e75c 100755
--- a/lib/resources/us_core/StructureDefinition-us-core-device.json
+++ b/lib/resources/us_core/StructureDefinition-us-core-device.json
@@ -3,12 +3,14 @@
   "id": "us-core-device",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-device\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-device</a></p><p><b>name</b>: US Core Implanted Device Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: Health Level Seven International (FHIR-Infrastructure)</p><p><b>contact</b>: </p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-device\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-device</a></p><p><b>name</b>: US Core Implanted Device Profile</p><p><b>status</b>: DRAFT</p><p><b>publisher</b>: Health Level Seven International (FHIR-Infrastructure)</p><p><b>contact</b>: </p><p><b>date</b>: 01/08/2016</p><blockquote><p><b>mapping</b></p><p><b>identity</b>: udi</p><p><b>uri</b>: <a href=\"http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/UniqueDeviceIdentification/default.htm\">http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/UniqueDeviceIdentification/default.htm</a></p><p><b>name</b>: UDI Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: rim</p><p><b>uri</b>: <a href=\"http://hl7.org/v3\">http://hl7.org/v3</a></p><p><b>name</b>: RIM Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: w5</p><p><b>uri</b>: <a href=\"http://hl7.org/fhir/w5\">http://hl7.org/fhir/w5</a></p><p><b>name</b>: W5 Mapping</p></blockquote><p><b>kind</b>: RESOURCE</p><p><b>abstract</b>: false</p><p><b>type</b>: Device</p><p><b>baseDefinition</b>: <a href=\"http://hl7.org/fhir/StructureDefinition/Device\">http://hl7.org/fhir/StructureDefinition/Device</a></p><p><b>derivation</b>: CONSTRAINT</p><h3>Snapshots</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table><h3>Differentials</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table></div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-device\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-device</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: US  Core Device Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: HL7 US Realm Steering Committee</p><p><b>contact</b>: </p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-device\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-device</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: US  Core Device Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: HL7 US Realm Steering Committee</p><p><b>contact</b>: </p><p><b>fhirVersion</b>: 3.0.0</p><blockquote><p><b>mapping</b></p><p><b>identity</b>: argonaut-dq-dstu2</p><p><b>uri</b>: <a href=\"http://unknown.org/Argonaut DQ DSTU2\">http://unknown.org/Argonaut DQ DSTU2</a></p><p><b>name</b>: Argonaut DQ DSTU2</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: rim</p><p><b>uri</b>: <a href=\"http://hl7.org/v3\">http://hl7.org/v3</a></p><p><b>name</b>: RIM Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: w5</p><p><b>uri</b>: <a href=\"http://hl7.org/fhir/w5\">http://hl7.org/fhir/w5</a></p><p><b>name</b>: W5 Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: udi</p><p><b>uri</b>: <a href=\"http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/UniqueDeviceIdentification/default.htm\">http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/UniqueDeviceIdentification/default.htm</a></p><p><b>name</b>: UDI Mapping</p></blockquote><p><b>kind</b>: RESOURCE</p><p><b>abstract</b>: false</p><p><b>type</b>: Device</p><p><b>baseDefinition</b>: <a href=\"http://hl7.org/fhir/StructureDefinition/Device\">http://hl7.org/fhir/StructureDefinition/Device</a></p><p><b>derivation</b>: CONSTRAINT</p><h3>Snapshots</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table><h3>Differentials</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table></div>"
   },
   "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-device",
-  "name": "US Core Implanted Device Profile",
+  "version": "1.0.0",
+  "name": "US  Core Device Profile",
   "status": "draft",
-  "publisher": "Health Level Seven International (FHIR-Infrastructure)",
+  "date": "2016-08-01",
+  "publisher": "HL7 US Realm Steering Committee",
   "contact": [
     {
       "telecom": [
@@ -19,12 +21,12 @@
       ]
     }
   ],
-  "date": "2016-08-01",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
-      "identity": "udi",
-      "uri": "http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/UniqueDeviceIdentification/default.htm",
-      "name": "UDI Mapping"
+      "identity": "argonaut-dq-dstu2",
+      "uri": "http://unknown.org/Argonaut DQ DSTU2",
+      "name": "Argonaut DQ DSTU2"
     },
     {
       "identity": "rim",
@@ -35,6 +37,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "udi",
+      "uri": "http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/UniqueDeviceIdentification/default.htm",
+      "name": "UDI Mapping"
     }
   ],
   "kind": "resource",
@@ -92,16 +99,11 @@
           }
         ],
         "mustSupport": false,
-        "isSummary": false,
         "mapping": [
           {
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
-          {
-            "identity": "udi",
-            "map": "N/A"
-          },
           {
             "identity": "rim",
             "map": "Device"
@@ -109,6 +111,10 @@
           {
             "identity": "w5",
             "map": "administrative.device"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Device"
           }
         ]
       },
@@ -117,7 +123,7 @@
         "path": "Device.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -156,7 +162,7 @@
         "path": "Device.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -177,7 +183,7 @@
         "path": "Device.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -197,6 +203,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -211,7 +225,7 @@
         "path": "Device.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -245,7 +259,7 @@
         "path": "Device.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -275,7 +289,7 @@
         "path": "Device.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -304,7 +318,7 @@
         "path": "Device.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,7 +348,7 @@
         "path": "Device.identifier",
         "short": "Instance identifier",
         "definition": "Unique instance identifiers assigned to a device by manufacturers other organizations or owners.",
-        "comments": "The barcode string from a barcode present on a device label or package may identify the instance, include names given to the device in local usage, or may identify the type of device. If the identifier identifies the type of device, Device.type element should be used.  For [UDI](device.html#5.11.3.2.2),  this element corresponds to the variable portion of the UDI that identifies the serial number of a specific device. See [UDI mappings](device-mappings.html#udi) for a complete mapping of UDI parts to Device.",
+        "comment": "The barcode string from a barcode present on a device label or package may identify the instance, include names given to the device in local usage, or may identify the type of device. If the identifier identifies the type of device, Device.type element should be used.  For [UDI](device.html#5.11.3.2.2),  this element corresponds to the variable portion of the UDI that identifies the serial number of a specific device. See [UDI mappings](device-mappings.html#udi) for a complete mapping of UDI parts to Device.",
         "alias": [
           "Serial Number"
         ],
@@ -353,7 +367,7 @@
         "mapping": [
           {
             "identity": "udi",
-            "map": "The serial number which is a component of the the production identifier (PI), a conditional, variable portion of a UDI.   The identifier.type code should be set to “SNO”(Serial Number) and the system left empty."
+            "map": "The serial number which is a component of the production identifier (PI), a conditional, variable portion of a UDI.   The identifier.type code should be set to “SNO”(Serial Number) and the system left empty."
           },
           {
             "identity": "rim",
@@ -366,49 +380,391 @@
         ]
       },
       {
-        "id": "Device:uscoredevice.udiCarrier",
-        "path": "Device.udiCarrier",
+        "id": "Device:uscoredevice.udi",
+        "path": "Device.udi",
         "short": "Unique Device Identifier (UDI) Barcode string",
-        "definition": "[Unique device identifier (UDI)](device.html#5.11.3.2.2) barcode or rfid string assigned to device label or package.",
-        "comments": "The udiCarrier string may identify an unique instance of a device, or it may only identify the type of the device. The Human Readable format (HRF) is required in FHIR. AIDC identifiers cannot be conveyed in FHIR, Because of limitations on character sets in XML and the need to round-trip JSON data through XML.  See [UDI mappings](device-mappings.html#udi) for a complete mapping of UDI parts to Device.",
+        "definition": "[Unique device identifier (UDI)](device.html#5.11.3.2.2) assigned to device label or package.",
+        "comment": "UDI may identify an unique instance of a device, or it may only identify the type of the device.  See [UDI mappings](device-mappings.html#udi) for a complete mapping of UDI parts to Device.",
+        "min": 1,
+        "max": "1",
+        "base": {
+          "path": "Device.udi",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "BackboneElement"
+          }
+        ],
+        "constraint": [
+          {
+            "key": "ele-1",
+            "severity": "error",
+            "human": "All FHIR elements must have a @value or children",
+            "expression": "children().count() > id.count()",
+            "xpath": "@value|f:*|h:div",
+            "source": "Element"
+          }
+        ],
+        "mustSupport": true,
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".id and .code"
+          },
+          {
+            "identity": "w5",
+            "map": "id"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Device.udi"
+          }
+        ]
+      },
+      {
+        "id": "Device:uscoredevice.udi.id",
+        "path": "Device.udi.id",
+        "representation": [
+          "xmlAttr"
+        ],
+        "short": "xml:id (or equivalent in JSON)",
+        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Element.id",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "Device:uscoredevice.udi.extension",
+        "path": "Device.udi.extension",
+        "short": "Additional Content defined by implementations",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "Element.extension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "Device:uscoredevice.udi.modifierExtension",
+        "path": "Device.udi.modifierExtension",
+        "short": "Extensions that cannot be ignored",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
+          "extensions",
+          "user content",
+          "modifiers"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "BackboneElement.modifierExtension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "isModifier": true,
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "N/A"
+          }
+        ]
+      },
+      {
+        "id": "Device:uscoredevice.udi.deviceIdentifier",
+        "path": "Device.udi.deviceIdentifier",
+        "short": "Mandatory fixed portion of UDI",
+        "definition": "The device identifier (DI) is a mandatory, fixed portion of a UDI that identifies the labeler and the specific version or model of a device.",
+        "alias": [
+          "DI"
+        ],
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Device.udi.deviceIdentifier",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "udi",
+            "map": "The device identifier (DI), a mandatory, fixed portion of a UDI that identifies the labeler and the specific version or model of a device."
+          },
+          {
+            "identity": "rim",
+            "map": "Role.id.extension"
+          },
+          {
+            "identity": "w5",
+            "map": "what"
+          }
+        ]
+      },
+      {
+        "id": "Device:uscoredevice.udi.name",
+        "path": "Device.udi.name",
+        "short": "Device Name as appears on UDI label",
+        "definition": "Name of device as used in labeling or catalog.",
+        "comment": "Use the `Device.type`  for a generic type or kind of device name.  Note the [GUDID](http://www.fda.gov/medicaldevices/deviceregulationandguidance/uniquedeviceidentification/globaludidatabasegudid/default.htm) lists the name as the 'Brand Name'.",
+        "alias": [
+          "Brand Name"
+        ],
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Device.udi.name",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "udi",
+            "map": "Propietary/Trade Name of the medical Device as used in the labeling or catalog"
+          },
+          {
+            "identity": "rim",
+            "map": ".displayName"
+          },
+          {
+            "identity": "w5",
+            "map": "what"
+          }
+        ]
+      },
+      {
+        "id": "Device:uscoredevice.udi.jurisdiction",
+        "path": "Device.udi.jurisdiction",
+        "short": "Regional UDI authority",
+        "definition": "The identity of the authoritative source for UDI generation within a  jurisdiction.  All UDIs are globally unique within a single namespace. with the appropriate repository uri as the system.  For example,  UDIs of devices managed in the U.S. by the FDA, the value is  http://hl7.org/fhir/NamingSystem/fda-udi.",
+        "requirements": "Allows a recipient of a UDI to know which database will contain the UDI-associated metadata.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Device.udi.jurisdiction",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "uri"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "Role.scoper"
+          }
+        ]
+      },
+      {
+        "id": "Device:uscoredevice.udi.carrierHRF",
+        "path": "Device.udi.carrierHRF",
+        "short": "UDI Human Readable Barcode String",
+        "definition": "The full UDI carrier as the human readable form (HRF) representation of the barcode string as printed on the packaging of the device.",
+        "comment": "If separate barcodes for DI and PI are present, concatenate the string with DI first and in order of human readable expression on label.",
+        "alias": [
+          "Human Readable Form",
           "UDI",
           "Barcode String"
         ],
-        "min": 1,
+        "min": 0,
         "max": "1",
         "base": {
-          "path": "Device.udiCarrier",
+          "path": "Device.udi.carrierHRF",
           "min": 0,
           "max": "1"
         },
         "type": [
           {
-            "code": "Identifier"
+            "code": "string"
           }
         ],
-        "mustSupport": true,
-        "isSummary": false,
+        "mustSupport": false,
+        "isSummary": true,
         "mapping": [
           {
             "identity": "udi",
-            "map": "The full UDI carrier - The Human Readable Form (HRF) representation of the barcode string as printed on the packaging of the device.  The  'type' component should be set to “UDI” and the 'system' component to the the appropriate repository url.  the additional URL is needed to identify the authoritative source for UDI generation within the jurisdiction.  All UDIs are globally unique within a single namespace. with the appropriate repository uri as the system.  This allows a recipient of a UDI to know which database will contain the UDI-associated metadata.  For example,  UDIs of devices managed in the U.S. by the FDA, the value is  http://hl7.org/fhir/NamingSystem/fda-udi.  Because of limitations on character sets in XML and the need to round-trip JSON data through XML, AIDC identifiers cannot be conveyed in FHIR."
+            "map": "A unique device identifier (UDI) on a device label in plain text"
           },
           {
             "identity": "rim",
-            "map": ".id[where root is root for UDI]"
+            "map": "Role.id.extension"
           },
           {
-            "identity": "w5",
-            "map": "id"
+            "identity": "argonaut-dq-dstu2",
+            "map": "Device.udi"
+          }
+        ]
+      },
+      {
+        "id": "Device:uscoredevice.udi.carrierAIDC",
+        "path": "Device.udi.carrierAIDC",
+        "short": "UDI Machine Readable Barcode String",
+        "definition": "The full UDI carrier of the Automatic Identification and Data Capture (AIDC) technology representation of the barcode string as printed on the packaging of the device - E.g a barcode or RFID.   Because of limitations on character sets in XML and the need to round-trip JSON data through XML, AIDC Formats *SHALL* be base64 encoded.",
+        "comment": "The AIDC form of UDIs should be scanned or otherwise used for the identification of the device whenever possible to minimize errors in records resulting from manual transcriptions. If separate barcodes for DI and PI are present, concatenate the string with DI first and in order of human readable expression on label.",
+        "alias": [
+          "Automatic Identification and Data Capture",
+          "UDI",
+          "Barcode String"
+        ],
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Device.udi.carrierAIDC",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "base64Binary"
+          }
+        ],
+        "mustSupport": false,
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "udi",
+            "map": "A unique device identifier (UDI) on a device label a form that uses automatic identification and data capture (AIDC) technology."
+          },
+          {
+            "identity": "rim",
+            "map": "Role.id.extension"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "NA (not Supoorted)"
+          }
+        ]
+      },
+      {
+        "id": "Device:uscoredevice.udi.issuer",
+        "path": "Device.udi.issuer",
+        "short": "UDI Issuing Organization",
+        "definition": "Organization that is charged with issuing UDIs for devices.  For example, the US FDA issuers include :\n1) GS1: \nhttp://hl7.org/fhir/NamingSystem/gs1-di, \n2) HIBCC:\nhttp://hl7.org/fhir/NamingSystem/hibcc-dI, \n3) ICCBBA for blood containers:\nhttp://hl7.org/fhir/NamingSystem/iccbba-blood-di, \n4) ICCBA for other devices:\nhttp://hl7.org/fhir/NamingSystem/iccbba-other-di.",
+        "alias": [
+          "Barcode System"
+        ],
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Device.udi.issuer",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "uri"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "udi",
+            "map": "All UDIs are to be issued under a system operated by an Jurisdiction-accredited issuing agency.\nGS1 DIs: \n http://hl7.org/fhir/NamingSystem/gs1\nHIBCC DIs:\n http://hl7.org/fhir/NamingSystem/hibcc\nICCBBA DIs for blood containers:\n http://hl7.org/fhir/NamingSystem/iccbba-blood\nICCBA DIs for other devices:\n http://hl7.org/fhir/NamingSystem/iccbba-other"
+          },
+          {
+            "identity": "rim",
+            "map": "Role.id.root"
+          }
+        ]
+      },
+      {
+        "id": "Device:uscoredevice.udi.entryType",
+        "path": "Device.udi.entryType",
+        "short": "barcode | rfid | manual +",
+        "definition": "A coded entry to indicate how the data was entered.",
+        "requirements": "Supports a way to distinguish hand entered from machine read data.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Device.udi.entryType",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "code"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "UDIEntryType"
+            }
+          ],
+          "strength": "required",
+          "description": "Codes to identify how UDI data was entered",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/udi-entry-type"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "NA"
           }
         ]
       },
       {
         "id": "Device:uscoredevice.status",
         "path": "Device.status",
-        "short": "available | not-available | entered-in-error",
+        "short": "active | inactive | entered-in-error | unknown",
         "definition": "Status of the Device availability.",
+        "comment": "This element is labeled as a modifier because the status contains the codes inactive and entered-in-error that mark the device (record)as not currently valid.",
         "min": 0,
         "max": "1",
         "base": {
@@ -424,17 +780,19 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "FHIRDeviceStatus"
+            }
+          ],
           "strength": "required",
           "description": "The availability status of the device.",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/devicestatus"
+            "reference": "http://hl7.org/fhir/ValueSet/device-status"
           }
         },
         "mapping": [
-          {
-            "identity": "udi",
-            "map": "N/A"
-          },
           {
             "identity": "rim",
             "map": ".statusCode"
@@ -450,7 +808,6 @@
         "path": "Device.type",
         "short": "What kind of device this is",
         "definition": "Code or identifier to identify a kind of device.",
-        "comments": "There can be different code values thath may correspond to different granularities of the same concept.  These can be represented as translations using  the [codeableConcept](datatypes.html#codeableconcept) datatype.  For [UDI](device.html#5.11.3.2.2), this element corresponds to the UDI device identifier (DI) part. See [UDI mappings](device-mappings.html#udi) for a complete mapping of UDI parts to Device.",
         "min": 1,
         "max": "1",
         "base": {
@@ -464,7 +821,6 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
         "binding": {
           "strength": "extensible",
           "description": "Codes to identify medical devices",
@@ -475,7 +831,7 @@
         "mapping": [
           {
             "identity": "udi",
-            "map": "The device identifier (DI), a mandatory, fixed portion of a UDI that identifies the labeler and the specific version or model of a devicet.  The system uri should be included. Possible URIs include GS1 DIs:   http://hl7.org/fhir/NamingSystem/gs1-di HIBCC DIs:  http://hl7.org/fhir/NamingSystem/hibcc-di ICCBBA DIs for blood containers:  http://hl7.org/fhir/NamingSystem/iccbba-blood-di ICCBA DIs for other devices:  http://hl7.org/fhir/NamingSystem/iccbba-other-di"
+            "map": "Type description using GMDN or other code system"
           },
           {
             "identity": "rim",
@@ -484,6 +840,10 @@
           {
             "identity": "w5",
             "map": "what"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Device.type"
           }
         ]
       },
@@ -492,7 +852,6 @@
         "path": "Device.lotNumber",
         "short": "Lot number of manufacture",
         "definition": "Lot number assigned by the manufacturer.",
-        "comments": "Alphanumeric. For [UDI](device.html#5.11.3.2.2), this element corresponds to the variable portion of a UDI that identifies the lot or batch number within which a physical instance of a device was manufactured. See [UDI mappings](device-mappings.html#udi) for a complete mapping of UDI parts to Device.",
         "min": 0,
         "max": "1",
         "base": {
@@ -508,7 +867,7 @@
         "mapping": [
           {
             "identity": "udi",
-            "map": "The lot or batch number within which a device was manufactured - which is a component of the the production identifier (PI), a conditional, variable portion of a UDI."
+            "map": "The lot or batch number within which a device was manufactured - which is a component of the production identifier (PI), a conditional, variable portion of a UDI."
           },
           {
             "identity": "rim",
@@ -557,7 +916,6 @@
         "path": "Device.manufactureDate",
         "short": "Date when the device was made",
         "definition": "The date and time when the device was manufactured.",
-        "comments": "For [UDI](device.html#5.11.3.2.2), this element corresponds to the variable portion of a UDI that identifies the date a physical instance of a device was manufactured. See [UDI mappings](device-mappings.html#udi) for a complete mapping of UDI parts to Device.",
         "min": 0,
         "max": "1",
         "base": {
@@ -573,7 +931,7 @@
         "mapping": [
           {
             "identity": "udi",
-            "map": "The date a specific device was manufactured - which is a component of the the production identifier (PI), a conditional, variable portion of a UDI.  For FHIR, The datetime syntax must converted to YYYY-MM-DD[THH:MM:SS].  If hour is present, the minutes and seconds should both be set to “00”."
+            "map": "The date a specific device was manufactured - which is a component of the production identifier (PI), a conditional, variable portion of a UDI.  For FHIR, The datetime syntax must converted to YYYY-MM-DD[THH:MM:SS].  If hour is present, the minutes and seconds should both be set to “00”."
           },
           {
             "identity": "rim",
@@ -590,7 +948,6 @@
         "path": "Device.expirationDate",
         "short": "Date and time of expiry of this device (if applicable)",
         "definition": "The date and time beyond which this device is no longer valid or should not be used (if applicable).",
-        "comments": "For [UDI](device.html#5.11.3.2.2), this element corresponds to the variable portion of a UDI that identifies the expiration date of a physical instance of a device. See [UDI mappings](device-mappings.html#udi) for a complete mapping of UDI parts to Device.",
         "min": 0,
         "max": "1",
         "base": {
@@ -606,7 +963,7 @@
         "mapping": [
           {
             "identity": "udi",
-            "map": "the expiration date of a specific device -  which is a component of the the production identifier (PI), a conditional, variable portion of a UDI.  For FHIR, The datetime syntax must converted to YYYY-MM-DD[THH:MM:SS].  If hour is present, the minutes and seconds should both be set to “00”."
+            "map": "the expiration date of a specific device -  which is a component of the production identifier (PI), a conditional, variable portion of a UDI.  For FHIR, The datetime syntax must converted to YYYY-MM-DD[THH:MM:SS].  If hour is present, the minutes and seconds should both be set to “00”."
           },
           {
             "identity": "rim",
@@ -636,10 +993,6 @@
           }
         ],
         "mapping": [
-          {
-            "identity": "udi",
-            "map": "N/A"
-          },
           {
             "identity": "rim",
             "map": ".playedRole[typeCode=MANU].code"
@@ -668,10 +1021,6 @@
           }
         ],
         "mapping": [
-          {
-            "identity": "udi",
-            "map": "N/A"
-          },
           {
             "identity": "rim",
             "map": ".softwareName (included as part)"
@@ -702,12 +1051,7 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
         "mapping": [
-          {
-            "identity": "udi",
-            "map": "N/A"
-          },
           {
             "identity": "rim",
             "map": ".playedRole[typeCode=USED].scoper.playedRole[typeCode=PAT]"
@@ -715,6 +1059,10 @@
           {
             "identity": "w5",
             "map": "who.focus"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Device.patient"
           }
         ]
       },
@@ -737,10 +1085,6 @@
           }
         ],
         "mapping": [
-          {
-            "identity": "udi",
-            "map": "N/A"
-          },
           {
             "identity": "rim",
             "map": ".playedRole[typeCode=OWN].scoper"
@@ -756,7 +1100,7 @@
         "path": "Device.contact",
         "short": "Details for human/organization for support",
         "definition": "Contact details for an organization or a particular human that is responsible for the device.",
-        "comments": "used for troubleshooting etc.",
+        "comment": "used for troubleshooting etc.",
         "min": 0,
         "max": "*",
         "base": {
@@ -770,10 +1114,6 @@
           }
         ],
         "mapping": [
-          {
-            "identity": "udi",
-            "map": "N/A"
-          },
           {
             "identity": "rim",
             "map": ".scopedRole[typeCode=CON].player"
@@ -804,10 +1144,6 @@
           }
         ],
         "mapping": [
-          {
-            "identity": "udi",
-            "map": "N/A"
-          },
           {
             "identity": "rim",
             "map": ".playedRole[typeCode=LOCE].scoper"
@@ -823,7 +1159,7 @@
         "path": "Device.url",
         "short": "Network address to contact device",
         "definition": "A network address on which the device may be contacted directly.",
-        "comments": "If the device is running a FHIR server, the network address should  be the Base URL from which a conformance statement may be retrieved.",
+        "comment": "If the device is running a FHIR server, the network address should  be the Base URL from which a conformance statement may be retrieved.",
         "min": 0,
         "max": "1",
         "base": {
@@ -837,10 +1173,6 @@
           }
         ],
         "mapping": [
-          {
-            "identity": "udi",
-            "map": "N/A"
-          },
           {
             "identity": "rim",
             "map": ".telecom"
@@ -869,15 +1201,49 @@
           }
         ],
         "mapping": [
-          {
-            "identity": "udi",
-            "map": "N/A"
-          },
           {
             "identity": "rim",
             "map": ".text"
           }
         ]
+      },
+      {
+        "id": "Device:uscoredevice.safety",
+        "path": "Device.safety",
+        "short": "Safety Characteristics of Device",
+        "definition": "Provides additional safety characteristics about a medical device.  For example devices containing latex.",
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "Device.safety",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "DeviceSafety"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes used to identify medical devices safety characterics. These codes are derived in part from the [United States Food and Drug Administration recommendations](http://www.fda.gov/downloads/medicaldevices/deviceregulationandguidance/guidancedocuments/ucm107708.pdf) and are provided here as a suggestive example.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/device-safety"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "NA"
+          }
+        ]
       }
     ]
   },
@@ -891,25 +1257,72 @@
         "definition": "The US Core Implanted Device Profile is based upon the core FHIR Device Resource and created to meet the 2015 Edition Common Clinical Data Set 'Unique device identifier(s) for a patient’s implantable device(s)' requirements.",
         "mustSupport": false,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Device"
+          }
+        ]
+      },
+      {
+        "id": "Device:uscoredevice.udi",
+        "path": "Device.udi",
+        "min": 1,
+        "max": "1",
+        "mustSupport": true,
+        "isModifier": false,
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Device.udi"
+          }
+        ]
+      },
+      {
+        "id": "Device:uscoredevice.udi.carrierHRF",
+        "path": "Device.udi.carrierHRF",
+        "alias": [
+          "UDI",
+          "Barcode String"
+        ],
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "mustSupport": false,
+        "isModifier": false,
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Device.udi"
+          }
+        ]
       },
       {
-        "id": "Device:uscoredevice.udiCarrier",
-        "path": "Device.udiCarrier",
+        "id": "Device:uscoredevice.udi.carrierAIDC",
+        "path": "Device.udi.carrierAIDC",
         "alias": [
           "UDI",
           "Barcode String"
         ],
-        "min": 1,
+        "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "Identifier"
+            "code": "base64Binary"
           }
         ],
-        "mustSupport": true,
+        "mustSupport": false,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "NA (not Supoorted)"
+          }
+        ]
       },
       {
         "id": "Device:uscoredevice.type",
@@ -923,14 +1336,19 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false,
         "binding": {
           "strength": "extensible",
           "description": "Codes to identify medical devices",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/device-kind"
           }
-        }
+        },
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Device.type"
+          }
+        ]
       },
       {
         "id": "Device:uscoredevice.patient",
@@ -945,8 +1363,13 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Device.patient"
+          }
+        ]
       }
     ]
   }
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/StructureDefinition-us-core-diagnosticreport.json b/lib/resources/us_core/StructureDefinition-us-core-diagnosticreport.json
index c5b511f..6a1b31c 100755
--- a/lib/resources/us_core/StructureDefinition-us-core-diagnosticreport.json
+++ b/lib/resources/us_core/StructureDefinition-us-core-diagnosticreport.json
@@ -3,12 +3,14 @@
   "id": "us-core-diagnosticreport",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport</a></p><p><b>name</b>: US Core Diagnostic Report Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: Health Level Seven International (FHIR-Infrastructure)</p><p><b>contact</b>: </p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport</a></p><p><b>name</b>: US Core Diagnostic Report Profile</p><p><b>status</b>: DRAFT</p><p><b>publisher</b>: Health Level Seven International (FHIR-Infrastructure)</p><p><b>contact</b>: </p><p><b>date</b>: 01/08/2016</p><blockquote><p><b>mapping</b></p><p><b>identity</b>: v2</p><p><b>uri</b>: <a href=\"http://hl7.org/v2\">http://hl7.org/v2</a></p><p><b>name</b>: HL7 v2 Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: rim</p><p><b>uri</b>: <a href=\"http://hl7.org/v3\">http://hl7.org/v3</a></p><p><b>name</b>: RIM Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: w5</p><p><b>uri</b>: <a href=\"http://hl7.org/fhir/w5\">http://hl7.org/fhir/w5</a></p><p><b>name</b>: W5 Mapping</p></blockquote><p><b>kind</b>: RESOURCE</p><p><b>abstract</b>: false</p><p><b>type</b>: DiagnosticReport</p><p><b>baseDefinition</b>: <a href=\"http://hl7.org/fhir/StructureDefinition/DiagnosticReport\">http://hl7.org/fhir/StructureDefinition/DiagnosticReport</a></p><p><b>derivation</b>: CONSTRAINT</p><h3>Snapshots</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table><h3>Differentials</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table></div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: US  Core DiagnosticReport Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: HL7 US Realm Steering Committee</p><p><b>contact</b>: </p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: US  Core DiagnosticReport Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: HL7 US Realm Steering Committee</p><p><b>contact</b>: </p><p><b>fhirVersion</b>: 3.0.0</p><blockquote><p><b>mapping</b></p><p><b>identity</b>: argonaut-dq-dstu2</p><p><b>uri</b>: <a href=\"http://unknown.org/Argonaut DQ DSTU2\">http://unknown.org/Argonaut DQ DSTU2</a></p><p><b>name</b>: Argonaut DQ DSTU2</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: workflow</p><p><b>uri</b>: <a href=\"http://hl7.org/fhir/workflow\">http://hl7.org/fhir/workflow</a></p><p><b>name</b>: Workflow Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: v2</p><p><b>uri</b>: <a href=\"http://hl7.org/v2\">http://hl7.org/v2</a></p><p><b>name</b>: HL7 v2 Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: rim</p><p><b>uri</b>: <a href=\"http://hl7.org/v3\">http://hl7.org/v3</a></p><p><b>name</b>: RIM Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: w5</p><p><b>uri</b>: <a href=\"http://hl7.org/fhir/w5\">http://hl7.org/fhir/w5</a></p><p><b>name</b>: W5 Mapping</p></blockquote><p><b>kind</b>: RESOURCE</p><p><b>abstract</b>: false</p><p><b>type</b>: DiagnosticReport</p><p><b>baseDefinition</b>: <a href=\"http://hl7.org/fhir/StructureDefinition/DiagnosticReport\">http://hl7.org/fhir/StructureDefinition/DiagnosticReport</a></p><p><b>derivation</b>: CONSTRAINT</p><h3>Snapshots</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table><h3>Differentials</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table></div>"
   },
   "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport",
-  "name": "US Core Diagnostic Report Profile",
+  "version": "1.0.0",
+  "name": "US  Core DiagnosticReport Profile",
   "status": "draft",
-  "publisher": "Health Level Seven International (FHIR-Infrastructure)",
+  "date": "2016-08-01",
+  "publisher": "HL7 US Realm Steering Committee",
   "contact": [
     {
       "telecom": [
@@ -19,8 +21,18 @@
       ]
     }
   ],
-  "date": "2016-08-01",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "argonaut-dq-dstu2",
+      "uri": "http://unknown.org/Argonaut DQ DSTU2",
+      "name": "Argonaut DQ DSTU2"
+    },
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -50,7 +62,7 @@
         "sliceName": "USCoreDiagnosticReport",
         "short": "US Core Diagnostic Report Profile",
         "definition": "The US Core Diagnostic Report Profile is based upon the core FHIR DiagnosticReport Resource and created to meet the 2015 Edition Common Clinical Data Set 'Laboratory test(s) and Laboratory value(s)/result(s)' requirements.",
-        "comments": "This is intended to capture a single report, and is not suitable for use in displaying summary information that covers multiple reports.  For example, this resource has not been designed for laboratory cumulative reporting formats nor detailed structured reports for sequencing.",
+        "comment": "This is intended to capture a single report, and is not suitable for use in displaying summary information that covers multiple reports.  For example, this resource has not been designed for laboratory cumulative reporting formats nor detailed structured reports for sequencing.",
         "alias": [
           "Report",
           "Test",
@@ -100,22 +112,18 @@
             "expression": "contained.where(('#'+id in %resource.descendants().reference).not()).empty()",
             "xpath": "not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat('#', $id))]))",
             "source": "DomainResource"
-          },
-          {
-            "key": "us-core-1",
-            "severity": "error",
-            "human": "Must have a result or presentedForm or both.",
-            "expression": "result.exists() or presemtedForm.exists()",
-            "xpath": "exists(f:result) or exists(f:presentedForm)"
           }
         ],
         "mustSupport": false,
-        "isSummary": false,
         "mapping": [
           {
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
           {
             "identity": "v2",
             "map": "ORU -> OBR"
@@ -127,6 +135,10 @@
           {
             "identity": "w5",
             "map": "clinical.diagnostics"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "DiagnosticReport"
           }
         ]
       },
@@ -135,7 +147,7 @@
         "path": "DiagnosticReport.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -174,7 +186,7 @@
         "path": "DiagnosticReport.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -195,7 +207,7 @@
         "path": "DiagnosticReport.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -215,6 +227,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -229,7 +249,7 @@
         "path": "DiagnosticReport.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -263,7 +283,7 @@
         "path": "DiagnosticReport.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -293,7 +313,7 @@
         "path": "DiagnosticReport.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -322,7 +342,7 @@
         "path": "DiagnosticReport.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -350,11 +370,14 @@
       {
         "id": "DiagnosticReport:uscorediagnosticreport.identifier",
         "path": "DiagnosticReport.identifier",
-        "short": "Id for external references to this report",
-        "definition": "The local ID assigned to the report by the order filler, usually by the Information System of the diagnostic service provider.",
+        "short": "Business identifier for report",
+        "definition": "Identifiers assigned to this report by the performer or other systems.",
+        "comment": "Usually assigned by the Information System of the diagnostic service provider (filler id).",
         "requirements": "Need to know what identifier to use when making queries about this report from the source laboratory, and for linking to the report outside FHIR context.",
         "alias": [
-          "ReportID"
+          "ReportID",
+          "Filler ID",
+          "Placer ID"
         ],
         "min": 0,
         "max": "*",
@@ -370,6 +393,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBR-51"
@@ -384,12 +411,70 @@
           }
         ]
       },
+      {
+        "id": "DiagnosticReport:uscorediagnosticreport.basedOn",
+        "path": "DiagnosticReport.basedOn",
+        "short": "What was requested",
+        "definition": "Details concerning a test or procedure requested.",
+        "comment": "Note: Usually there is one test request for each result, however in some circumstances multiple test requests may be represented using a single test result resource. Note that there are also cases where one request leads to multiple reports.",
+        "requirements": "This allows tracing of authorization for the report and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Request"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "DiagnosticReport.basedOn",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC? OBR-2/3?"
+          },
+          {
+            "identity": "rim",
+            "map": "outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "DiagnosticReport:uscorediagnosticreport.status",
         "path": "DiagnosticReport.status",
-        "short": "registered | partial | final | corrected | appended | cancelled | entered-in-error",
+        "short": "registered | partial | preliminary | final +",
         "definition": "The status of the diagnostic report as a whole.",
-        "comments": "This is labeled as \"Is Modifier\" because applications need to take appropriate action if a report is withdrawn.",
+        "comment": "This is labeled as \"Is Modifier\" because applications need to take appropriate action if a report is withdrawn.",
         "requirements": "Diagnostic services routinely issue provisional/incomplete reports, and sometimes withdraw previously released reports.",
         "min": 1,
         "max": "1",
@@ -405,7 +490,7 @@
         ],
         "mustSupport": true,
         "isModifier": true,
-        "isSummary": false,
+        "isSummary": true,
         "binding": {
           "strength": "required",
           "valueSetReference": {
@@ -413,6 +498,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
           {
             "identity": "v2",
             "map": "OBR-25 (not 1:1 mapping)"
@@ -424,6 +513,10 @@
           {
             "identity": "w5",
             "map": "status"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "DiagnosticReport.status"
           }
         ]
       },
@@ -432,8 +525,12 @@
         "path": "DiagnosticReport.category",
         "short": "Service category",
         "definition": "A code that classifies the clinical discipline, department or diagnostic service that created the report (e.g. cardiology, biochemistry, hematology, MRI). This is used for searching, sorting and display purposes.",
-        "comments": "The level of granularity is defined by the category concepts in the value set. More fine-grained filtering can be performed using the metadata and/or terminology hierarchy in DiagnosticReport.code.",
+        "comment": "The level of granularity is defined by the category concepts in the value set. More fine-grained filtering can be performed using the metadata and/or terminology hierarchy in DiagnosticReport.code.",
         "alias": [
+          "Department",
+          "Sub-department",
+          "Service",
+          "Discipline",
           "Department",
           "Sub-department",
           "service",
@@ -454,14 +551,20 @@
         "patternCodeableConcept": {
           "coding": [
             {
-              "system": "http://hl7.org/fhir/DiagnosticReport-category",
+              "system": "http://hl7.org/fhir/v2/0074",
               "code": "LAB"
             }
           ]
         },
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "DiagnosticServiceSection"
+            }
+          ],
           "strength": "example",
           "description": "Codes for diagnostic service sections.",
           "valueSetReference": {
@@ -480,15 +583,22 @@
           {
             "identity": "w5",
             "map": "class"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "DiagnosticReport.category"
           }
         ]
       },
       {
         "id": "DiagnosticReport:uscorediagnosticreport.code",
         "path": "DiagnosticReport.code",
-        "short": "US Realm Laboratory Report Order Code",
+        "short": "US Core Laboratory Report Order Code",
         "definition": "The test, panel or battery that was ordered.",
-        "comments": "UsageNote= The typical patterns for codes are:  1)  a LOINC code either as a  translation from a \"local\" code or as a primary code, or 2)  a local code only if no suitable LOINC exists,  or 3)  both the local and the LOINC translation.   Systems SHALL be capable of sending the local code if one exists.",
+        "comment": "UsageNote= The typical patterns for codes are:  1)  a LOINC code either as a  translation from a \"local\" code or as a primary code, or 2)  a local code only if no suitable LOINC exists,  or 3)  both the local and the LOINC translation.   Systems SHALL be capable of sending the local code if one exists.",
+        "alias": [
+          "Type"
+        ],
         "min": 1,
         "max": "1",
         "base": {
@@ -502,7 +612,7 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "binding": {
           "strength": "extensible",
           "description": "LOINC codes",
@@ -511,6 +621,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
           {
             "identity": "v2",
             "map": "OBR-4 (HL7 v2 doesn't provide an easy way to indicate both the ordered test and the performed panel)"
@@ -522,13 +636,17 @@
           {
             "identity": "w5",
             "map": "what"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "DiagnosticReport.code"
           }
         ]
       },
       {
         "id": "DiagnosticReport:uscorediagnosticreport.subject",
         "path": "DiagnosticReport.subject",
-        "short": "The subject of the report, usually, but not always, the patient",
+        "short": "The subject of the report - usually, but not always, the patient",
         "definition": "The subject of the report. Usually, but not always, this is a patient. However diagnostic services also perform analyses on specimens collected from a variety of other sources.",
         "requirements": "SHALL know the subject context.",
         "alias": [
@@ -548,8 +666,12 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3 (no HL7 v2 mapping for Group or Device)"
@@ -561,18 +683,27 @@
           {
             "identity": "w5",
             "map": "who.focus"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "DiagnosticReport.subject"
           }
         ]
       },
       {
-        "id": "DiagnosticReport:uscorediagnosticreport.encounter",
-        "path": "DiagnosticReport.encounter",
+        "id": "DiagnosticReport:uscorediagnosticreport.context",
+        "path": "DiagnosticReport.context",
         "short": "Health care event when test ordered",
-        "definition": "The link to the health care event (encounter) when the order was made.",
+        "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) which this DiagnosticReport per is about.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
+        "requirements": "Links the request to the Encounter context.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "base": {
-          "path": "DiagnosticReport.encounter",
+          "path": "DiagnosticReport.context",
           "min": 0,
           "max": "1"
         },
@@ -580,10 +711,18 @@
           {
             "code": "Reference",
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1-19"
@@ -603,11 +742,12 @@
         "path": "DiagnosticReport.effective[x]",
         "short": "Specimen Collection Datetime or Period",
         "definition": "This is the Specimen Collection Datetime or Period which is the physically relevent dateTime for laboratory tests.",
-        "comments": "If the diagnostic procedure was performed on the patient, this is the time it was performed. If there are specimens, the diagnostically relevant time can be derived from the specimen collection times, but the specimen information is not always available, and the exact relationship between the specimens and the diagnostically relevant time is not always automatic.",
+        "comment": "If the diagnostic procedure was performed on the patient, this is the time it was performed. If there are specimens, the diagnostically relevant time can be derived from the specimen collection times, but the specimen information is not always available, and the exact relationship between the specimens and the diagnostically relevant time is not always automatic.",
         "requirements": "Need to know where in the patient history to file/present this report.",
         "alias": [
           "Observation time",
-          "Effective Time"
+          "Effective Time",
+          "Occurrence"
         ],
         "min": 1,
         "max": "1",
@@ -625,8 +765,12 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBR-7"
@@ -638,6 +782,10 @@
           {
             "identity": "w5",
             "map": "when.done"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "DiagnosticReport.effective[x]"
           }
         ]
       },
@@ -646,7 +794,7 @@
         "path": "DiagnosticReport.issued",
         "short": "DateTime this version was released",
         "definition": "The date and time that this version of the report was released from the source diagnostic service.",
-        "comments": "May be different from the update time of the resource itself, because that is the status of the record (potentially a secondary copy), not the actual release time of the report.",
+        "comment": "May be different from the update time of the resource itself, because that is the status of the record (potentially a secondary copy), not the actual release time of the report.",
         "requirements": "Clinicians need to be able to check the date that the report was released.",
         "alias": [
           "Date Created",
@@ -666,7 +814,7 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -679,16 +827,18 @@
           {
             "identity": "w5",
             "map": "when.recorded"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "DiagnosticReport.issued"
           }
         ]
       },
       {
         "id": "DiagnosticReport:uscorediagnosticreport.performer",
         "path": "DiagnosticReport.performer",
-        "short": "Responsible Diagnostic Service",
-        "definition": "The diagnostic service that is responsible for issuing the report.",
-        "comments": "This is not necessarily the source of the atomic data items. It is the entity that takes responsibility for the clinical report.",
-        "requirements": "Need to know whom to contact if there are queries about the results. Also may need to track the source of reports for secondary data analysis.",
+        "short": "Participants in producing the report",
+        "definition": "Indicates who or what participated in producing the report.",
         "alias": [
           "Laboratory",
           "Service",
@@ -705,67 +855,220 @@
         },
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-pract"
-          },
+            "code": "BackboneElement"
+          }
+        ],
+        "constraint": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization"
+            "key": "ele-1",
+            "severity": "error",
+            "human": "All FHIR elements must have a @value or children",
+            "expression": "children().count() > id.count()",
+            "xpath": "@value|f:*|h:div",
+            "source": "Element"
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "PRT-8 (where this PRT-4-Participation = \"PO\")"
           },
           {
             "identity": "rim",
-            "map": "participation[typeCode=AUT].role[classCode=ASSIGN].scoper"
+            "map": ".participation[typeCode=PRF]"
           },
           {
             "identity": "w5",
             "map": "who.witness"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "NA (new element in STU3)"
           }
         ]
       },
       {
-        "id": "DiagnosticReport:uscorediagnosticreport.request",
-        "path": "DiagnosticReport.request",
-        "short": "What was requested",
-        "definition": "Details concerning a test or procedure requested.",
-        "comments": "Note: Usually there is one test request for each result, however in some circumstances multiple test requests may be represented using a single test result resource. Note that there are also cases where one request leads to multiple reports.",
-        "requirements": "Need to be able to track completion of requests based on reports issued and also to report what diagnostic tests were requested (not always the same as what is delivered).",
+        "id": "DiagnosticReport:uscorediagnosticreport.performer.id",
+        "path": "DiagnosticReport.performer.id",
+        "representation": [
+          "xmlAttr"
+        ],
+        "short": "xml:id (or equivalent in JSON)",
+        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Element.id",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "DiagnosticReport:uscorediagnosticreport.performer.extension",
+        "path": "DiagnosticReport.performer.extension",
+        "short": "Additional Content defined by implementations",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content"
+        ],
         "min": 0,
         "max": "*",
         "base": {
-          "path": "DiagnosticReport.request",
+          "path": "Element.extension",
           "min": 0,
           "max": "*"
         },
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DiagnosticRequest"
+            "code": "Extension"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "DiagnosticReport:uscorediagnosticreport.performer.modifierExtension",
+        "path": "DiagnosticReport.performer.modifierExtension",
+        "short": "Extensions that cannot be ignored",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content",
+          "modifiers"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "BackboneElement.modifierExtension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "isModifier": true,
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "N/A"
+          }
+        ]
+      },
+      {
+        "id": "DiagnosticReport:uscorediagnosticreport.performer.role",
+        "path": "DiagnosticReport.performer.role",
+        "short": "Type of performer",
+        "definition": "Describes the type of participation (e.g.  a responsible party, author, or verifier).",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "DiagnosticReport.performer.role",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Role"
+            }
+          ],
+          "strength": "example",
+          "description": "Indicate a role of diagnostic report performer",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/performer-role"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer.role"
+          },
+          {
+            "identity": "v2",
+            "map": "PRT-8 (where this PRT-4-Participation = \"PO\")"
           },
+          {
+            "identity": "rim",
+            "map": ".functionCode"
+          }
+        ]
+      },
+      {
+        "id": "DiagnosticReport:uscorediagnosticreport.performer.actor",
+        "path": "DiagnosticReport.performer.actor",
+        "short": "Practitioner or Organization  participant",
+        "definition": "The reference to the  practitioner or organization involved in producing the report. For example, the diagnostic service that is responsible for issuing the report.",
+        "comment": "This is not necessarily the source of the atomic data items. It is the entity that takes responsibility for the clinical report.",
+        "requirements": "Need to know whom to contact if there are queries about the results. Also may need to track the source of reports for secondary data analysis.",
+        "min": 1,
+        "max": "1",
+        "base": {
+          "path": "DiagnosticReport.performer.actor",
+          "min": 1,
+          "max": "1"
+        },
+        "type": [
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+            "targetProfile": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner"
           },
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+            "targetProfile": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization"
           }
         ],
+        "mustSupport": true,
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer.actor"
+          },
           {
             "identity": "v2",
-            "map": "ORC? OBR-2/3?"
+            "map": "PRT-8 (where this PRT-4-Participation = \"PO\")"
           },
           {
             "identity": "rim",
-            "map": "outboundRelationship[typeCode=FLFS].target"
+            "map": ".role"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "DiagnosticReport.performer"
           }
         ]
       },
@@ -774,7 +1077,7 @@
         "path": "DiagnosticReport.specimen",
         "short": "Specimens this report is based on",
         "definition": "Details about the specimens on which this diagnostic report is based.",
-        "comments": "If the specimen is sufficiently specified with a code in the test result name, then this additional data may be redundant. If there are multiple specimens, these may be represented per Observation or group.",
+        "comment": "If the specimen is sufficiently specified with a code in the test result name, then this additional data may be redundant. If there are multiple specimens, these may be represented per observation or group.",
         "requirements": "Need to be able to report information about the collected specimens on which the report is based.",
         "min": 0,
         "max": "*",
@@ -831,7 +1134,6 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
         "mapping": [
           {
             "identity": "v2",
@@ -840,6 +1142,10 @@
           {
             "identity": "rim",
             "map": "outboundRelationship[typeCode=COMP].target"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "DiagnosticReport.result"
           }
         ]
       },
@@ -848,7 +1154,7 @@
         "path": "DiagnosticReport.imagingStudy",
         "short": "Reference to full details of imaging associated with the diagnostic report",
         "definition": "One or more links to full details of any imaging performed during the diagnostic investigation. Typically, this is imaging performed by DICOM enabled modalities, but this is not required. A fully enabled PACS viewer can use this information to provide views of the source images.",
-        "comments": "ImagingStudy and ImageManifest and the image element are somewhat overlapping - typically, the list of image references in the image element will also be found in one of the imaging study resources. However each caters to different types of displays for different types of purposes. Neither, either, or both may be provided.",
+        "comment": "ImagingStudy and ImageManifest and the image element are somewhat overlapping - typically, the list of image references in the image element will also be found in one of the imaging study resources. However each caters to different types of displays for different types of purposes. Neither, either, or both may be provided.",
         "min": 0,
         "max": "*",
         "base": {
@@ -906,6 +1212,7 @@
             "source": "Element"
           }
         ],
+        "mustSupport": true,
         "isSummary": true,
         "mapping": [
           {
@@ -915,6 +1222,10 @@
           {
             "identity": "rim",
             "map": "outboundRelationship[typeCode=COMP].target"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "DiagnosticReport.image"
           }
         ]
       },
@@ -950,7 +1261,7 @@
         "path": "DiagnosticReport.image.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -979,7 +1290,7 @@
         "path": "DiagnosticReport.image.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1011,7 +1322,7 @@
         "path": "DiagnosticReport.image.comment",
         "short": "Comment about the image (e.g. explanation)",
         "definition": "A comment about the image. Typically, this is used to provide an explanation for why the image is included, or to draw the viewer's attention to important features.",
-        "comments": "The comment should be displayed with the image. It would be common for the report to include additional discussion of the image contents in other sections such as the conclusion.",
+        "comment": "The comment should be displayed with the image. It would be common for the report to include additional discussion of the image contents in other sections such as the conclusion.",
         "requirements": "The provider of the report should make a comment about each image included in the report.",
         "min": 0,
         "max": "1",
@@ -1108,8 +1419,14 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AdjunctDiagnosis"
+            }
+          ],
           "strength": "example",
-          "description": "Diagnoses codes provided as adjuncts to the report.",
+          "description": "Diagnosis codes provided as adjuncts to the report.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/clinical-findings"
           }
@@ -1130,8 +1447,8 @@
         "path": "DiagnosticReport.presentedForm",
         "short": "Entire report as issued",
         "definition": "Rich text representation of the entire result as issued by the diagnostic service. Multiple formats are allowed but they SHALL be semantically equivalent.",
-        "comments": "\"application/pdf\" is recommended as the most reliable and interoperable in this context.",
-        "requirements": "Gives Laboratory the ability to provide its own fully formatted report for clinical fidelity.",
+        "comment": "\"application/pdf\" is recommended as the most reliable and interoperable in this context.",
+        "requirements": "Gives laboratory the ability to provide its own fully formatted report for clinical fidelity.",
         "min": 0,
         "max": "*",
         "base": {
@@ -1145,7 +1462,6 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
         "mapping": [
           {
             "identity": "v2",
@@ -1154,6 +1470,10 @@
           {
             "identity": "rim",
             "map": "text (type=ED)"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "DiagnosticReport.presentedForm"
           }
         ]
       }
@@ -1171,18 +1491,14 @@
           "Lab Result",
           "Lab Report"
         ],
-        "constraint": [
-          {
-            "key": "us-core-1",
-            "severity": "error",
-            "human": "Must have a result or presentedForm or both.",
-            "expression": "result.exists() or presemtedForm.exists()",
-            "xpath": "exists(f:result) or exists(f:presentedForm)"
-          }
-        ],
         "mustSupport": false,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "DiagnosticReport"
+          }
+        ]
       },
       {
         "id": "DiagnosticReport:uscorediagnosticreport.status",
@@ -1196,13 +1512,18 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false,
         "binding": {
           "strength": "required",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/diagnostic-report-status"
           }
-        }
+        },
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "DiagnosticReport.status"
+          }
+        ]
       },
       {
         "id": "DiagnosticReport:uscorediagnosticreport.category",
@@ -1223,21 +1544,26 @@
         "patternCodeableConcept": {
           "coding": [
             {
-              "system": "http://hl7.org/fhir/DiagnosticReport-category",
+              "system": "http://hl7.org/fhir/v2/0074",
               "code": "LAB"
             }
           ]
         },
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "DiagnosticReport.category"
+          }
+        ]
       },
       {
         "id": "DiagnosticReport:uscorediagnosticreport.code",
         "path": "DiagnosticReport.code",
-        "short": "US Realm Laboratory Report Order Code",
+        "short": "US Core Laboratory Report Order Code",
         "definition": "The test, panel or battery that was ordered.",
-        "comments": "UsageNote= The typical patterns for codes are:  1)  a LOINC code either as a  translation from a \"local\" code or as a primary code, or 2)  a local code only if no suitable LOINC exists,  or 3)  both the local and the LOINC translation.   Systems SHALL be capable of sending the local code if one exists.",
+        "comment": "UsageNote= The typical patterns for codes are:  1)  a LOINC code either as a  translation from a \"local\" code or as a primary code, or 2)  a local code only if no suitable LOINC exists,  or 3)  both the local and the LOINC translation.   Systems SHALL be capable of sending the local code if one exists.",
         "min": 1,
         "max": "1",
         "type": [
@@ -1247,14 +1573,19 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false,
         "binding": {
           "strength": "extensible",
           "description": "LOINC codes",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/report-codes"
           }
-        }
+        },
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "DiagnosticReport.code"
+          }
+        ]
       },
       {
         "id": "DiagnosticReport:uscorediagnosticreport.subject",
@@ -1269,7 +1600,12 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "DiagnosticReport.subject"
+          }
+        ]
       },
       {
         "id": "DiagnosticReport:uscorediagnosticreport.effective[x]",
@@ -1288,7 +1624,12 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "DiagnosticReport.effective[x]"
+          }
+        ]
       },
       {
         "id": "DiagnosticReport:uscorediagnosticreport.issued",
@@ -1302,17 +1643,36 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "DiagnosticReport.issued"
+          }
+        ]
       },
       {
         "id": "DiagnosticReport:uscorediagnosticreport.performer",
         "path": "DiagnosticReport.performer",
         "min": 0,
         "max": "*",
+        "mustSupport": true,
+        "isModifier": false,
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "NA (new element in STU3)"
+          }
+        ]
+      },
+      {
+        "id": "DiagnosticReport:uscorediagnosticreport.performer.actor",
+        "path": "DiagnosticReport.performer.actor",
+        "min": 1,
+        "max": "1",
         "type": [
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-pract"
+            "targetProfile": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner"
           },
           {
             "code": "Reference",
@@ -1321,7 +1681,12 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "DiagnosticReport.performer"
+          }
+        ]
       },
       {
         "id": "DiagnosticReport:uscorediagnosticreport.result",
@@ -1336,7 +1701,26 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "DiagnosticReport.result"
+          }
+        ]
+      },
+      {
+        "id": "DiagnosticReport:uscorediagnosticreport.image",
+        "path": "DiagnosticReport.image",
+        "min": 0,
+        "max": "*",
+        "mustSupport": true,
+        "isModifier": false,
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "DiagnosticReport.image"
+          }
+        ]
       },
       {
         "id": "DiagnosticReport:uscorediagnosticreport.presentedForm",
@@ -1350,8 +1734,13 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "DiagnosticReport.presentedForm"
+          }
+        ]
       }
     ]
   }
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/StructureDefinition-us-core-direct.json b/lib/resources/us_core/StructureDefinition-us-core-direct.json
index 88e9037..c2c7874 100755
--- a/lib/resources/us_core/StructureDefinition-us-core-direct.json
+++ b/lib/resources/us_core/StructureDefinition-us-core-direct.json
@@ -3,13 +3,15 @@
   "id": "us-core-direct",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-direct\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-direct</a></p><p><b>name</b>: Email is a &quot;direct&quot; email</p><p><b>title</b>: US Core Direct email Extension</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: Health Level Seven International (FHIR-Infrastructure)</p><p><b>contact</b>: </p><p><b>description</b>: This email address is associated with a &quot;direct&quot; service - e.g. http://wiki.directproject.org/Addressing+Specification.</p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-direct\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-direct</a></p><p><b>name</b>: Email is a &quot;direct&quot; email</p><p><b>title</b>: US Core Direct email Extension</p><p><b>status</b>: DRAFT</p><p><b>publisher</b>: Health Level Seven International (FHIR-Infrastructure)</p><p><b>contact</b>: </p><p><b>date</b>: 01/08/2016</p><p><b>description</b>: This email address is associated with a &quot;direct&quot; service - e.g. http://wiki.directproject.org/Addressing+Specification.</p><p><b>fhirVersion</b>: 1.8.0</p><h3>Mappings</h3><table class=\"grid\"><tr><td>-</td><td><b>Identity</b></td><td><b>Uri</b></td><td><b>Name</b></td></tr><tr><td>*</td><td>rim</td><td><a href=\"http://hl7.org/v3\">http://hl7.org/v3</a></td><td>RIM Mapping</td></tr></table><p><b>kind</b>: COMPLEXTYPE</p><p><b>abstract</b>: false</p><p><b>contextType</b>: DATATYPE</p><p><b>context</b>: ContactPoint</p><p><b>type</b>: Extension</p><p><b>baseDefinition</b>: <a href=\"http://hl7.org/fhir/StructureDefinition/Extension\">http://hl7.org/fhir/StructureDefinition/Extension</a></p><p><b>derivation</b>: CONSTRAINT</p><h3>Snapshots</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table><h3>Differentials</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table></div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-direct\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-direct</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: Email is a &quot;direct&quot; email</p><p><b>title</b>: US Core Direct email Extension</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: HL7 US Realm Steering Committee</p><p><b>contact</b>: </p><p><b>description</b>: This email address is associated with a [direct](http://wiki.directproject.org/Addressing+Specification) service.  This extension can only be used on contact points where the system = 'email'</p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-direct\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-direct</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: Email is a &quot;direct&quot; email</p><p><b>title</b>: US Core Direct email Extension</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: HL7 US Realm Steering Committee</p><p><b>contact</b>: </p><p><b>description</b>: This email address is associated with a [direct](http://wiki.directproject.org/Addressing+Specification) service.  This extension can only be used on contact points where the system = 'email'</p><p><b>fhirVersion</b>: 3.0.0</p><h3>Mappings</h3><table class=\"grid\"><tr><td>-</td><td><b>Identity</b></td><td><b>Uri</b></td><td><b>Name</b></td></tr><tr><td>*</td><td>rim</td><td><a href=\"http://hl7.org/v3\">http://hl7.org/v3</a></td><td>RIM Mapping</td></tr></table><p><b>kind</b>: COMPLEXTYPE</p><p><b>abstract</b>: false</p><p><b>contextType</b>: DATATYPE</p><p><b>context</b>: ContactPoint</p><p><b>type</b>: Extension</p><p><b>baseDefinition</b>: <a href=\"http://hl7.org/fhir/StructureDefinition/Extension\">http://hl7.org/fhir/StructureDefinition/Extension</a></p><p><b>derivation</b>: CONSTRAINT</p><h3>Snapshots</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table><h3>Differentials</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table></div>"
   },
   "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-direct",
+  "version": "1.0.0",
   "name": "Email is a \"direct\" email",
   "title": "US Core Direct email Extension",
   "status": "draft",
-  "publisher": "Health Level Seven International (FHIR-Infrastructure)",
+  "date": "2016-08-01",
+  "publisher": "HL7 US Realm Steering Committee",
   "contact": [
     {
       "telecom": [
@@ -20,9 +22,8 @@
       ]
     }
   ],
-  "date": "2016-08-01",
-  "description": "This email address is associated with a \"direct\" service - e.g. http://wiki.directproject.org/Addressing+Specification.",
-  "fhirVersion": "1.8.0",
+  "description": "This email address is associated with a [direct](http://wiki.directproject.org/Addressing+Specification) service.  This extension can only be used on contact points where the system = 'email'",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "rim",
@@ -46,8 +47,8 @@
         "path": "Extension",
         "sliceName": "direct",
         "short": "Email is a \"direct\" email",
-        "definition": "This email address is associated with a \"direct\" service - e.g. http://wiki.directproject.org/Addressing+Specification.",
-        "comments": "This extension can only be used on contact points where the system = 'email'.",
+        "definition": "This email address is associated with a [direct](http://wiki.directproject.org/Addressing+Specification) service.",
+        "comment": "This extension can only be used on contact points where the system = 'email'.",
         "min": 0,
         "max": "1",
         "base": {
@@ -120,7 +121,7 @@
         "path": "Extension.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -152,7 +153,7 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
+        "comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -206,8 +207,8 @@
         "path": "Extension",
         "sliceName": "direct",
         "short": "Email is a \"direct\" email",
-        "definition": "This email address is associated with a \"direct\" service - e.g. http://wiki.directproject.org/Addressing+Specification.",
-        "comments": "This extension can only be used on contact points where the system = 'email'.",
+        "definition": "This email address is associated with a \"direct\" service - e.g. http://wiki.directproject.org/Addressing+Specification. This extension can only be used on contact points where the system = 'email'",
+        "comment": "This extension can only be used on contact points where the system = 'email'.",
         "min": 0,
         "max": "1",
         "isModifier": false,
@@ -228,8 +229,10 @@
         "fixedUri": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-direct"
       },
       {
-        "id": "Extension:direct.value[x]",
-        "path": "Extension.value[x]",
+        "id": "Extension:direct.valueBoolean",
+        "path": "Extension.valueBoolean",
+        "min": 0,
+        "max": "1",
         "type": [
           {
             "code": "boolean"
@@ -238,4 +241,4 @@
       }
     ]
   }
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/StructureDefinition-us-core-ethnicity.json b/lib/resources/us_core/StructureDefinition-us-core-ethnicity.json
index da25647..9ea20bb 100755
--- a/lib/resources/us_core/StructureDefinition-us-core-ethnicity.json
+++ b/lib/resources/us_core/StructureDefinition-us-core-ethnicity.json
@@ -3,13 +3,15 @@
   "id": "us-core-ethnicity",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity</a></p><p><b>name</b>: US Core ethnicity Extension</p><p><b>title</b>: US Core ethnicity Extension</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: Health Level Seven International (FHIR-Infrastructure)</p><p><b>contact</b>: </p><p><b>description</b>: Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The ethnicity codes used to represent these concepts are based upon the [CDC ethnicity and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 43 reference ethnicity.  The ethnicity concepts are grouped by and pre-mapped to the 2 OMB ethnicity categories:\r- Hispanic or Latino\r- Not Hispanic or Latino.</p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity</a></p><p><b>name</b>: US Core ethnicity Extension</p><p><b>title</b>: US Core ethnicity Extension</p><p><b>status</b>: DRAFT</p><p><b>publisher</b>: Health Level Seven International (FHIR-Infrastructure)</p><p><b>contact</b>: </p><p><b>date</b>: 01/08/2016</p><p><b>description</b>: Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The ethnicity codes used to represent these concepts are based upon the [CDC ethnicity and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 43 reference ethnicity.  The ethnicity concepts are grouped by and pre-mapped to the 2 OMB ethnicity categories:\r- Hispanic or Latino\r- Not Hispanic or Latino.</p><p><b>purpose</b>: Complies with 2015 Edition Common Clinical Data Set for patient race.</p><p><b>fhirVersion</b>: 1.8.0</p><h3>Mappings</h3><table class=\"grid\"><tr><td>-</td><td><b>Identity</b></td><td><b>Uri</b></td><td><b>Name</b></td></tr><tr><td>*</td><td>rim</td><td><a href=\"http://hl7.org/v3\">http://hl7.org/v3</a></td><td>RIM Mapping</td></tr></table><p><b>kind</b>: COMPLEXTYPE</p><p><b>abstract</b>: false</p><p><b>contextType</b>: RESOURCE</p><p><b>context</b>: Patient</p><p><b>type</b>: Extension</p><p><b>baseDefinition</b>: <a href=\"http://hl7.org/fhir/StructureDefinition/Extension\">http://hl7.org/fhir/StructureDefinition/Extension</a></p><p><b>derivation</b>: CONSTRAINT</p><h3>Snapshots</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table><h3>Differentials</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table></div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: US Core ethnicity Extension</p><p><b>title</b>: US Core ethnicity Extension</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: HL7 US Realm Steering Committee</p><p><b>contact</b>: </p><p><b>description</b>: Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The ethnicity codes used to represent these concepts are based upon the [CDC ethnicity and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 43 reference ethnicity.  The ethnicity concepts are grouped by and pre-mapped to the 2 OMB ethnicity categories: - Hispanic or Latino - Not Hispanic or Latino.</p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: US Core ethnicity Extension</p><p><b>title</b>: US Core ethnicity Extension</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: HL7 US Realm Steering Committee</p><p><b>contact</b>: </p><p><b>description</b>: Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The ethnicity codes used to represent these concepts are based upon the [CDC ethnicity and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 43 reference ethnicity.  The ethnicity concepts are grouped by and pre-mapped to the 2 OMB ethnicity categories: - Hispanic or Latino - Not Hispanic or Latino.</p><p><b>purpose</b>: Complies with 2015 Edition Common Clinical Data Set for patient race.</p><p><b>fhirVersion</b>: 3.0.0</p><h3>Mappings</h3><table class=\"grid\"><tr><td>-</td><td><b>Identity</b></td><td><b>Uri</b></td><td><b>Name</b></td></tr><tr><td>*</td><td>rim</td><td><a href=\"http://hl7.org/v3\">http://hl7.org/v3</a></td><td>RIM Mapping</td></tr></table><p><b>kind</b>: COMPLEXTYPE</p><p><b>abstract</b>: false</p><p><b>contextType</b>: RESOURCE</p><p><b>context</b>: Patient</p><p><b>type</b>: Extension</p><p><b>baseDefinition</b>: <a href=\"http://hl7.org/fhir/StructureDefinition/Extension\">http://hl7.org/fhir/StructureDefinition/Extension</a></p><p><b>derivation</b>: CONSTRAINT</p><h3>Snapshots</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table><h3>Differentials</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table></div>"
   },
   "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity",
+  "version": "1.0.0",
   "name": "US Core ethnicity Extension",
   "title": "US Core ethnicity Extension",
   "status": "draft",
-  "publisher": "Health Level Seven International (FHIR-Infrastructure)",
+  "date": "2016-08-01",
+  "publisher": "HL7 US Realm Steering Committee",
   "contact": [
     {
       "telecom": [
@@ -20,10 +22,9 @@
       ]
     }
   ],
-  "date": "2016-08-01",
-  "description": "Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The ethnicity codes used to represent these concepts are based upon the [CDC ethnicity and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 43 reference ethnicity.  The ethnicity concepts are grouped by and pre-mapped to the 2 OMB ethnicity categories:\r- Hispanic or Latino\r- Not Hispanic or Latino.",
+  "description": "Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The ethnicity codes used to represent these concepts are based upon the [CDC ethnicity and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 43 reference ethnicity.  The ethnicity concepts are grouped by and pre-mapped to the 2 OMB ethnicity categories: - Hispanic or Latino - Not Hispanic or Latino.",
   "purpose": "Complies with 2015 Edition Common Clinical Data Set for patient race.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "rim",
@@ -47,7 +48,7 @@
         "path": "Extension",
         "sliceName": "ethnicity",
         "short": "US Core ethnicity Extension",
-        "definition": "Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The ethnicity codes used to represent these concepts are based upon the [CDC ethnicity and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 43 reference ethnicity.  The ethnicity concepts are grouped by and pre-mapped to the 2 OMB ethnicity categories:\r- Hispanic or Latino\r- Not Hispanic or Latino.",
+        "definition": "Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The ethnicity codes used to represent these concepts are based upon the [CDC ethnicity and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 43 reference ethnicity.  The ethnicity concepts are grouped by and pre-mapped to the 2 OMB ethnicity categories: - Hispanic or Latino - Not Hispanic or Latino.",
         "min": 0,
         "max": "1",
         "base": {
@@ -111,7 +112,10 @@
         "slicing": {
           "id": "2",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -137,7 +141,7 @@
         "sliceName": "ombCategory",
         "short": "Hispanic or Latino|Not Hispanic or Latino",
         "definition": "The 2 ethnicity category codes according to the [OMB Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity, Statistical Policy Directive No. 15, as revised, October 30, 1997](https://www.whitehouse.gov/omb/fedreg_1997standards).",
-        "min": 1,
+        "min": 0,
         "max": "1",
         "base": {
           "path": "Element.extension",
@@ -149,6 +153,7 @@
             "code": "Extension"
           }
         ],
+        "mustSupport": true,
         "isModifier": false,
         "mapping": [
           {
@@ -189,13 +194,13 @@
         "path": "Extension.extension.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
         ],
         "min": 0,
-        "max": "*",
+        "max": "0",
         "base": {
           "path": "Element.extension",
           "min": 0,
@@ -221,7 +226,7 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
+        "comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -234,6 +239,7 @@
             "code": "uri"
           }
         ],
+        "fixedUri": "ombCategory",
         "mapping": [
           {
             "identity": "rim",
@@ -246,7 +252,7 @@
         "path": "Extension.extension.valueCoding",
         "short": "Value of extension",
         "definition": "Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).",
-        "min": 0,
+        "min": 1,
         "max": "1",
         "base": {
           "path": "Extension.value[x]",
@@ -262,7 +268,7 @@
           "strength": "required",
           "description": "The 2 ethnicity category codes according to the [OMB Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity, Statistical Policy Directive No. 15, as revised, October 30, 1997](https://www.whitehouse.gov/omb/fedreg_1997standards).",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/us/core/ValueSet/omb-ethnicity"
+            "reference": "http://hl7.org/fhir/us/core/ValueSet/omb-ethnicity-category"
           }
         },
         "mapping": [
@@ -330,13 +336,13 @@
         "path": "Extension.extension.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
         ],
         "min": 0,
-        "max": "*",
+        "max": "0",
         "base": {
           "path": "Element.extension",
           "min": 0,
@@ -362,7 +368,7 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
+        "comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -375,6 +381,7 @@
             "code": "uri"
           }
         ],
+        "fixedUri": "detailed",
         "mapping": [
           {
             "identity": "rim",
@@ -387,7 +394,7 @@
         "path": "Extension.extension.valueCoding",
         "short": "Value of extension",
         "definition": "Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).",
-        "min": 0,
+        "min": 1,
         "max": "1",
         "base": {
           "path": "Extension.value[x]",
@@ -419,7 +426,7 @@
         "sliceName": "text",
         "short": "ethnicity Text",
         "definition": "Plain text representation of the ethnicity concept(s).",
-        "min": 0,
+        "min": 1,
         "max": "1",
         "base": {
           "path": "Element.extension",
@@ -431,6 +438,7 @@
             "code": "Extension"
           }
         ],
+        "mustSupport": true,
         "isModifier": false
       },
       {
@@ -465,13 +473,13 @@
         "path": "Extension.extension.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
         ],
         "min": 0,
-        "max": "*",
+        "max": "0",
         "base": {
           "path": "Element.extension",
           "min": 0,
@@ -497,7 +505,7 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
+        "comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -510,6 +518,7 @@
             "code": "uri"
           }
         ],
+        "fixedUri": "text",
         "mapping": [
           {
             "identity": "rim",
@@ -522,7 +531,7 @@
         "path": "Extension.extension.valueString",
         "short": "Value of extension",
         "definition": "Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).",
-        "min": 0,
+        "min": 1,
         "max": "1",
         "base": {
           "path": "Extension.value[x]",
@@ -549,7 +558,7 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
+        "comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -714,7 +723,7 @@
         "path": "Extension",
         "sliceName": "ethnicity",
         "short": "US Core ethnicity Extension",
-        "definition": "Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The ethnicity codes used to represent these concepts are based upon the [CDC ethnicity and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 43 reference ethnicity.  The ethnicity concepts are grouped by and pre-mapped to the 2 OMB ethnicity categories:\r- Hispanic or Latino\r- Not Hispanic or Latino.",
+        "definition": "Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The ethnicity codes used to represent these concepts are based upon the [CDC ethnicity and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 43 reference ethnicity.  The ethnicity concepts are grouped by and pre-mapped to the 2 OMB ethnicity categories: - Hispanic or Latino - Not Hispanic or Latino.",
         "min": 0,
         "max": "1",
         "isModifier": false
@@ -725,13 +734,14 @@
         "sliceName": "ombCategory",
         "short": "Hispanic or Latino|Not Hispanic or Latino",
         "definition": "The 2 ethnicity category codes according to the [OMB Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity, Statistical Policy Directive No. 15, as revised, October 30, 1997](https://www.whitehouse.gov/omb/fedreg_1997standards).",
-        "min": 1,
+        "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Extension"
           }
         ],
+        "mustSupport": true,
         "isModifier": false,
         "mapping": [
           {
@@ -741,8 +751,22 @@
         ]
       },
       {
-        "id": "Extension:ethnicity.extension:ombcategory.value[x]",
-        "path": "Extension.extension.value[x]",
+        "id": "Extension:ethnicity.extension:ombcategory.url",
+        "path": "Extension.extension.url",
+        "min": 1,
+        "max": "1",
+        "type": [
+          {
+            "code": "uri"
+          }
+        ],
+        "fixedUri": "ombCategory"
+      },
+      {
+        "id": "Extension:ethnicity.extension:ombcategory.valueCoding",
+        "path": "Extension.extension.valueCoding",
+        "min": 1,
+        "max": "1",
         "type": [
           {
             "code": "Coding"
@@ -752,7 +776,7 @@
           "strength": "required",
           "description": "The 2 ethnicity category codes according to the [OMB Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity, Statistical Policy Directive No. 15, as revised, October 30, 1997](https://www.whitehouse.gov/omb/fedreg_1997standards).",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/us/core/ValueSet/omb-ethnicity"
+            "reference": "http://hl7.org/fhir/us/core/ValueSet/omb-ethnicity-category"
           }
         }
       },
@@ -778,8 +802,22 @@
         ]
       },
       {
-        "id": "Extension:ethnicity.extension:detailed.value[x]",
-        "path": "Extension.extension.value[x]",
+        "id": "Extension:ethnicity.extension:detailed.url",
+        "path": "Extension.extension.url",
+        "min": 1,
+        "max": "1",
+        "type": [
+          {
+            "code": "uri"
+          }
+        ],
+        "fixedUri": "detailed"
+      },
+      {
+        "id": "Extension:ethnicity.extension:detailed.valueCoding",
+        "path": "Extension.extension.valueCoding",
+        "min": 1,
+        "max": "1",
         "type": [
           {
             "code": "Coding"
@@ -799,18 +837,33 @@
         "sliceName": "text",
         "short": "ethnicity Text",
         "definition": "Plain text representation of the ethnicity concept(s).",
-        "min": 0,
+        "min": 1,
         "max": "1",
         "type": [
           {
             "code": "Extension"
           }
         ],
+        "mustSupport": true,
         "isModifier": false
       },
       {
-        "id": "Extension:ethnicity.extension:text.value[x]",
-        "path": "Extension.extension.value[x]",
+        "id": "Extension:ethnicity.extension:text.url",
+        "path": "Extension.extension.url",
+        "min": 1,
+        "max": "1",
+        "type": [
+          {
+            "code": "uri"
+          }
+        ],
+        "fixedUri": "text"
+      },
+      {
+        "id": "Extension:ethnicity.extension:text.valueString",
+        "path": "Extension.extension.valueString",
+        "min": 1,
+        "max": "1",
         "type": [
           {
             "code": "string"
@@ -820,13 +873,10 @@
       {
         "id": "Extension:ethnicity.url",
         "path": "Extension.url",
+        "min": 1,
+        "max": "1",
         "fixedUri": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity"
-      },
-      {
-        "id": "Extension:ethnicity.value[x]",
-        "path": "Extension.value[x]",
-        "max": "0"
       }
     ]
   }
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/StructureDefinition-us-core-goal.json b/lib/resources/us_core/StructureDefinition-us-core-goal.json
index 1bf7fb8..3a1d0c8 100755
--- a/lib/resources/us_core/StructureDefinition-us-core-goal.json
+++ b/lib/resources/us_core/StructureDefinition-us-core-goal.json
@@ -3,12 +3,14 @@
   "id": "us-core-goal",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-goal\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-goal</a></p><p><b>name</b>: US Core Goal Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: Health Level Seven International (FHIR-Infrastructure)</p><p><b>contact</b>: </p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-goal\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-goal</a></p><p><b>name</b>: US Core Goal Profile</p><p><b>status</b>: DRAFT</p><p><b>publisher</b>: Health Level Seven International (FHIR-Infrastructure)</p><p><b>contact</b>: </p><p><b>date</b>: 01/08/2016</p><blockquote><p><b>mapping</b></p><p><b>identity</b>: v2</p><p><b>uri</b>: <a href=\"http://hl7.org/v2\">http://hl7.org/v2</a></p><p><b>name</b>: HL7 v2 Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: rim</p><p><b>uri</b>: <a href=\"http://hl7.org/v3\">http://hl7.org/v3</a></p><p><b>name</b>: RIM Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: w5</p><p><b>uri</b>: <a href=\"http://hl7.org/fhir/w5\">http://hl7.org/fhir/w5</a></p><p><b>name</b>: W5 Mapping</p></blockquote><p><b>kind</b>: RESOURCE</p><p><b>abstract</b>: false</p><p><b>type</b>: Goal</p><p><b>baseDefinition</b>: <a href=\"http://hl7.org/fhir/StructureDefinition/Goal\">http://hl7.org/fhir/StructureDefinition/Goal</a></p><p><b>derivation</b>: CONSTRAINT</p><h3>Snapshots</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table><h3>Differentials</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table></div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-goal\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-goal</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: US  Core Goal Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: HL7 US Realm Steering Committee</p><p><b>contact</b>: </p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-goal\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-goal</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: US  Core Goal Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: HL7 US Realm Steering Committee</p><p><b>contact</b>: </p><p><b>fhirVersion</b>: 3.0.0</p><blockquote><p><b>mapping</b></p><p><b>identity</b>: argonaut-dq-dstu2</p><p><b>uri</b>: <a href=\"http://unknown.org/Argonaut DQ DSTU2\">http://unknown.org/Argonaut DQ DSTU2</a></p><p><b>name</b>: Argonaut DQ DSTU2</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: v2</p><p><b>uri</b>: <a href=\"http://hl7.org/v2\">http://hl7.org/v2</a></p><p><b>name</b>: HL7 v2 Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: rim</p><p><b>uri</b>: <a href=\"http://hl7.org/v3\">http://hl7.org/v3</a></p><p><b>name</b>: RIM Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: w5</p><p><b>uri</b>: <a href=\"http://hl7.org/fhir/w5\">http://hl7.org/fhir/w5</a></p><p><b>name</b>: W5 Mapping</p></blockquote><p><b>kind</b>: RESOURCE</p><p><b>abstract</b>: false</p><p><b>type</b>: Goal</p><p><b>baseDefinition</b>: <a href=\"http://hl7.org/fhir/StructureDefinition/Goal\">http://hl7.org/fhir/StructureDefinition/Goal</a></p><p><b>derivation</b>: CONSTRAINT</p><h3>Snapshots</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table><h3>Differentials</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table></div>"
   },
   "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-goal",
-  "name": "US Core Goal Profile",
+  "version": "1.0.0",
+  "name": "US  Core Goal Profile",
   "status": "draft",
-  "publisher": "Health Level Seven International (FHIR-Infrastructure)",
+  "date": "2016-08-01",
+  "publisher": "HL7 US Realm Steering Committee",
   "contact": [
     {
       "telecom": [
@@ -19,8 +21,13 @@
       ]
     }
   ],
-  "date": "2016-08-01",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "argonaut-dq-dstu2",
+      "uri": "http://unknown.org/Argonaut DQ DSTU2",
+      "name": "Argonaut DQ DSTU2"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -50,7 +57,7 @@
         "sliceName": "USCoreGoal",
         "short": "US Core Goal Profile",
         "definition": "The US Core Goal Profile is based upon the core FHIR Goal Resource and created to meet the 2015 Edition Common Clinical Data Set 'Goals' requirements.",
-        "comments": "Goal can be achieving a particular change or merely maintaining a current state or even slowing a decline.",
+        "comment": "Goal can be achieving a particular change or merely maintaining a current state or even slowing a decline.",
         "min": 0,
         "max": "*",
         "base": {
@@ -93,7 +100,6 @@
           }
         ],
         "mustSupport": false,
-        "isSummary": false,
         "mapping": [
           {
             "identity": "rim",
@@ -110,6 +116,10 @@
           {
             "identity": "w5",
             "map": "clinical.careprovision"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Goal"
           }
         ]
       },
@@ -118,7 +128,7 @@
         "path": "Goal.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -157,7 +167,7 @@
         "path": "Goal.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +188,7 @@
         "path": "Goal.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -198,6 +208,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -212,7 +230,7 @@
         "path": "Goal.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -246,7 +264,7 @@
         "path": "Goal.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -276,7 +294,7 @@
         "path": "Goal.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -305,7 +323,7 @@
         "path": "Goal.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -362,8 +380,9 @@
       {
         "id": "Goal:uscoregoal.status",
         "path": "Goal.status",
-        "short": "proposed | planned | accepted | rejected | in-progress | achieved | sustaining | on-hold | cancelled | on-target | ahead-of-target | behind-target | entered-in-error",
+        "short": "proposed | accepted | planned | in-progress | on-target | ahead-of-target | behind-target | sustaining | achieved | on-hold | cancelled | entered-in-error | rejected",
         "definition": "Type of plan.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Identifies what \"kind\" of plan this is to support differentiation between multiple co-existing plans; e.g. \"Home health\", \"psychiatric\", \"asthma\", \"disease management\", \"wellness plan\", etc.",
         "min": 1,
         "max": "1",
@@ -379,7 +398,7 @@
         ],
         "mustSupport": true,
         "isModifier": true,
-        "isSummary": false,
+        "isSummary": true,
         "binding": {
           "strength": "required",
           "valueSetReference": {
@@ -398,6 +417,10 @@
           {
             "identity": "w5",
             "map": "status"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Goal.status"
           }
         ]
       },
@@ -421,6 +444,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "GoalCategory"
+            }
+          ],
           "strength": "example",
           "description": "Codes for grouping and sorting goals",
           "valueSetReference": {
@@ -437,9 +466,9 @@
       {
         "id": "Goal:uscoregoal.priority",
         "path": "Goal.priority",
-        "short": "high | medium |low",
+        "short": "high-priority | medium-priority | low-priority",
         "definition": "Identifies the mutually agreed level of importance associated with reaching/sustaining the goal.",
-        "comments": "Extensions are available to track priorities as established by each participant (i.e. Priority from the patient's perspective, different practitioners' perspectives, family member's perspectives)  The ordinal extension on Coding can be used to convey a numerically comparable ranking to priority.  (Keep in mind that different coding systems may use a \"low value=important\".",
+        "comment": "Extensions are available to track priorities as established by each participant (i.e. Priority from the patient's perspective, different practitioners' perspectives, family member's perspectives)\r\rThe ordinal extension on Coding can be used to convey a numerically comparable ranking to priority.  (Keep in mind that different coding systems may use a \"low value=important\".",
         "requirements": "Used for sorting and presenting goals.",
         "min": 0,
         "max": "1",
@@ -455,6 +484,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "GoalPriority"
+            }
+          ],
           "strength": "preferred",
           "description": "The level of importance associated with a goal",
           "valueSetReference": {
@@ -477,7 +512,7 @@
         "path": "Goal.description",
         "short": "Code or text describing goal",
         "definition": "proposed | draft | active | completed | cancelled.",
-        "comments": "If no code is available, use CodeableConcept.text.",
+        "comment": "If no code is available, use CodeableConcept.text.",
         "requirements": "Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record.",
         "min": 1,
         "max": "1",
@@ -492,10 +527,19 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "GoalDescription"
+            }
+          ],
           "strength": "example",
-          "description": "Codes providing the details of a particular goal.  This will generally be system or implementation guide-specific.  In many systems, only the text element will be used."
+          "description": "Codes providing the details of a particular goal.  This will generally be system or implementation guide-specific.  In many systems, only the text element will be used.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/clinical-findings"
+          }
         },
         "mapping": [
           {
@@ -509,6 +553,10 @@
           {
             "identity": "w5",
             "map": "what"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Goal.description"
           }
         ]
       },
@@ -532,7 +580,7 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -545,6 +593,10 @@
           {
             "identity": "w5",
             "map": "who.focus"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Goal.subject"
           }
         ]
       },
@@ -571,6 +623,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "GoalStartEvent"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing events that can trigger the initiation of a goal",
           "valueSetReference": {
@@ -585,15 +643,215 @@
         ]
       },
       {
-        "id": "Goal:uscoregoal.target[x]",
-        "path": "Goal.target[x]",
+        "id": "Goal:uscoregoal.target",
+        "path": "Goal.target",
+        "short": "Target outcome for the goal",
+        "definition": "Indicates what should be done by when.",
+        "requirements": "Allows the progress of the goal to be monitored against an observation or due date.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Goal.target",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "BackboneElement"
+          }
+        ],
+        "condition": [
+          "gol-1"
+        ],
+        "constraint": [
+          {
+            "key": "ele-1",
+            "severity": "error",
+            "human": "All FHIR elements must have a @value or children",
+            "expression": "children().count() > id.count()",
+            "xpath": "@value|f:*|h:div",
+            "source": "Element"
+          },
+          {
+            "key": "gol-1",
+            "severity": "error",
+            "human": "Goal.target.measure is required if Goal.target.detail is populated",
+            "expression": "(detail.exists() and measure.exists()) or detail.exists().not()",
+            "xpath": "(exists(f:detail) and exists(f:measure)) or not(exists(f:detail))"
+          }
+        ]
+      },
+      {
+        "id": "Goal:uscoregoal.target.id",
+        "path": "Goal.target.id",
+        "representation": [
+          "xmlAttr"
+        ],
+        "short": "xml:id (or equivalent in JSON)",
+        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Element.id",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "Goal:uscoregoal.target.extension",
+        "path": "Goal.target.extension",
+        "short": "Additional Content defined by implementations",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "Element.extension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "Goal:uscoregoal.target.modifierExtension",
+        "path": "Goal.target.modifierExtension",
+        "short": "Extensions that cannot be ignored",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content",
+          "modifiers"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "BackboneElement.modifierExtension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "isModifier": true,
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "N/A"
+          }
+        ]
+      },
+      {
+        "id": "Goal:uscoregoal.target.measure",
+        "path": "Goal.target.measure",
+        "short": "The parameter whose value is being tracked",
+        "definition": "The parameter whose value is being tracked, e.g. body weight, blood pressure, or hemoglobin A1c level.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Goal.target.measure",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "condition": [
+          "gol-1"
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "GoalTargetMeasure"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes to identify the value being tracked, e.g. body weight, blood pressure, or hemoglobin A1c level.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/observation-codes"
+          }
+        }
+      },
+      {
+        "id": "Goal:uscoregoal.target.detail[x]",
+        "path": "Goal.target.detail[x]",
+        "short": "The target value to be achieved",
+        "definition": "The target value of the focus to be achieved to signify the fulfillment of the goal, e.g. 150 pounds, 7.0%. Either the high or low or both values of the range can be specified. When a low value is missing, it indicates that the goal is achieved at any focus value at or below the high value. Similarly, if the high value is missing, it indicates that the goal is achieved at any focus value at or above the low value.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Goal.target.detail[x]",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "Quantity"
+          },
+          {
+            "code": "Range"
+          },
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "condition": [
+          "gol-1"
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "GoalTargetDetail"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes to identify the target value of the focus to be achieved to signify the fulfillment of the goal."
+        }
+      },
+      {
+        "id": "Goal:uscoregoal.target.due[x]",
+        "path": "Goal.target.due[x]",
         "short": "Reach goal on or before",
         "definition": "Indicates either the date or the duration after start by which the goal should be met.",
         "requirements": "Identifies when the goal should be evaluated.",
         "min": 0,
         "max": "1",
         "base": {
-          "path": "Goal.target[x]",
+          "path": "Goal.target.due[x]",
           "min": 0,
           "max": "1"
         },
@@ -618,7 +876,7 @@
         "path": "Goal.statusDate",
         "short": "When goal status took effect",
         "definition": "Identifies when the current status.  I.e. When initially created, when achieved, when cancelled, etc.",
-        "comments": "To see the date for past statuses, query history.",
+        "comment": "To see the date for past statuses, query history.",
         "min": 0,
         "max": "1",
         "base": {
@@ -644,33 +902,26 @@
         "path": "Goal.statusReason",
         "short": "Reason for current status",
         "definition": "Captures the reason for the current status.",
-        "comments": "This will typically be captured for statuses such as rejected, on-hold or cancelled, but could be present for others.",
+        "comment": "This will typically be captured for statuses such as rejected, on-hold or cancelled, but could be present for others.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "base": {
           "path": "Goal.statusReason",
           "min": 0,
-          "max": "*"
+          "max": "1"
         },
         "type": [
           {
-            "code": "CodeableConcept"
-          }
-        ],
-        "binding": {
-          "strength": "example",
-          "description": "Codes to identify the reason for a goal's current status",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/goal-status-reason"
+            "code": "string"
           }
-        }
+        ]
       },
       {
         "id": "Goal:uscoregoal.expressedBy",
         "path": "Goal.expressedBy",
         "short": "Who's responsible for creating Goal?",
         "definition": "Indicates whose goal this is - patient goal, practitioner goal, etc.",
-        "comments": "This is the individual reponsible for establishing the goal, not necessarily who recorded it.  (For that, use the Provenance resource.).",
+        "comment": "This is the individual reponsible for establishing the goal, not necessarily who recorded it.  (For that, use the Provenance resource.).",
         "min": 0,
         "max": "1",
         "base": {
@@ -728,7 +979,7 @@
           },
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionRequest"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
           },
           {
             "code": "Reference",
@@ -755,7 +1006,7 @@
         "path": "Goal.note",
         "short": "Comments about the goal",
         "definition": "Any comments related to the goal.",
-        "comments": "May be used for progress notes, concerns or other related information that doesn't actually describe the goal itself.",
+        "comment": "May be used for progress notes, concerns or other related information that doesn't actually describe the goal itself.",
         "requirements": "There's a need to capture information about the goal that doesn't actually describe the goal.",
         "min": 0,
         "max": "*",
@@ -781,148 +1032,58 @@
         ]
       },
       {
-        "id": "Goal:uscoregoal.outcome",
-        "path": "Goal.outcome",
+        "id": "Goal:uscoregoal.outcomeCode",
+        "path": "Goal.outcomeCode",
         "short": "What result was achieved regarding the goal?",
-        "definition": "Identifies the change (or lack of change) at the point where the goal was deemed to be cancelled or achieved.",
-        "comments": "Note that this should not duplicate the goal status.",
+        "definition": "Identifies the change (or lack of change) at the point when the status of the goal is assessed.",
+        "comment": "Note that this should not duplicate the goal status.",
         "requirements": "Outcome tracking is a key aspect of care planning.",
         "min": 0,
         "max": "*",
         "base": {
-          "path": "Goal.outcome",
-          "min": 0,
-          "max": "*"
-        },
-        "type": [
-          {
-            "code": "BackboneElement"
-          }
-        ],
-        "constraint": [
-          {
-            "key": "ele-1",
-            "severity": "error",
-            "human": "All FHIR elements must have a @value or children",
-            "expression": "children().count() > id.count()",
-            "xpath": "@value|f:*|h:div",
-            "source": "Element"
-          }
-        ]
-      },
-      {
-        "id": "Goal:uscoregoal.outcome.id",
-        "path": "Goal.outcome.id",
-        "representation": [
-          "xmlAttr"
-        ],
-        "short": "xml:id (or equivalent in JSON)",
-        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "Element.id",
-          "min": 0,
-          "max": "1"
-        },
-        "type": [
-          {
-            "code": "string"
-          }
-        ],
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "n/a"
-          }
-        ]
-      },
-      {
-        "id": "Goal:uscoregoal.outcome.extension",
-        "path": "Goal.outcome.extension",
-        "short": "Additional Content defined by implementations",
-        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
-        "alias": [
-          "extensions",
-          "user content"
-        ],
-        "min": 0,
-        "max": "*",
-        "base": {
-          "path": "Element.extension",
+          "path": "Goal.outcomeCode",
           "min": 0,
           "max": "*"
         },
         "type": [
           {
-            "code": "Extension"
+            "code": "CodeableConcept"
           }
         ],
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "n/a"
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "GoalOutcome"
+            }
+          ],
+          "strength": "example",
+          "description": "The result of the goal; e.g. \"25% increase in shoulder mobility\", \"Anxiety reduced to moderate levels\".  \"15 kg weight loss sustained over 6 months\"",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/clinical-findings"
           }
-        ]
+        }
       },
       {
-        "id": "Goal:uscoregoal.outcome.modifierExtension",
-        "path": "Goal.outcome.modifierExtension",
-        "short": "Extensions that cannot be ignored",
-        "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
-        "alias": [
-          "extensions",
-          "user content",
-          "modifiers"
-        ],
+        "id": "Goal:uscoregoal.outcomeReference",
+        "path": "Goal.outcomeReference",
+        "short": "Observation that resulted from goal",
+        "definition": "Details of what's changed (or not changed).",
+        "comment": "The goal outcome is independent of the outcome of the related activities.  For example, if the Goal is to achieve a target body weight of 150 lb and a care plan activity is defined to diet, then the care plan’s activity outcome could be calories consumed whereas goal outcome is an observation for the actual body weight measured.",
+        "requirements": "Outcome tracking is a key aspect of care planning.",
         "min": 0,
         "max": "*",
         "base": {
-          "path": "BackboneElement.modifierExtension",
+          "path": "Goal.outcomeReference",
           "min": 0,
           "max": "*"
         },
         "type": [
-          {
-            "code": "Extension"
-          }
-        ],
-        "isModifier": true,
-        "isSummary": true,
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "N/A"
-          }
-        ]
-      },
-      {
-        "id": "Goal:uscoregoal.outcome.result[x]",
-        "path": "Goal.outcome.result[x]",
-        "short": "Code or observation that resulted from goal",
-        "definition": "Details of what's changed (or not changed).",
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "Goal.outcome.result[x]",
-          "min": 0,
-          "max": "1"
-        },
-        "type": [
-          {
-            "code": "CodeableConcept"
-          },
           {
             "code": "Reference",
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/Observation"
           }
-        ],
-        "binding": {
-          "strength": "example",
-          "description": "The result of the goal; e.g. \"25% increase in shoulder mobility\", \"Anxiety reduced to moderate levels\".  \"15 kg weight loss sustained over 6 months\""
-        }
+        ]
       }
     ]
   },
@@ -936,7 +1097,12 @@
         "definition": "The US Core Goal Profile is based upon the core FHIR Goal Resource and created to meet the 2015 Edition Common Clinical Data Set 'Goals' requirements.",
         "mustSupport": false,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Goal"
+          }
+        ]
       },
       {
         "id": "Goal:uscoregoal.status",
@@ -952,13 +1118,18 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false,
         "binding": {
           "strength": "required",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/goal-status"
           }
-        }
+        },
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Goal.status"
+          }
+        ]
       },
       {
         "id": "Goal:uscoregoal.description",
@@ -974,7 +1145,12 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Goal.description"
+          }
+        ]
       },
       {
         "id": "Goal:uscoregoal.subject",
@@ -991,8 +1167,13 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Goal.subject"
+          }
+        ]
       }
     ]
   }
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/StructureDefinition-us-core-immunization.json b/lib/resources/us_core/StructureDefinition-us-core-immunization.json
index e820cb1..2e13cbc 100755
--- a/lib/resources/us_core/StructureDefinition-us-core-immunization.json
+++ b/lib/resources/us_core/StructureDefinition-us-core-immunization.json
@@ -3,12 +3,14 @@
   "id": "us-core-immunization",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization</a></p><p><b>name</b>: US Core Immunization Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: Health Level Seven International (FHIR-Infrastructure)</p><p><b>contact</b>: </p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization</a></p><p><b>name</b>: US Core Immunization Profile</p><p><b>status</b>: DRAFT</p><p><b>publisher</b>: Health Level Seven International (FHIR-Infrastructure)</p><p><b>contact</b>: </p><p><b>date</b>: 01/08/2016</p><blockquote><p><b>mapping</b></p><p><b>identity</b>: quick</p><p><b>uri</b>: <a href=\"http://wiki.siframework.org/CQF\">http://wiki.siframework.org/CQF</a></p><p><b>name</b>: Quality Improvement and Clinical Knowledge (QUICK)</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: v2</p><p><b>uri</b>: <a href=\"http://hl7.org/v2\">http://hl7.org/v2</a></p><p><b>name</b>: HL7 v2 Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: rim</p><p><b>uri</b>: <a href=\"http://hl7.org/v3\">http://hl7.org/v3</a></p><p><b>name</b>: RIM Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: w5</p><p><b>uri</b>: <a href=\"http://hl7.org/fhir/w5\">http://hl7.org/fhir/w5</a></p><p><b>name</b>: W5 Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: cda</p><p><b>uri</b>: <a href=\"http://hl7.org/v3/cda\">http://hl7.org/v3/cda</a></p><p><b>name</b>: CDA (R2)</p></blockquote><p><b>kind</b>: RESOURCE</p><p><b>abstract</b>: false</p><p><b>type</b>: Immunization</p><p><b>baseDefinition</b>: <a href=\"http://hl7.org/fhir/StructureDefinition/Immunization\">http://hl7.org/fhir/StructureDefinition/Immunization</a></p><p><b>derivation</b>: CONSTRAINT</p><h3>Snapshots</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table><h3>Differentials</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table></div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: US  Core Immunization Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: HL7 US Realm Steering Committee</p><p><b>contact</b>: </p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: US  Core Immunization Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: HL7 US Realm Steering Committee</p><p><b>contact</b>: </p><p><b>fhirVersion</b>: 3.0.0</p><blockquote><p><b>mapping</b></p><p><b>identity</b>: quick</p><p><b>uri</b>: <a href=\"http://unknown.org/QUICK\">http://unknown.org/QUICK</a></p><p><b>name</b>: QUICK</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: argonaut-dq-dstu2</p><p><b>uri</b>: <a href=\"http://unknown.org/Argonaut DQ DSTU2\">http://unknown.org/Argonaut DQ DSTU2</a></p><p><b>name</b>: Argonaut DQ DSTU2</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: v2</p><p><b>uri</b>: <a href=\"http://hl7.org/v2\">http://hl7.org/v2</a></p><p><b>name</b>: HL7 v2 Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: rim</p><p><b>uri</b>: <a href=\"http://hl7.org/v3\">http://hl7.org/v3</a></p><p><b>name</b>: RIM Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: w5</p><p><b>uri</b>: <a href=\"http://hl7.org/fhir/w5\">http://hl7.org/fhir/w5</a></p><p><b>name</b>: W5 Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: workflow</p><p><b>uri</b>: <a href=\"http://hl7.org/fhir/workflow\">http://hl7.org/fhir/workflow</a></p><p><b>name</b>: Workflow Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: cda</p><p><b>uri</b>: <a href=\"http://hl7.org/v3/cda\">http://hl7.org/v3/cda</a></p><p><b>name</b>: CDA (R2)</p></blockquote><p><b>kind</b>: RESOURCE</p><p><b>abstract</b>: false</p><p><b>type</b>: Immunization</p><p><b>baseDefinition</b>: <a href=\"http://hl7.org/fhir/StructureDefinition/Immunization\">http://hl7.org/fhir/StructureDefinition/Immunization</a></p><p><b>derivation</b>: CONSTRAINT</p><h3>Snapshots</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table><h3>Differentials</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table></div>"
   },
   "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization",
-  "name": "US Core Immunization Profile",
+  "version": "1.0.0",
+  "name": "US  Core Immunization Profile",
   "status": "draft",
-  "publisher": "Health Level Seven International (FHIR-Infrastructure)",
+  "date": "2016-08-01",
+  "publisher": "HL7 US Realm Steering Committee",
   "contact": [
     {
       "telecom": [
@@ -19,12 +21,17 @@
       ]
     }
   ],
-  "date": "2016-08-01",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "quick",
-      "uri": "http://wiki.siframework.org/CQF",
-      "name": "Quality Improvement and Clinical Knowledge (QUICK)"
+      "uri": "http://unknown.org/QUICK",
+      "name": "QUICK"
+    },
+    {
+      "identity": "argonaut-dq-dstu2",
+      "uri": "http://unknown.org/Argonaut DQ DSTU2",
+      "name": "Argonaut DQ DSTU2"
     },
     {
       "identity": "v2",
@@ -41,6 +48,11 @@
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
     },
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
     {
       "identity": "cda",
       "uri": "http://hl7.org/v3/cda",
@@ -55,9 +67,8 @@
   "snapshot": {
     "element": [
       {
-        "id": "Immunization:uscoreimmunization",
+        "id": "Immunization:uscoreimmunizationprofile",
         "path": "Immunization",
-        "sliceName": "USCoreImmunization",
         "short": "US Core Immunization Profile",
         "definition": "The US Core Immunization Profile is based upon the core FHIR Immunization Resource and created to meet the 2015 Edition Common Clinical Data Set 'Immunizations' requirements.",
         "min": 0,
@@ -103,22 +114,21 @@
           {
             "key": "imm-2",
             "severity": "error",
-            "human": "If immunization was administered (wasNotGiven=false) then explanation.reasonNotGiven SHALL be absent.",
-            "expression": "(wasNotGiven = true) or explanation.reasonNotGiven.empty()",
-            "xpath": "not(f:wasNotGiven/@value=false() and exists(f:explanation/f:reasonNotGiven))",
+            "human": "If immunization was administered (notGiven=false) then explanation.reasonNotGiven SHALL be absent.",
+            "expression": "(notGiven = true) or explanation.reasonNotGiven.empty()",
+            "xpath": "not(f:notGiven/@value=false() and exists(f:explanation/f:reasonNotGiven))",
             "source": "Immunization"
           },
           {
             "key": "imm-1",
             "severity": "error",
-            "human": "If immunization was not administered (wasNotGiven=true) then there SHALL be no reaction nor explanation.reason present",
-            "expression": "(wasNotGiven = true).not() or (reaction.empty() and explanation.reason.empty())",
-            "xpath": "not(f:wasNotGiven/@value=true() and (count(f:reaction) > 0 or exists(f:explanation/f:reason)))",
+            "human": "If immunization was not administered (notGiven=true) then there SHALL be no reaction nor explanation.reason present",
+            "expression": "(notGiven = true).not() or (reaction.empty() and explanation.reason.empty())",
+            "xpath": "not(f:notGiven/@value=true() and (count(f:reaction) > 0 or exists(f:explanation/f:reason)))",
             "source": "Immunization"
           }
         ],
         "mustSupport": false,
-        "isSummary": false,
         "mapping": [
           {
             "identity": "rim",
@@ -139,15 +149,19 @@
           {
             "identity": "quick",
             "map": "ImmunizationPerformanceOccurrence"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Immunization"
           }
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.id",
+        "id": "Immunization:uscoreimmunizationprofile.id",
         "path": "Immunization.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -163,7 +177,7 @@
         "isSummary": true
       },
       {
-        "id": "Immunization:uscoreimmunization.meta",
+        "id": "Immunization:uscoreimmunizationprofile.meta",
         "path": "Immunization.meta",
         "short": "Metadata about the resource",
         "definition": "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.",
@@ -182,11 +196,11 @@
         "isSummary": true
       },
       {
-        "id": "Immunization:uscoreimmunization.implicitRules",
+        "id": "Immunization:uscoreimmunizationprofile.implicitRules",
         "path": "Immunization.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -203,11 +217,11 @@
         "isSummary": true
       },
       {
-        "id": "Immunization:uscoreimmunization.language",
+        "id": "Immunization:uscoreimmunizationprofile.language",
         "path": "Immunization.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -227,6 +241,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -237,11 +259,11 @@
         }
       },
       {
-        "id": "Immunization:uscoreimmunization.text",
+        "id": "Immunization:uscoreimmunizationprofile.text",
         "path": "Immunization.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -271,11 +293,11 @@
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.contained",
+        "id": "Immunization:uscoreimmunizationprofile.contained",
         "path": "Immunization.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -301,11 +323,11 @@
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.extension",
+        "id": "Immunization:uscoreimmunizationprofile.extension",
         "path": "Immunization.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -330,11 +352,11 @@
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.modifierExtension",
+        "id": "Immunization:uscoreimmunizationprofile.modifierExtension",
         "path": "Immunization.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -360,7 +382,7 @@
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.identifier",
+        "id": "Immunization:uscoreimmunizationprofile.identifier",
         "path": "Immunization.identifier",
         "short": "Business identifier",
         "definition": "A unique identifier assigned to this immunization record.",
@@ -377,6 +399,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "rim",
             "map": ".id"
@@ -392,11 +418,11 @@
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.status",
+        "id": "Immunization:uscoreimmunizationprofile.status",
         "path": "Immunization.status",
         "short": "completed | entered-in-error",
         "definition": "Indicates the current status of the vaccination event.",
-        "comments": "Will generally be set to show that the immunization has been completed.",
+        "comment": "Will generally be set to show that the immunization has been completed.\n\nThis element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "min": 1,
         "max": "1",
         "base": {
@@ -411,15 +437,19 @@
         ],
         "mustSupport": true,
         "isModifier": true,
-        "isSummary": false,
+        "isSummary": true,
         "binding": {
           "strength": "required",
           "description": "Constrained list of immunizaiotn status",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/us/core/ValueSet/us-core-immunization-status"
+            "reference": "http://hl7.org/fhir/ValueSet/immunization-status"
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
           {
             "identity": "rim",
             "map": "statusCode"
@@ -427,54 +457,55 @@
           {
             "identity": "w5",
             "map": "status"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Immunization.status"
           }
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.date",
-        "path": "Immunization.date",
-        "short": "Vaccination administration date",
-        "definition": "Date vaccine administered or was to be administered.",
-        "comments": "When immunizations are given a specific date and time should always be known.   When immunizations are patient reported, a specific date might not be known.  Although partial dates are allowed, an adult patient might not be able to recall the year a childhood immunization was given.",
+        "id": "Immunization:uscoreimmunizationprofile.notGiven",
+        "path": "Immunization.notGiven",
+        "short": "Flag for whether immunization was given",
+        "definition": "Indicates if the vaccination was or was not given.",
+        "comment": "This element is labeled as a modifier because it indicates that an immunization didn't happen.",
         "min": 1,
         "max": "1",
         "base": {
-          "path": "Immunization.date",
-          "min": 0,
+          "path": "Immunization.notGiven",
+          "min": 1,
           "max": "1"
         },
         "type": [
           {
-            "code": "dateTime"
+            "code": "boolean"
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isModifier": true,
+        "isSummary": true,
         "mapping": [
           {
-            "identity": "v2",
-            "map": "RXA-3"
+            "identity": "workflow",
+            "map": "Event.notDone"
           },
           {
             "identity": "rim",
-            "map": ".effectiveTime"
-          },
-          {
-            "identity": "cda",
-            "map": "ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/effectiveTime/value"
+            "map": "[actionNegationInd=true].reasonCode"
           },
           {
             "identity": "w5",
-            "map": "when.init"
+            "map": "status"
           },
           {
-            "identity": "quick",
-            "map": "performanceTime"
+            "identity": "argonaut-dq-dstu2",
+            "map": "Immunization.wasNotGiven"
           }
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.vaccineCode",
+        "id": "Immunization:uscoreimmunizationprofile.vaccineCode",
         "path": "Immunization.vaccineCode",
         "short": "Vaccine Product Type (bind to CVX)",
         "definition": "Vaccine that was administered or was to be administered.",
@@ -490,16 +521,42 @@
             "code": "CodeableConcept"
           }
         ],
+        "constraint": [
+          {
+            "extension": [
+              {
+                "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice",
+                "valueBoolean": true
+              }
+            ],
+            "key": "us-core-1",
+            "severity": "warning",
+            "human": "SHOULD have a translation to the NDC value set",
+            "expression": "coding.where(system='http://hl7.org/fhir/sid/ndc').empty()",
+            "xpath": "not(exists(f:coding/f:system[@value='http://hl7.org/fhir/sid/ndc']))"
+          }
+        ],
         "mustSupport": true,
-        "isSummary": false,
         "binding": {
-          "strength": "example",
-          "description": "The code for vaccine product administered",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
+              "valueReference": {
+                "reference": "http://hl7.org/fhir/us/core/ValueSet/us-core-cvx"
+              }
+            }
+          ],
+          "strength": "extensible",
+          "description": "The CVX (vaccine administered) code system",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/vaccine-code"
+            "reference": "http://hl7.org/fhir/us/core/ValueSet/us-core-cvx"
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
           {
             "identity": "v2",
             "map": "RXA-5"
@@ -519,567 +576,537 @@
           {
             "identity": "quick",
             "map": "vaccine"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Immunization.vaccineCode"
           }
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.vaccineCode.id",
-        "path": "Immunization.vaccineCode.id",
-        "representation": [
-          "xmlAttr"
+        "id": "Immunization:uscoreimmunizationprofile.patient",
+        "path": "Immunization.patient",
+        "short": "Who was immunized",
+        "definition": "The patient who either received or did not receive the immunization.",
+        "alias": [
+          "Patient"
         ],
-        "short": "xml:id (or equivalent in JSON)",
-        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
-        "min": 0,
+        "min": 1,
         "max": "1",
         "base": {
-          "path": "Element.id",
-          "min": 0,
+          "path": "Immunization.patient",
+          "min": 1,
           "max": "1"
         },
         "type": [
           {
-            "code": "string"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"
           }
         ],
+        "mustSupport": true,
         "mapping": [
           {
-            "identity": "rim",
-            "map": "n/a"
-          }
-        ]
-      },
-      {
-        "id": "Immunization:uscoreimmunization.vaccineCode.extension",
-        "path": "Immunization.vaccineCode.extension",
-        "short": "Additional Content defined by implementations",
-        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
-        "alias": [
-          "extensions",
-          "user content"
-        ],
-        "min": 0,
-        "max": "*",
-        "base": {
-          "path": "Element.extension",
-          "min": 0,
-          "max": "*"
-        },
-        "type": [
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
-            "code": "Extension"
-          }
-        ],
-        "mapping": [
+            "identity": "v2",
+            "map": "PID-3"
+          },
           {
             "identity": "rim",
-            "map": "n/a"
+            "map": ".partipication[ttypeCode=].role"
+          },
+          {
+            "identity": "w5",
+            "map": "who.focus"
+          },
+          {
+            "identity": "quick",
+            "map": "subject"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Immunization.patient"
           }
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.vaccineCode.coding",
-        "path": "Immunization.vaccineCode.coding",
-        "slicing": {
-          "discriminator": [
-            "code"
-          ],
-          "rules": "open"
-        },
-        "short": "Code defined by a terminology system",
-        "definition": "A reference to a code defined by a terminology system.",
-        "comments": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true.",
-        "requirements": "Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings.",
+        "id": "Immunization:uscoreimmunizationprofile.encounter",
+        "path": "Immunization.encounter",
+        "short": "Encounter administered as part of",
+        "definition": "The visit or admission or other contact between patient and health care provider the immunization was performed as part of.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "base": {
-          "path": "CodeableConcept.coding",
+          "path": "Immunization.encounter",
           "min": 0,
-          "max": "*"
+          "max": "1"
         },
         "type": [
           {
-            "code": "Coding"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Encounter"
           }
         ],
-        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
-            "map": "C*E.1-8, C*E.10-22"
+            "map": "PV1-19"
           },
           {
             "identity": "rim",
-            "map": "union(., ./translation)"
+            "map": "component->EncounterEvent"
           },
           {
-            "identity": "orim",
-            "map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"
+            "identity": "w5",
+            "map": "context"
           }
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.vaccineCode.coding:uscorevaccinecodes",
-        "path": "Immunization.vaccineCode.coding",
-        "sliceName": "USCoreVaccineCodes",
-        "short": "Code defined by a terminology system",
-        "definition": "A reference to a code defined by a terminology system.",
-        "comments": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true.",
-        "requirements": "Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings.",
+        "id": "Immunization:uscoreimmunizationprofile.date",
+        "path": "Immunization.date",
+        "short": "Vaccination administration date",
+        "definition": "Date vaccine administered or was to be administered.",
+        "comment": "When immunizations are given a specific date and time should always be known.   When immunizations are patient reported, a specific date might not be known.  Although partial dates are allowed, an adult patient might not be able to recall the year a childhood immunization was given.",
         "min": 1,
         "max": "1",
         "base": {
-          "path": "CodeableConcept.coding",
+          "path": "Immunization.date",
           "min": 0,
-          "max": "*"
+          "max": "1"
         },
         "type": [
           {
-            "code": "Coding"
+            "code": "dateTime"
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
-        "binding": {
-          "strength": "required",
-          "description": "The CVX (vaccine administered) code system",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/us/core/ValueSet/us-core-cvx"
-          }
-        },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence.occurrenceDateTime"
+          },
           {
             "identity": "v2",
-            "map": "C*E.1-8, C*E.10-22"
+            "map": "RXA-3"
           },
           {
             "identity": "rim",
-            "map": "union(., ./translation)"
+            "map": ".effectiveTime"
           },
           {
-            "identity": "orim",
-            "map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"
+            "identity": "cda",
+            "map": "ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/effectiveTime/value"
+          },
+          {
+            "identity": "w5",
+            "map": "when.init"
           },
           {
             "identity": "quick",
-            "map": "vaccine"
+            "map": "performanceTime"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Immunization.date"
           }
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.vaccineCode.coding",
-        "path": "Immunization.vaccineCode.coding",
-        "short": "Code defined by a terminology system",
-        "definition": "A reference to a code defined by a terminology system.",
-        "comments": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true.",
-        "requirements": "Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings.",
-        "min": 0,
+        "id": "Immunization:uscoreimmunizationprofile.primarySource",
+        "path": "Immunization.primarySource",
+        "short": "Indicates context the data was recorded in",
+        "definition": "An indication that the content of the record is based on information from the person who administered the vaccine. This reflects the context under which the data was originally recorded.",
+        "comment": "Reflects the “reliability” of the content.",
+        "min": 1,
         "max": "1",
         "base": {
-          "path": "CodeableConcept.coding",
-          "min": 0,
-          "max": "*"
+          "path": "Immunization.primarySource",
+          "min": 1,
+          "max": "1"
         },
         "type": [
           {
-            "code": "Coding"
+            "code": "boolean"
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
-        "binding": {
-          "strength": "required",
-          "description": "NDC codes to identify vaccines",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/us/core/ValueSet/us-core-ndc-vaccine-codes"
-          }
-        },
         "mapping": [
           {
             "identity": "v2",
-            "map": "C*E.1-8, C*E.10-22"
+            "map": "RXA-9"
           },
           {
             "identity": "rim",
-            "map": "union(., ./translation)"
+            "map": "immunization.uncertaintycode (if primary source=false, uncertainty=U)"
           },
           {
-            "identity": "orim",
-            "map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"
+            "identity": "w5",
+            "map": "who.source"
           },
           {
             "identity": "quick",
-            "map": "vaccine"
+            "map": "reported"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Immunization.reported"
           }
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.vaccineCode.text",
-        "path": "Immunization.vaccineCode.text",
-        "short": "Plain text representation of the concept",
-        "definition": "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.",
-        "comments": "Very often the text is the same as a displayName of one of the codings.",
-        "requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.",
+        "id": "Immunization:uscoreimmunizationprofile.reportOrigin",
+        "path": "Immunization.reportOrigin",
+        "short": "Indicates the source of a secondarily reported record",
+        "definition": "The source of the data when the report of the immunization event is not based on information from the person who administered the vaccine.",
+        "comment": "Should not be populated if primarySource = True, will not be required even if primarySource = False.",
         "min": 0,
         "max": "1",
         "base": {
-          "path": "CodeableConcept.text",
+          "path": "Immunization.reportOrigin",
           "min": 0,
           "max": "1"
         },
         "type": [
           {
-            "code": "string"
+            "code": "CodeableConcept"
           }
         ],
-        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ImmunizationReportOrigin"
+            }
+          ],
+          "strength": "example",
+          "description": "The source of the data for a record which is not from a primary source.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/immunization-origin"
+          }
+        },
         "mapping": [
           {
             "identity": "v2",
-            "map": "C*E.9. But note many systems use C*E.2 for this"
+            "map": "RXA-9"
           },
           {
             "identity": "rim",
-            "map": "./originalText[mediaType/code=\"text/plain\"]/data"
+            "map": ".participation[typeCode=INF].role[classCode=PAT] (this syntax for self-reported)\n.participation[typeCode=INF].role[classCode=LIC] (this syntax for health care professional)\n.participation[typeCode=INF].role[classCode=PRS] (this syntax for family member)"
           },
           {
-            "identity": "orim",
-            "map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"
+            "identity": "w5",
+            "map": "who.source"
           }
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.patient",
-        "path": "Immunization.patient",
-        "short": "Who was immunized",
-        "definition": "The patient who either received or did not receive the immunization.",
-        "alias": [
-          "Patient"
-        ],
-        "min": 1,
+        "id": "Immunization:uscoreimmunizationprofile.location",
+        "path": "Immunization.location",
+        "short": "Where vaccination occurred",
+        "definition": "The service delivery location where the vaccine administration occurred.",
+        "min": 0,
         "max": "1",
         "base": {
-          "path": "Immunization.patient",
-          "min": 1,
+          "path": "Immunization.location",
+          "min": 0,
           "max": "1"
         },
         "type": [
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Location"
           }
         ],
-        "mustSupport": true,
-        "isSummary": false,
         "mapping": [
           {
             "identity": "v2",
-            "map": "PID-3"
-          },
-          {
-            "identity": "rim",
-            "map": ".partipication[ttypeCode=].role"
-          },
-          {
-            "identity": "w5",
-            "map": "who.focus"
+            "map": "RXA-27  (or RXA-11, deprecated as of v2.7)"
           },
-          {
-            "identity": "quick",
-            "map": "subject"
-          }
-        ]
-      },
-      {
-        "id": "Immunization:uscoreimmunization.wasNotGiven",
-        "path": "Immunization.wasNotGiven",
-        "short": "Flag for whether immunization was given",
-        "definition": "Indicates if the vaccination was or was not given.",
-        "min": 1,
-        "max": "1",
-        "base": {
-          "path": "Immunization.wasNotGiven",
-          "min": 1,
-          "max": "1"
-        },
-        "type": [
-          {
-            "code": "boolean"
-          }
-        ],
-        "mustSupport": true,
-        "isModifier": true,
-        "isSummary": false,
-        "mapping": [
           {
             "identity": "rim",
-            "map": "[actionNegationInd=true].reasonCode"
+            "map": ".participation[typeCode=LOC].COCT_MT240000UV"
           },
           {
             "identity": "w5",
-            "map": "status"
+            "map": "where"
           }
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.primarySource",
-        "path": "Immunization.primarySource",
-        "short": "Indicates context the data was recorded in",
-        "definition": "An indication that the content of the record is based on information from the person who administered the vaccine. This reflects the context under which the data was originally recorded.",
-        "comments": "Reflects the “reliability” of the content.",
-        "min": 1,
+        "id": "Immunization:uscoreimmunizationprofile.manufacturer",
+        "path": "Immunization.manufacturer",
+        "short": "Vaccine manufacturer",
+        "definition": "Name of vaccine manufacturer.",
+        "min": 0,
         "max": "1",
         "base": {
-          "path": "Immunization.primarySource",
-          "min": 1,
+          "path": "Immunization.manufacturer",
+          "min": 0,
           "max": "1"
         },
         "type": [
           {
-            "code": "boolean"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
           }
         ],
-        "mustSupport": true,
-        "isSummary": false,
         "mapping": [
           {
             "identity": "v2",
-            "map": "RXA-9"
+            "map": "RXA-17"
           },
           {
             "identity": "rim",
-            "map": "immunization.uncertaintycode (if primary source=false, uncertainty=U)"
-          },
-          {
-            "identity": "w5",
-            "map": "who.source"
+            "map": ".participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=ORG]"
           },
           {
-            "identity": "quick",
-            "map": "reported"
+            "identity": "cda",
+            "map": "ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacuturerOrganization/name"
           }
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.reportOrigin",
-        "path": "Immunization.reportOrigin",
-        "short": "Indicates the source of a secondarily reported record",
-        "definition": "The source of the data when the report of the immunization event is not based on information from the person who administered the vaccine.",
-        "comments": "Should not be populated if primarySource = True, will not be required even if primarySource = False.",
+        "id": "Immunization:uscoreimmunizationprofile.lotNumber",
+        "path": "Immunization.lotNumber",
+        "short": "Vaccine lot number",
+        "definition": "Lot number of the  vaccine product.",
         "min": 0,
         "max": "1",
         "base": {
-          "path": "Immunization.reportOrigin",
+          "path": "Immunization.lotNumber",
           "min": 0,
           "max": "1"
         },
         "type": [
           {
-            "code": "CodeableConcept"
+            "code": "string"
           }
         ],
-        "binding": {
-          "strength": "example",
-          "description": "The source of the data for a record which is not from a primary source.",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/immunization-origin"
-          }
-        },
         "mapping": [
           {
             "identity": "v2",
-            "map": "RXA-9"
+            "map": "RXA-15"
           },
           {
             "identity": "rim",
-            "map": ".participation[typeCode=INF].role[classCode=PAT] (this syntax for self-reported) .participation[typeCode=INF].role[classCode=LIC] (this syntax for health care professional) .participation[typeCode=INF].role[classCode=PRS] (this syntax for family member)"
+            "map": ".participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].id"
           },
           {
-            "identity": "w5",
-            "map": "who.source"
+            "identity": "cda",
+            "map": "ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacturedMaterial/lotNumberText"
           }
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.performer",
-        "path": "Immunization.performer",
-        "short": "Who administered vaccine",
-        "definition": "Clinician who administered the vaccine.",
+        "id": "Immunization:uscoreimmunizationprofile.expirationDate",
+        "path": "Immunization.expirationDate",
+        "short": "Vaccine expiration date",
+        "definition": "Date vaccine batch expires.",
         "min": 0,
         "max": "1",
         "base": {
-          "path": "Immunization.performer",
+          "path": "Immunization.expirationDate",
           "min": 0,
           "max": "1"
         },
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
+            "code": "date"
           }
         ],
         "mapping": [
           {
             "identity": "v2",
-            "map": "RXA-10"
+            "map": "RXA-16"
           },
           {
             "identity": "rim",
-            "map": ".participation[typeCode=PRF].COCT_MT090102UV"
-          },
-          {
-            "identity": "cda",
-            "map": "ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/performer/assignedEntity/assignedPerson/name"
-          },
-          {
-            "identity": "w5",
-            "map": "who.actor"
+            "map": ".participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].expirationTime"
           }
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.requester",
-        "path": "Immunization.requester",
-        "short": "Who ordered vaccination",
-        "definition": "Clinician who ordered the vaccination.",
-        "comments": "Other participants - delegate to Provenance resource.",
+        "id": "Immunization:uscoreimmunizationprofile.site",
+        "path": "Immunization.site",
+        "short": "Body site vaccine  was administered",
+        "definition": "Body site where vaccine was administered.",
         "min": 0,
         "max": "1",
         "base": {
-          "path": "Immunization.requester",
+          "path": "Immunization.site",
           "min": 0,
           "max": "1"
         },
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
+            "code": "CodeableConcept"
           }
         ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ImmunizationSite"
+            }
+          ],
+          "strength": "example",
+          "description": "The site at which the vaccine was administered",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/immunization-site"
+          }
+        },
         "mapping": [
           {
             "identity": "v2",
-            "map": "ORC-12"
+            "map": "RXR-2"
           },
           {
             "identity": "rim",
-            "map": "outboundRelationship.target[classCode=SBADM].participation[typeCode=AUT].COCT_MT090102UV"
+            "map": "observation.targetSiteCode"
           },
           {
-            "identity": "w5",
-            "map": "who.cause"
+            "identity": "cda",
+            "map": "ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/approachSiteCode/code"
           }
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.encounter",
-        "path": "Immunization.encounter",
-        "short": "Encounter administered as part of",
-        "definition": "The visit or admission or other contact between patient and health care provider the immunization was performed as part of.",
+        "id": "Immunization:uscoreimmunizationprofile.route",
+        "path": "Immunization.route",
+        "short": "How vaccine entered body",
+        "definition": "The path by which the vaccine product is taken into the body.",
         "min": 0,
         "max": "1",
         "base": {
-          "path": "Immunization.encounter",
+          "path": "Immunization.route",
           "min": 0,
           "max": "1"
         },
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Encounter"
+            "code": "CodeableConcept"
           }
         ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ImmunizationRoute"
+            }
+          ],
+          "strength": "example",
+          "description": "The route by which the vaccine was administered",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/immunization-route"
+          }
+        },
         "mapping": [
           {
             "identity": "v2",
-            "map": "PV1-19"
+            "map": "RXR-1"
           },
           {
             "identity": "rim",
-            "map": "component->EncounterEvent"
+            "map": ".routeCode"
           },
           {
-            "identity": "w5",
-            "map": "context"
+            "identity": "cda",
+            "map": "ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/routeCode/code"
           }
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.manufacturer",
-        "path": "Immunization.manufacturer",
-        "short": "Vaccine manufacturer",
-        "definition": "Name of vaccine manufacturer.",
+        "id": "Immunization:uscoreimmunizationprofile.doseQuantity",
+        "path": "Immunization.doseQuantity",
+        "short": "Amount of vaccine administered",
+        "definition": "The quantity of vaccine product that was administered.",
         "min": 0,
         "max": "1",
         "base": {
-          "path": "Immunization.manufacturer",
+          "path": "Immunization.doseQuantity",
           "min": 0,
           "max": "1"
         },
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
+            "code": "Quantity",
+            "profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
           }
         ],
         "mapping": [
           {
             "identity": "v2",
-            "map": "RXA-17"
+            "map": "RXA-6 / RXA-7.1"
           },
           {
             "identity": "rim",
-            "map": ".participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=ORG]"
-          },
-          {
-            "identity": "cda",
-            "map": "ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacuturerOrganization/name"
+            "map": ".doseQuantity"
           }
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.location",
-        "path": "Immunization.location",
-        "short": "Where vaccination occurred",
-        "definition": "The service delivery location where the vaccine administration occurred.",
+        "id": "Immunization:uscoreimmunizationprofile.practitioner",
+        "path": "Immunization.practitioner",
+        "short": "Who performed event",
+        "definition": "Indicates who or what performed the event.",
         "min": 0,
-        "max": "1",
+        "max": "*",
         "base": {
-          "path": "Immunization.location",
+          "path": "Immunization.practitioner",
           "min": 0,
-          "max": "1"
+          "max": "*"
         },
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Location"
+            "code": "BackboneElement"
+          }
+        ],
+        "constraint": [
+          {
+            "key": "ele-1",
+            "severity": "error",
+            "human": "All FHIR elements must have a @value or children",
+            "expression": "children().count() > id.count()",
+            "xpath": "@value|f:*|h:div",
+            "source": "Element"
           }
         ],
+        "isSummary": true,
         "mapping": [
           {
-            "identity": "v2",
-            "map": "RXA-27  (or RXA-11, deprecated as of v2.7)"
+            "identity": "workflow",
+            "map": "Event.performer"
           },
           {
-            "identity": "rim",
-            "map": ".participation[typeCode=LOC].COCT_MT240000UV"
+            "identity": "v2",
+            "map": "ORC-12 / RXA-10"
           },
           {
-            "identity": "w5",
-            "map": "where"
+            "identity": "rim",
+            "map": ".participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]"
           }
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.lotNumber",
-        "path": "Immunization.lotNumber",
-        "short": "Vaccine lot number",
-        "definition": "Lot number of the  vaccine product.",
+        "id": "Immunization:uscoreimmunizationprofile.practitioner.id",
+        "path": "Immunization.practitioner.id",
+        "representation": [
+          "xmlAttr"
+        ],
+        "short": "xml:id (or equivalent in JSON)",
+        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
         "min": 0,
         "max": "1",
         "base": {
-          "path": "Immunization.lotNumber",
+          "path": "Element.id",
           "min": 0,
           "max": "1"
         },
@@ -1089,96 +1116,82 @@
           }
         ],
         "mapping": [
-          {
-            "identity": "v2",
-            "map": "RXA-15"
-          },
           {
             "identity": "rim",
-            "map": ".participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].id"
-          },
-          {
-            "identity": "cda",
-            "map": "ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacturedMaterial/lotNumberText"
+            "map": "n/a"
           }
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.expirationDate",
-        "path": "Immunization.expirationDate",
-        "short": "Vaccine expiration date",
-        "definition": "Date vaccine batch expires.",
+        "id": "Immunization:uscoreimmunizationprofile.practitioner.extension",
+        "path": "Immunization.practitioner.extension",
+        "short": "Additional Content defined by implementations",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content"
+        ],
         "min": 0,
-        "max": "1",
+        "max": "*",
         "base": {
-          "path": "Immunization.expirationDate",
+          "path": "Element.extension",
           "min": 0,
-          "max": "1"
+          "max": "*"
         },
         "type": [
           {
-            "code": "date"
+            "code": "Extension"
           }
         ],
         "mapping": [
-          {
-            "identity": "v2",
-            "map": "RXA-16"
-          },
           {
             "identity": "rim",
-            "map": ".participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].expirationTime"
+            "map": "n/a"
           }
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.site",
-        "path": "Immunization.site",
-        "short": "Body site vaccine  was administered",
-        "definition": "Body site where vaccine was administered.",
+        "id": "Immunization:uscoreimmunizationprofile.practitioner.modifierExtension",
+        "path": "Immunization.practitioner.modifierExtension",
+        "short": "Extensions that cannot be ignored",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content",
+          "modifiers"
+        ],
         "min": 0,
-        "max": "1",
+        "max": "*",
         "base": {
-          "path": "Immunization.site",
+          "path": "BackboneElement.modifierExtension",
           "min": 0,
-          "max": "1"
+          "max": "*"
         },
         "type": [
           {
-            "code": "CodeableConcept"
+            "code": "Extension"
           }
         ],
-        "binding": {
-          "strength": "example",
-          "description": "The site at which the vaccine was administered",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/immunization-site"
-          }
-        },
+        "isModifier": true,
+        "isSummary": true,
         "mapping": [
-          {
-            "identity": "v2",
-            "map": "RXR-2"
-          },
           {
             "identity": "rim",
-            "map": "observation.targetSiteCode"
-          },
-          {
-            "identity": "cda",
-            "map": "ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/approachSiteCode/code"
+            "map": "N/A"
           }
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.route",
-        "path": "Immunization.route",
-        "short": "How vaccine entered body",
-        "definition": "The path by which the vaccine product is taken into the body.",
+        "id": "Immunization:uscoreimmunizationprofile.practitioner.role",
+        "path": "Immunization.practitioner.role",
+        "short": "What type of performance was done",
+        "definition": "Describes the type of performance (e.g. ordering provider, administering provider, etc.).",
         "min": 0,
         "max": "1",
         "base": {
-          "path": "Immunization.route",
+          "path": "Immunization.practitioner.role",
           "min": 0,
           "max": "1"
         },
@@ -1187,59 +1200,67 @@
             "code": "CodeableConcept"
           }
         ],
+        "isSummary": true,
         "binding": {
-          "strength": "example",
-          "description": "The route by which the vaccine was administered",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ImmunizationRole"
+            }
+          ],
+          "strength": "extensible",
+          "description": "The role a practitioner plays in the immunization event",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/immunization-route"
+            "reference": "http://hl7.org/fhir/ValueSet/immunization-role"
           }
         },
         "mapping": [
           {
-            "identity": "v2",
-            "map": "RXR-1"
+            "identity": "workflow",
+            "map": "Event.performer.role"
           },
           {
             "identity": "rim",
-            "map": ".routeCode"
-          },
-          {
-            "identity": "cda",
-            "map": "ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/routeCode/code"
+            "map": ".participation.functionCode"
           }
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.doseQuantity",
-        "path": "Immunization.doseQuantity",
-        "short": "Amount of vaccine administered",
-        "definition": "The quantity of vaccine product that was administered.",
-        "min": 0,
+        "id": "Immunization:uscoreimmunizationprofile.practitioner.actor",
+        "path": "Immunization.practitioner.actor",
+        "short": "Individual who was performing",
+        "definition": "The device, practitioner, etc. who performed the action.",
+        "min": 1,
         "max": "1",
         "base": {
-          "path": "Immunization.doseQuantity",
-          "min": 0,
+          "path": "Immunization.practitioner.actor",
+          "min": 1,
           "max": "1"
         },
         "type": [
           {
-            "code": "Quantity",
-            "profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
           }
         ],
+        "isSummary": true,
         "mapping": [
           {
-            "identity": "v2",
-            "map": "RXA-6 / RXA-7.1"
+            "identity": "workflow",
+            "map": "Event.performer.actor"
           },
           {
             "identity": "rim",
-            "map": ".doseQuantity"
+            "map": ".player"
+          },
+          {
+            "identity": "w5",
+            "map": "who.actor"
           }
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.note",
+        "id": "Immunization:uscoreimmunizationprofile.note",
         "path": "Immunization.note",
         "short": "Vaccination notes",
         "definition": "Extra information about the immunization that is not conveyed by the other attributes.",
@@ -1257,6 +1278,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "rim",
             "map": "note"
@@ -1264,7 +1289,7 @@
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.explanation",
+        "id": "Immunization:uscoreimmunizationprofile.explanation",
         "path": "Immunization.explanation",
         "short": "Administration/non-administration reasons",
         "definition": "Reasons why a vaccine was or was not administered.",
@@ -1298,7 +1323,7 @@
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.explanation.id",
+        "id": "Immunization:uscoreimmunizationprofile.explanation.id",
         "path": "Immunization.explanation.id",
         "representation": [
           "xmlAttr"
@@ -1325,11 +1350,11 @@
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.explanation.extension",
+        "id": "Immunization:uscoreimmunizationprofile.explanation.extension",
         "path": "Immunization.explanation.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1354,11 +1379,11 @@
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.explanation.modifierExtension",
+        "id": "Immunization:uscoreimmunizationprofile.explanation.modifierExtension",
         "path": "Immunization.explanation.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1386,7 +1411,7 @@
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.explanation.reason",
+        "id": "Immunization:uscoreimmunizationprofile.explanation.reason",
         "path": "Immunization.explanation.reason",
         "short": "Why immunization occurred",
         "definition": "Reasons why a vaccine was administered.",
@@ -1403,6 +1428,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ImmunizationReason"
+            }
+          ],
           "strength": "example",
           "description": "The reason why a vaccine was administered",
           "valueSetReference": {
@@ -1410,6 +1441,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.reasonCodeableConcept"
+          },
           {
             "identity": "rim",
             "map": "[actionNegationInd=false].reasonCode"
@@ -1417,7 +1452,7 @@
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.explanation.reasonNotGiven",
+        "id": "Immunization:uscoreimmunizationprofile.explanation.reasonNotGiven",
         "path": "Immunization.explanation.reasonNotGiven",
         "short": "Why immunization did not occur",
         "definition": "Reason why a vaccine was not administered.",
@@ -1434,6 +1469,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "NoImmunizationReason"
+            }
+          ],
           "strength": "example",
           "description": "The reason why a vaccine was not administered",
           "valueSetReference": {
@@ -1441,6 +1482,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDoneReason"
+          },
           {
             "identity": "v2",
             "map": "RXA-18"
@@ -1452,11 +1497,11 @@
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.reaction",
+        "id": "Immunization:uscoreimmunizationprofile.reaction",
         "path": "Immunization.reaction",
         "short": "Details of a reaction that follows immunization",
         "definition": "Categorical data indicating that an adverse event is associated in time to an immunization.",
-        "comments": "A reaction may be an indication of an allergy or intolerance and, if this is determined to be the case,  it should be recorded as a new [AllergyIntolerance](allergyintolerance.html) resource instance as most systems will not query against  past Immunization.reaction elements.",
+        "comment": "A reaction may be an indication of an allergy or intolerance and, if this is determined to be the case,  it should be recorded as a new [AllergyIntolerance](allergyintolerance.html) resource instance as most systems will not query against  past Immunization.reaction elements.",
         "min": 0,
         "max": "*",
         "base": {
@@ -1491,7 +1536,7 @@
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.reaction.id",
+        "id": "Immunization:uscoreimmunizationprofile.reaction.id",
         "path": "Immunization.reaction.id",
         "representation": [
           "xmlAttr"
@@ -1518,11 +1563,11 @@
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.reaction.extension",
+        "id": "Immunization:uscoreimmunizationprofile.reaction.extension",
         "path": "Immunization.reaction.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1547,11 +1592,11 @@
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.reaction.modifierExtension",
+        "id": "Immunization:uscoreimmunizationprofile.reaction.modifierExtension",
         "path": "Immunization.reaction.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1579,7 +1624,7 @@
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.reaction.date",
+        "id": "Immunization:uscoreimmunizationprofile.reaction.date",
         "path": "Immunization.reaction.date",
         "short": "When reaction started",
         "definition": "Date of reaction to the immunization.",
@@ -1607,7 +1652,7 @@
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.reaction.detail",
+        "id": "Immunization:uscoreimmunizationprofile.reaction.detail",
         "path": "Immunization.reaction.detail",
         "short": "Additional information on reaction",
         "definition": "Details of the reaction.",
@@ -1636,7 +1681,7 @@
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.reaction.reported",
+        "id": "Immunization:uscoreimmunizationprofile.reaction.reported",
         "path": "Immunization.reaction.reported",
         "short": "Indicates self-reported reaction",
         "definition": "Self-reported indicator.",
@@ -1664,7 +1709,7 @@
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.vaccinationProtocol",
+        "id": "Immunization:uscoreimmunizationprofile.vaccinationProtocol",
         "path": "Immunization.vaccinationProtocol",
         "short": "What protocol was followed",
         "definition": "Contains information about the protocol(s) under which the vaccine was administered.",
@@ -1702,7 +1747,7 @@
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.vaccinationProtocol.id",
+        "id": "Immunization:uscoreimmunizationprofile.vaccinationProtocol.id",
         "path": "Immunization.vaccinationProtocol.id",
         "representation": [
           "xmlAttr"
@@ -1729,11 +1774,11 @@
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.vaccinationProtocol.extension",
+        "id": "Immunization:uscoreimmunizationprofile.vaccinationProtocol.extension",
         "path": "Immunization.vaccinationProtocol.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1758,11 +1803,11 @@
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.vaccinationProtocol.modifierExtension",
+        "id": "Immunization:uscoreimmunizationprofile.vaccinationProtocol.modifierExtension",
         "path": "Immunization.vaccinationProtocol.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1790,7 +1835,7 @@
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.vaccinationProtocol.doseSequence",
+        "id": "Immunization:uscoreimmunizationprofile.vaccinationProtocol.doseSequence",
         "path": "Immunization.vaccinationProtocol.doseSequence",
         "short": "Dose number within series",
         "definition": "Nominal position in a series.",
@@ -1814,7 +1859,7 @@
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.vaccinationProtocol.description",
+        "id": "Immunization:uscoreimmunizationprofile.vaccinationProtocol.description",
         "path": "Immunization.vaccinationProtocol.description",
         "short": "Details of vaccine protocol",
         "definition": "Contains the description about the protocol under which the vaccine was administered.",
@@ -1838,7 +1883,7 @@
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.vaccinationProtocol.authority",
+        "id": "Immunization:uscoreimmunizationprofile.vaccinationProtocol.authority",
         "path": "Immunization.vaccinationProtocol.authority",
         "short": "Who is responsible for protocol",
         "definition": "Indicates the authority who published the protocol.  E.g. ACIP.",
@@ -1863,7 +1908,7 @@
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.vaccinationProtocol.series",
+        "id": "Immunization:uscoreimmunizationprofile.vaccinationProtocol.series",
         "path": "Immunization.vaccinationProtocol.series",
         "short": "Name of vaccine series",
         "definition": "One possible path to achieve presumed immunity against a disease - within the context of an authority.",
@@ -1887,7 +1932,7 @@
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.vaccinationProtocol.seriesDoses",
+        "id": "Immunization:uscoreimmunizationprofile.vaccinationProtocol.seriesDoses",
         "path": "Immunization.vaccinationProtocol.seriesDoses",
         "short": "Recommended number of doses for immunity",
         "definition": "The recommended number of doses to achieve immunity.",
@@ -1911,7 +1956,7 @@
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.vaccinationProtocol.targetDisease",
+        "id": "Immunization:uscoreimmunizationprofile.vaccinationProtocol.targetDisease",
         "path": "Immunization.vaccinationProtocol.targetDisease",
         "short": "Disease immunized against",
         "definition": "The targeted disease.",
@@ -1928,6 +1973,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "VaccinationProtocoltargetDisease"
+            }
+          ],
           "strength": "example",
           "description": "The disease target of the vaccination protocol",
           "valueSetReference": {
@@ -1942,11 +1993,11 @@
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.vaccinationProtocol.doseStatus",
+        "id": "Immunization:uscoreimmunizationprofile.vaccinationProtocol.doseStatus",
         "path": "Immunization.vaccinationProtocol.doseStatus",
         "short": "Indicates if dose counts towards immunity",
         "definition": "Indicates if the immunization event should \"count\" against  the protocol.",
-        "comments": "May need to differentiate between status declarations by a provider vs. a CDS engine.",
+        "comment": "May need to differentiate between status declarations by a provider vs. a CDS engine.",
         "min": 1,
         "max": "1",
         "base": {
@@ -1960,6 +2011,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "VaccinationProtocolDoseStatus"
+            }
+          ],
           "strength": "example",
           "description": "The status of the vaccination protocol (i.e. should this count)",
           "valueSetReference": {
@@ -1974,7 +2031,7 @@
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.vaccinationProtocol.doseStatusReason",
+        "id": "Immunization:uscoreimmunizationprofile.vaccinationProtocol.doseStatusReason",
         "path": "Immunization.vaccinationProtocol.doseStatusReason",
         "short": "Why dose does (not) count",
         "definition": "Provides an explanation as to why an immunization event should or should not count against the protocol.",
@@ -1991,6 +2048,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "VaccinationProtocolDoseStatusReason"
+            }
+          ],
           "strength": "example",
           "description": "The reason for the determining if a vaccination should count or why vaccination should not count.",
           "valueSetReference": {
@@ -2009,15 +2072,21 @@
   "differential": {
     "element": [
       {
-        "id": "Immunization:uscoreimmunization",
+        "id": "Immunization:uscoreimmunizationprofile",
         "path": "Immunization",
-        "sliceName": "USCoreImmunization",
         "short": "US Core Immunization Profile",
         "definition": "The US Core Immunization Profile is based upon the core FHIR Immunization Resource and created to meet the 2015 Edition Common Clinical Data Set 'Immunizations' requirements.",
         "mustSupport": false,
         "isModifier": false,
-        "isSummary": false,
         "mapping": [
+          {
+            "identity": "quick",
+            "map": "ImmunizationPerformanceOccurrence"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Immunization"
+          },
           {
             "identity": "quick",
             "map": "ImmunizationPerformanceOccurrence"
@@ -2025,7 +2094,7 @@
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.status",
+        "id": "Immunization:uscoreimmunizationprofile.status",
         "path": "Immunization.status",
         "min": 1,
         "max": "1",
@@ -2036,37 +2105,41 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false,
         "binding": {
           "strength": "required",
           "description": "Constrained list of immunizaiotn status",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/us/core/ValueSet/us-core-immunization-status"
+            "reference": "http://hl7.org/fhir/ValueSet/immunization-status"
           }
-        }
+        },
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Immunization.status"
+          }
+        ]
       },
       {
-        "id": "Immunization:uscoreimmunization.date",
-        "path": "Immunization.date",
+        "id": "Immunization:uscoreimmunizationprofile.notGiven",
+        "path": "Immunization.notGiven",
         "min": 1,
         "max": "1",
         "type": [
           {
-            "code": "dateTime"
+            "code": "boolean"
           }
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false,
         "mapping": [
           {
-            "identity": "quick",
-            "map": "performanceTime"
+            "identity": "argonaut-dq-dstu2",
+            "map": "Immunization.wasNotGiven"
           }
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.vaccineCode",
+        "id": "Immunization:uscoreimmunizationprofile.vaccineCode",
         "path": "Immunization.vaccineCode",
         "short": "Vaccine Product Type (bind to CVX)",
         "min": 1,
@@ -2076,38 +2149,33 @@
             "code": "CodeableConcept"
           }
         ],
-        "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false,
-        "mapping": [
-          {
-            "identity": "quick",
-            "map": "vaccine"
-          }
-        ]
-      },
-      {
-        "id": "Immunization:uscoreimmunization.vaccineCode.coding:uscorevaccinecodes",
-        "path": "Immunization.vaccineCode.coding",
-        "sliceName": "USCoreVaccineCodes",
-        "slicing": {
-          "discriminator": [
-            "code"
-          ],
-          "rules": "open"
-        },
-        "min": 1,
-        "max": "1",
-        "type": [
+        "constraint": [
           {
-            "code": "Coding"
+            "extension": [
+              {
+                "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice",
+                "valueBoolean": true
+              }
+            ],
+            "key": "us-core-1",
+            "severity": "warning",
+            "human": "SHOULD have a translation to the NDC value set",
+            "expression": "coding.where(system='http://hl7.org/fhir/sid/ndc').empty()",
+            "xpath": "not(exists(f:coding/f:system[@value='http://hl7.org/fhir/sid/ndc']))"
           }
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false,
         "binding": {
-          "strength": "required",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
+              "valueReference": {
+                "reference": "http://hl7.org/fhir/us/core/ValueSet/us-core-cvx"
+              }
+            }
+          ],
+          "strength": "extensible",
           "description": "The CVX (vaccine administered) code system",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/us/core/ValueSet/us-core-cvx"
@@ -2117,30 +2185,11 @@
           {
             "identity": "quick",
             "map": "vaccine"
-          }
-        ]
-      },
-      {
-        "id": "Immunization:uscoreimmunization.vaccineCode.coding",
-        "path": "Immunization.vaccineCode.coding",
-        "min": 0,
-        "max": "1",
-        "type": [
+          },
           {
-            "code": "Coding"
-          }
-        ],
-        "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false,
-        "binding": {
-          "strength": "required",
-          "description": "NDC codes to identify vaccines",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/us/core/ValueSet/us-core-ndc-vaccine-codes"
-          }
-        },
-        "mapping": [
+            "identity": "argonaut-dq-dstu2",
+            "map": "Immunization.vaccineCode"
+          },
           {
             "identity": "quick",
             "map": "vaccine"
@@ -2148,7 +2197,7 @@
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.patient",
+        "id": "Immunization:uscoreimmunizationprofile.patient",
         "path": "Immunization.patient",
         "alias": [
           "Patient"
@@ -2163,8 +2212,15 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false,
         "mapping": [
+          {
+            "identity": "quick",
+            "map": "subject"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Immunization.patient"
+          },
           {
             "identity": "quick",
             "map": "subject"
@@ -2172,21 +2228,34 @@
         ]
       },
       {
-        "id": "Immunization:uscoreimmunization.wasNotGiven",
-        "path": "Immunization.wasNotGiven",
+        "id": "Immunization:uscoreimmunizationprofile.date",
+        "path": "Immunization.date",
         "min": 1,
         "max": "1",
         "type": [
           {
-            "code": "boolean"
+            "code": "dateTime"
           }
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "quick",
+            "map": "performanceTime"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Immunization.date"
+          },
+          {
+            "identity": "quick",
+            "map": "performanceTime"
+          }
+        ]
       },
       {
-        "id": "Immunization:uscoreimmunization.primarySource",
+        "id": "Immunization:uscoreimmunizationprofile.primarySource",
         "path": "Immunization.primarySource",
         "min": 1,
         "max": "1",
@@ -2197,8 +2266,15 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false,
         "mapping": [
+          {
+            "identity": "quick",
+            "map": "reported"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Immunization.reported"
+          },
           {
             "identity": "quick",
             "map": "reported"
@@ -2207,4 +2283,4 @@
       }
     ]
   }
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/StructureDefinition-us-core-location.json b/lib/resources/us_core/StructureDefinition-us-core-location.json
index 6df9ddc..cbf009d 100755
--- a/lib/resources/us_core/StructureDefinition-us-core-location.json
+++ b/lib/resources/us_core/StructureDefinition-us-core-location.json
@@ -3,12 +3,14 @@
   "id": "us-core-location",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-location\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-location</a></p><p><b>name</b>: US Core Location Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: Health Level Seven International (FHIR-Infrastructure)</p><p><b>contact</b>: </p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-location\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-location</a></p><p><b>name</b>: US Core Location Profile</p><p><b>status</b>: DRAFT</p><p><b>publisher</b>: Health Level Seven International (FHIR-Infrastructure)</p><p><b>contact</b>: </p><p><b>date</b>: 01/08/2016</p><blockquote><p><b>mapping</b></p><p><b>identity</b>: servd</p><p><b>uri</b>: <a href=\"http://www.omg.org/spec/ServD/1.0/\">http://www.omg.org/spec/ServD/1.0/</a></p><p><b>name</b>: ServD</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: rim</p><p><b>uri</b>: <a href=\"http://hl7.org/v3\">http://hl7.org/v3</a></p><p><b>name</b>: RIM Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: w5</p><p><b>uri</b>: <a href=\"http://hl7.org/fhir/w5\">http://hl7.org/fhir/w5</a></p><p><b>name</b>: W5 Mapping</p></blockquote><p><b>kind</b>: RESOURCE</p><p><b>abstract</b>: false</p><p><b>type</b>: Location</p><p><b>baseDefinition</b>: <a href=\"http://hl7.org/fhir/StructureDefinition/Location\">http://hl7.org/fhir/StructureDefinition/Location</a></p><p><b>derivation</b>: CONSTRAINT</p><h3>Snapshots</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table><h3>Differentials</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table></div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-location\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-location</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: US  Core Location Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: HL7 US Realm Steering Committee</p><p><b>contact</b>: </p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-location\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-location</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: US  Core Location Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: HL7 US Realm Steering Committee</p><p><b>contact</b>: </p><p><b>fhirVersion</b>: 3.0.0</p><blockquote><p><b>mapping</b></p><p><b>identity</b>: servd</p><p><b>uri</b>: <a href=\"http://www.omg.org/spec/ServD/1.0/\">http://www.omg.org/spec/ServD/1.0/</a></p><p><b>name</b>: ServD</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: rim</p><p><b>uri</b>: <a href=\"http://hl7.org/v3\">http://hl7.org/v3</a></p><p><b>name</b>: RIM Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: w5</p><p><b>uri</b>: <a href=\"http://hl7.org/fhir/w5\">http://hl7.org/fhir/w5</a></p><p><b>name</b>: W5 Mapping</p></blockquote><p><b>kind</b>: RESOURCE</p><p><b>abstract</b>: false</p><p><b>type</b>: Location</p><p><b>baseDefinition</b>: <a href=\"http://hl7.org/fhir/StructureDefinition/Location\">http://hl7.org/fhir/StructureDefinition/Location</a></p><p><b>derivation</b>: CONSTRAINT</p><h3>Snapshots</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table><h3>Differentials</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table></div>"
   },
   "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-location",
-  "name": "US Core Location Profile",
+  "version": "1.0.0",
+  "name": "US  Core Location Profile",
   "status": "draft",
-  "publisher": "Health Level Seven International (FHIR-Infrastructure)",
+  "date": "2016-08-01",
+  "publisher": "HL7 US Realm Steering Committee",
   "contact": [
     {
       "telecom": [
@@ -19,7 +21,7 @@
       ]
     }
   ],
-  "date": "2016-08-01",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "servd",
@@ -92,7 +94,6 @@
           }
         ],
         "mustSupport": false,
-        "isSummary": false,
         "mapping": [
           {
             "identity": "rim",
@@ -117,7 +118,7 @@
         "path": "Location.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -156,7 +157,7 @@
         "path": "Location.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -177,7 +178,7 @@
         "path": "Location.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -197,6 +198,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -211,7 +220,7 @@
         "path": "Location.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -245,7 +254,7 @@
         "path": "Location.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -275,7 +284,7 @@
         "path": "Location.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -304,7 +313,7 @@
         "path": "Location.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -363,7 +372,8 @@
         "id": "Location:uscorelocation.status",
         "path": "Location.status",
         "short": "active | suspended | inactive",
-        "definition": "active | suspended | inactive.",
+        "definition": "The status property covers the general availability of the resource, not the current value which may be covered by the operationStatus, or by a schedule/slots if they are configured for the location.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "min": 0,
         "max": "1",
         "base": {
@@ -378,8 +388,14 @@
         ],
         "mustSupport": true,
         "isModifier": true,
-        "isSummary": false,
+        "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "LocationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Indicates whether the location is still in use.",
           "valueSetReference": {
@@ -397,12 +413,54 @@
           }
         ]
       },
+      {
+        "id": "Location:uscorelocation.operationalStatus",
+        "path": "Location.operationalStatus",
+        "short": "The Operational status of the location (typically only for a bed/room)",
+        "definition": "The Operational status covers operation values most relevant to beds (but can also apply to rooms/units/chair/etc such as an isolation unit/dialisys chair). This typically covers concepts such as contamination, housekeeping and other activities like maintenance.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Location.operationalStatus",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "Coding"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "OperationalStatus"
+            }
+          ],
+          "strength": "preferred",
+          "description": "The operational status if the location (where typically a bed/room)",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/v2-0116"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          },
+          {
+            "identity": "w5",
+            "map": "status"
+          }
+        ]
+      },
       {
         "id": "Location:uscorelocation.name",
         "path": "Location.name",
         "short": "Name of the location as used by humans",
         "definition": "Name of the location as used by humans. Does not need to be unique.",
-        "comments": "If the name of an location changes, consider putting the old name in the alias column so that it can still be located through searches.",
+        "comment": "If the name of an location changes, consider putting the old name in the alias column so that it can still be located through searches.",
         "min": 1,
         "max": "1",
         "base": {
@@ -416,7 +474,7 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
           {
             "identity": "rim",
@@ -433,8 +491,8 @@
         "path": "Location.alias",
         "short": "A list of alternate names that the location is known as, or was known as in the past",
         "definition": "A list of alternate names that the location is known as, or was known as in the past.",
-        "comments": "There are no dates associated with the alias/historic names, as this is not intended to track when names were used, but to assist in searching so that older names can still result in identifying the location.",
-        "requirements": "Over time locations and organizations go through many changes and can be known by different names.  For searching knowing previous names that the location was known by can be very useful.",
+        "comment": "There are no dates associated with the alias/historic names, as this is not intended to track when names were used, but to assist in searching so that older names can still result in identifying the location.",
+        "requirements": "Over time locations and organizations go through many changes and can be known by different names.\n\nFor searching knowing previous names that the location was known by can be very useful.",
         "min": 0,
         "max": "*",
         "base": {
@@ -485,6 +543,7 @@
         "path": "Location.mode",
         "short": "instance | kind",
         "definition": "Indicates whether a resource instance represents a specific location or a class of locations.",
+        "comment": "This is labeled as a modifer because whether or not the location is a class of locations changes how it can be used and understood.",
         "requirements": "When using a Location resource for scheduling or orders, we need to be able to refer to a class of Locations instead of a specific Location.",
         "min": 0,
         "max": "1",
@@ -501,6 +560,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "LocationMode"
+            }
+          ],
           "strength": "required",
           "description": "Indicates whether a resource instance represents a specific location or a class of locations.",
           "valueSetReference": {
@@ -537,6 +602,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "LocationType"
+            }
+          ],
           "strength": "extensible",
           "description": "Indicates the type of function performed at the location.",
           "valueSetReference": {
@@ -572,7 +643,6 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
         "mapping": [
           {
             "identity": "rim",
@@ -585,7 +655,7 @@
         "path": "Location.address",
         "short": "Physical location",
         "definition": "Physical location.",
-        "comments": "This was kept as 0..1 as there is no use property on the address, so wouldn't be able to identify different address types.",
+        "comment": "This was kept as 0..1 as there is no use property on the address, so wouldn't be able to identify different address types.",
         "requirements": "If locations can be visited, we need to keep track of their address.",
         "min": 0,
         "max": "1",
@@ -600,7 +670,6 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
         "mapping": [
           {
             "identity": "rim",
@@ -642,9 +711,19 @@
       {
         "id": "Location:uscorelocation.address.extension",
         "path": "Location.address.extension",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -673,7 +752,7 @@
         "path": "Location.address.use",
         "short": "home | work | temp | old - purpose of this address",
         "definition": "The purpose of this address.",
-        "comments": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary or old address etc.for a current/permanent one. Applications can assume that an address is current unless it explicitly says that it is temporary or old.",
+        "comment": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary or old address etc.for a current/permanent one. Applications can assume that an address is current unless it explicitly says that it is temporary or old.",
         "requirements": "Allows an appropriate address to be chosen from a list of many.",
         "min": 0,
         "max": "1",
@@ -696,6 +775,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AddressUse"
+            }
+          ],
           "strength": "required",
           "description": "The use of an address",
           "valueSetReference": {
@@ -742,6 +827,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AddressType"
+            }
+          ],
           "strength": "required",
           "description": "The type of an address (physical / postal)",
           "valueSetReference": {
@@ -768,7 +859,7 @@
         "path": "Location.address.text",
         "short": "Text representation of the address",
         "definition": "A full text representation of the address.",
-        "comments": "Can provide both a text representation and parts.",
+        "comment": "Can provide both a text representation and parts.",
         "requirements": "A renderable, unencoded form.",
         "min": 0,
         "max": "1",
@@ -822,6 +913,7 @@
             "code": "string"
           }
         ],
+        "orderMeaning": "The order in which lines should appear in an address label",
         "example": [
           {
             "label": "General",
@@ -829,7 +921,7 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -876,7 +968,7 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -901,7 +993,7 @@
         "path": "Location.address.district",
         "short": "District name (aka county)",
         "definition": "The name of the administrative area (county).",
-        "comments": "District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead.",
+        "comment": "District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead.",
         "alias": [
           "County"
         ],
@@ -957,7 +1049,7 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "binding": {
           "strength": "extensible",
           "description": "Two letter USPS alphabetic codes.",
@@ -1015,7 +1107,7 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -1040,7 +1132,7 @@
         "path": "Location.address.country",
         "short": "Country (e.g. can be ISO 3166 2 or 3 letter code)",
         "definition": "Country - a nation as commonly understood or generally accepted.",
-        "comments": "ISO 3166 3 letter codes can be used in place of a full country name.",
+        "comment": "ISO 3166 3 letter codes can be used in place of a full country name.",
         "min": 0,
         "max": "1",
         "base": {
@@ -1136,6 +1228,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "PhysicalType"
+            }
+          ],
           "strength": "example",
           "description": "Physical form of the location",
           "valueSetReference": {
@@ -1220,7 +1318,7 @@
         "path": "Location.position.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1249,7 +1347,7 @@
         "path": "Location.position.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1353,7 +1451,7 @@
         "path": "Location.managingOrganization",
         "short": "Organization responsible for provisioning and upkeep",
         "definition": "The organization responsible for the provisioning and upkeep of the location.",
-        "comments": "This can also be used as the part of the organization hierarchy where this location provides services. These services can be defined through the HealthcareService resource.",
+        "comment": "This can also be used as the part of the organization hierarchy where this location provides services. These services can be defined through the HealthcareService resource.",
         "requirements": "Need to know who manages the location.",
         "min": 0,
         "max": "1",
@@ -1369,7 +1467,7 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
           {
             "identity": "rim",
@@ -1440,7 +1538,6 @@
         "short": "US Core Location Profile",
         "mustSupport": false,
         "isModifier": false,
-        "isSummary": false,
         "mapping": [
           {
             "identity": "servd",
@@ -1459,8 +1556,7 @@
           }
         ],
         "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false
+        "isModifier": false
       },
       {
         "id": "Location:uscorelocation.name",
@@ -1474,7 +1570,6 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false,
         "mapping": [
           {
             "identity": "servd",
@@ -1493,8 +1588,7 @@
           }
         ],
         "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false
+        "isModifier": false
       },
       {
         "id": "Location:uscorelocation.address",
@@ -1508,7 +1602,6 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false,
         "mapping": [
           {
             "identity": "servd",
@@ -1527,8 +1620,7 @@
           }
         ],
         "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false
+        "isModifier": false
       },
       {
         "id": "Location:uscorelocation.address.city",
@@ -1541,8 +1633,7 @@
           }
         ],
         "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false
+        "isModifier": false
       },
       {
         "id": "Location:uscorelocation.address.state",
@@ -1556,7 +1647,6 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false,
         "binding": {
           "strength": "extensible",
           "description": "Two letter USPS alphabetic codes.",
@@ -1583,8 +1673,7 @@
           }
         ],
         "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false
+        "isModifier": false
       },
       {
         "id": "Location:uscorelocation.managingOrganization",
@@ -1598,9 +1687,8 @@
           }
         ],
         "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false
+        "isModifier": false
       }
     ]
   }
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/StructureDefinition-us-core-medication.json b/lib/resources/us_core/StructureDefinition-us-core-medication.json
index 9f6b6ee..c397001 100755
--- a/lib/resources/us_core/StructureDefinition-us-core-medication.json
+++ b/lib/resources/us_core/StructureDefinition-us-core-medication.json
@@ -3,12 +3,14 @@
   "id": "us-core-medication",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication</a></p><p><b>name</b>: US Core Medication Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: Health Level Seven International (FHIR-Infrastructure)</p><p><b>contact</b>: </p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication</a></p><p><b>name</b>: US Core Medication Profile</p><p><b>status</b>: DRAFT</p><p><b>publisher</b>: Health Level Seven International (FHIR-Infrastructure)</p><p><b>contact</b>: </p><p><b>date</b>: 01/08/2016</p><blockquote><p><b>mapping</b></p><p><b>identity</b>: script10.6</p><p><b>uri</b>: <a href=\"http://ncpdp.org/SCRIPT10_6\">http://ncpdp.org/SCRIPT10_6</a></p><p><b>name</b>: Mapping to NCPDP SCRIPT 10.6</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: rim</p><p><b>uri</b>: <a href=\"http://hl7.org/v3\">http://hl7.org/v3</a></p><p><b>name</b>: RIM Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: w5</p><p><b>uri</b>: <a href=\"http://hl7.org/fhir/w5\">http://hl7.org/fhir/w5</a></p><p><b>name</b>: W5 Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: v2</p><p><b>uri</b>: <a href=\"http://hl7.org/v2\">http://hl7.org/v2</a></p><p><b>name</b>: HL7 v2 Mapping</p></blockquote><p><b>kind</b>: RESOURCE</p><p><b>abstract</b>: false</p><p><b>type</b>: Medication</p><p><b>baseDefinition</b>: <a href=\"http://hl7.org/fhir/StructureDefinition/Medication\">http://hl7.org/fhir/StructureDefinition/Medication</a></p><p><b>derivation</b>: CONSTRAINT</p><h3>Snapshots</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table><h3>Differentials</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table></div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: US  Core Medication Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: HL7 US Realm Steering Committee</p><p><b>contact</b>: </p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: US  Core Medication Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: HL7 US Realm Steering Committee</p><p><b>contact</b>: </p><p><b>fhirVersion</b>: 3.0.0</p><blockquote><p><b>mapping</b></p><p><b>identity</b>: argonaut-dq-dstu2</p><p><b>uri</b>: <a href=\"http://unknown.org/Argonaut DQ DSTU2\">http://unknown.org/Argonaut DQ DSTU2</a></p><p><b>name</b>: Argonaut DQ DSTU2</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: script10.6</p><p><b>uri</b>: <a href=\"http://ncpdp.org/SCRIPT10_6\">http://ncpdp.org/SCRIPT10_6</a></p><p><b>name</b>: Mapping to NCPDP SCRIPT 10.6</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: rim</p><p><b>uri</b>: <a href=\"http://hl7.org/v3\">http://hl7.org/v3</a></p><p><b>name</b>: RIM Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: w5</p><p><b>uri</b>: <a href=\"http://hl7.org/fhir/w5\">http://hl7.org/fhir/w5</a></p><p><b>name</b>: W5 Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: v2</p><p><b>uri</b>: <a href=\"http://hl7.org/v2\">http://hl7.org/v2</a></p><p><b>name</b>: HL7 v2 Mapping</p></blockquote><p><b>kind</b>: RESOURCE</p><p><b>abstract</b>: false</p><p><b>type</b>: Medication</p><p><b>baseDefinition</b>: <a href=\"http://hl7.org/fhir/StructureDefinition/Medication\">http://hl7.org/fhir/StructureDefinition/Medication</a></p><p><b>derivation</b>: CONSTRAINT</p><h3>Snapshots</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table><h3>Differentials</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table></div>"
   },
   "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication",
-  "name": "US Core Medication Profile",
+  "version": "1.0.0",
+  "name": "US  Core Medication Profile",
   "status": "draft",
-  "publisher": "Health Level Seven International (FHIR-Infrastructure)",
+  "date": "2016-08-01",
+  "publisher": "HL7 US Realm Steering Committee",
   "contact": [
     {
       "telecom": [
@@ -19,8 +21,13 @@
       ]
     }
   ],
-  "date": "2016-08-01",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "argonaut-dq-dstu2",
+      "uri": "http://unknown.org/Argonaut DQ DSTU2",
+      "name": "Argonaut DQ DSTU2"
+    },
     {
       "identity": "script10.6",
       "uri": "http://ncpdp.org/SCRIPT10_6",
@@ -97,7 +104,6 @@
           }
         ],
         "mustSupport": false,
-        "isSummary": false,
         "mapping": [
           {
             "identity": "rim",
@@ -105,7 +111,7 @@
           },
           {
             "identity": "script10.6",
-            "map": "NewRx/MedicationPrescribed -or- RxFill/MedicationDispensed -or- RxHistoryResponse/MedicationDispensed -or- RxHistoryResponse/MedicationPrescribed"
+            "map": "NewRx/MedicationPrescribed\r-or-\rRxFill/MedicationDispensed\r-or-\rRxHistoryResponse/MedicationDispensed\r-or-\rRxHistoryResponse/MedicationPrescribed"
           },
           {
             "identity": "rim",
@@ -114,6 +120,10 @@
           {
             "identity": "w5",
             "map": "clinical.medication"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Medication"
           }
         ]
       },
@@ -122,7 +132,7 @@
         "path": "Medication.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -161,7 +171,7 @@
         "path": "Medication.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -182,7 +192,7 @@
         "path": "Medication.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -202,6 +212,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -216,7 +234,7 @@
         "path": "Medication.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -250,7 +268,7 @@
         "path": "Medication.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -280,7 +298,7 @@
         "path": "Medication.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -309,7 +327,7 @@
         "path": "Medication.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -339,7 +357,7 @@
         "path": "Medication.code",
         "short": "Codes that identify this medication",
         "definition": "A code (or set of codes) that specify this medication, or a textual description if no code is available. Usage note: This could be a standard medication code such as a code from RxNorm, SNOMED CT, IDMP etc. It could also be a national or local formulary code, optionally with translations to other code systems.",
-        "comments": "Depending on the context of use, the code that was actually selected by the user (prescriber, dispenser, etc.) should be marked as \"primary\". Other codes can only be literal translations to alternative code systems, or codes at a lower level of granularity (e.g. a generic code for a vendor-specific primary one).",
+        "comment": "Depending on the context of use, the code that was actually selected by the user (prescriber, dispenser, etc.) will have the coding.userSelected set to true.  As described in the coding datatype: \"A coding may be marked as a \"userSelected\" if a user selected the particular coded value in a user interface (e.g. the user selects an item in a pick-list). If a user selected coding exists, it is the preferred choice for performing translations etc.",
         "min": 1,
         "max": "1",
         "base": {
@@ -353,7 +371,7 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "binding": {
           "strength": "extensible",
           "description": "Prescribable medications",
@@ -364,7 +382,7 @@
         "mapping": [
           {
             "identity": "script10.6",
-            "map": "coding.code = //element(*,MedicationType)/DrugCoded/ProductCode  coding.system = //element(*,MedicationType)/DrugCoded/ProductCodeQualifier  coding.display = //element(*,MedicationType)/DrugDescription"
+            "map": "coding.code = //element(*,MedicationType)/DrugCoded/ProductCode\r\rcoding.system = //element(*,MedicationType)/DrugCoded/ProductCodeQualifier\r\rcoding.display = //element(*,MedicationType)/DrugDescription"
           },
           {
             "identity": "v2",
@@ -377,58 +395,67 @@
           {
             "identity": "w5",
             "map": "class"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Medication.code"
           }
         ]
       },
       {
-        "id": "Medication:uscoremedication.isBrand",
-        "path": "Medication.isBrand",
-        "short": "True if a brand",
-        "definition": "Set to true if the item is attributable to a specific manufacturer.",
+        "id": "Medication:uscoremedication.status",
+        "path": "Medication.status",
+        "short": "active | inactive | entered-in-error",
+        "definition": "A code to indicate if the medication is in active use.",
+        "comment": "This status is not intended to specify if a medication is part of a formulary.",
         "min": 0,
         "max": "1",
         "base": {
-          "path": "Medication.isBrand",
+          "path": "Medication.status",
           "min": 0,
           "max": "1"
         },
         "type": [
           {
-            "code": "boolean"
+            "code": "code"
           }
         ],
         "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MedicationStatus"
+            }
+          ],
+          "strength": "required",
+          "description": "A coded concept defining if the medication is in active use",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/medication-status"
+          }
+        },
         "mapping": [
-          {
-            "identity": "script10.6",
-            "map": "no mapping"
-          },
           {
             "identity": "rim",
-            "map": "true if .player.scopingRole[typeCode=MANU] exists"
-          },
-          {
-            "identity": "w5",
-            "map": "class"
+            "map": ".statusCode"
           }
         ]
       },
       {
-        "id": "Medication:uscoremedication.manufacturer",
-        "path": "Medication.manufacturer",
-        "short": "Manufacturer of the item",
-        "definition": "Describes the details of the manufacturer.",
+        "id": "Medication:uscoremedication.isBrand",
+        "path": "Medication.isBrand",
+        "short": "True if a brand",
+        "definition": "Set to true if the item is attributable to a specific manufacturer.",
         "min": 0,
         "max": "1",
         "base": {
-          "path": "Medication.manufacturer",
+          "path": "Medication.isBrand",
           "min": 0,
           "max": "1"
         },
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
+            "code": "boolean"
           }
         ],
         "isSummary": true,
@@ -437,156 +464,93 @@
             "identity": "script10.6",
             "map": "no mapping"
           },
-          {
-            "identity": "v2",
-            "map": "RXD-20-Substance Manufacturer Name / RXG-21-Substance Manufacturer Name / RXA-17-Substance Manufacturer Name"
-          },
           {
             "identity": "rim",
-            "map": ".player.scopingRole[typeCode=MANU].scoper"
+            "map": "true if .player.scopingRole[typeCode=MANU] exists"
           },
           {
             "identity": "w5",
-            "map": "who.actor"
+            "map": "class"
           }
         ]
       },
       {
-        "id": "Medication:uscoremedication.product",
-        "path": "Medication.product",
-        "short": "Administrable medication details",
-        "definition": "Information that only applies to products (not packages).",
+        "id": "Medication:uscoremedication.isOverTheCounter",
+        "path": "Medication.isOverTheCounter",
+        "short": "True if medication does not require a prescription",
+        "definition": "Set to true if the medication can be obtained without an order from a prescriber.",
         "min": 0,
         "max": "1",
         "base": {
-          "path": "Medication.product",
+          "path": "Medication.isOverTheCounter",
           "min": 0,
           "max": "1"
         },
         "type": [
           {
-            "code": "BackboneElement"
-          }
-        ],
-        "constraint": [
-          {
-            "key": "ele-1",
-            "severity": "error",
-            "human": "All FHIR elements must have a @value or children",
-            "expression": "children().count() > id.count()",
-            "xpath": "@value|f:*|h:div",
-            "source": "Element"
+            "code": "boolean"
           }
         ],
+        "isSummary": true,
         "mapping": [
           {
-            "identity": "script10.6",
-            "map": "//element(*,DrugCodedType)/"
+            "identity": "rim",
+            "map": "NA"
           },
           {
-            "identity": "rim",
-            "map": ".player [classCode != CONT]"
+            "identity": "w5",
+            "map": "class"
           }
         ]
       },
       {
-        "id": "Medication:uscoremedication.product.id",
-        "path": "Medication.product.id",
-        "representation": [
-          "xmlAttr"
-        ],
-        "short": "xml:id (or equivalent in JSON)",
-        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+        "id": "Medication:uscoremedication.manufacturer",
+        "path": "Medication.manufacturer",
+        "short": "Manufacturer of the item",
+        "definition": "Describes the details of the manufacturer of the medication product.  This is not intended to represent the distributor of a medication product.",
         "min": 0,
         "max": "1",
         "base": {
-          "path": "Element.id",
+          "path": "Medication.manufacturer",
           "min": 0,
           "max": "1"
         },
         "type": [
           {
-            "code": "string"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
           }
         ],
+        "isSummary": true,
         "mapping": [
           {
-            "identity": "rim",
-            "map": "n/a"
-          }
-        ]
-      },
-      {
-        "id": "Medication:uscoremedication.product.extension",
-        "path": "Medication.product.extension",
-        "short": "Additional Content defined by implementations",
-        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
-        "alias": [
-          "extensions",
-          "user content"
-        ],
-        "min": 0,
-        "max": "*",
-        "base": {
-          "path": "Element.extension",
-          "min": 0,
-          "max": "*"
-        },
-        "type": [
+            "identity": "script10.6",
+            "map": "no mapping"
+          },
           {
-            "code": "Extension"
-          }
-        ],
-        "mapping": [
+            "identity": "v2",
+            "map": "RXD-20-Substance Manufacturer Name / RXG-21-Substance Manufacturer Name / RXA-17-Substance Manufacturer Name"
+          },
           {
             "identity": "rim",
-            "map": "n/a"
-          }
-        ]
-      },
-      {
-        "id": "Medication:uscoremedication.product.modifierExtension",
-        "path": "Medication.product.modifierExtension",
-        "short": "Extensions that cannot be ignored",
-        "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
-        "alias": [
-          "extensions",
-          "user content",
-          "modifiers"
-        ],
-        "min": 0,
-        "max": "*",
-        "base": {
-          "path": "BackboneElement.modifierExtension",
-          "min": 0,
-          "max": "*"
-        },
-        "type": [
-          {
-            "code": "Extension"
-          }
-        ],
-        "isModifier": true,
-        "isSummary": true,
-        "mapping": [
+            "map": ".player.scopingRole[typeCode=MANU].scoper"
+          },
           {
-            "identity": "rim",
-            "map": "N/A"
+            "identity": "w5",
+            "map": "who.actor"
           }
         ]
       },
       {
-        "id": "Medication:uscoremedication.product.form",
-        "path": "Medication.product.form",
+        "id": "Medication:uscoremedication.form",
+        "path": "Medication.form",
         "short": "powder | tablets | capsule +",
         "definition": "Describes the form of the item.  Powder; tablets; capsule.",
-        "comments": "When Medication is referenced from MedicationRequest, this is the ordered form.  When Medication is referenced within MedicationDispense, this is the dispensed form.  When Medication is referenced within MedicationAdministration, this is administered form.",
+        "comment": "When Medication is referenced from MedicationRequest, this is the ordered form.  When Medication is referenced within MedicationDispense, this is the dispensed form.  When Medication is referenced within MedicationAdministration, this is administered form.",
         "min": 0,
         "max": "1",
         "base": {
-          "path": "Medication.product.form",
+          "path": "Medication.form",
           "min": 0,
           "max": "1"
         },
@@ -596,6 +560,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MedicationForm"
+            }
+          ],
           "strength": "example",
           "description": "A coded concept defining the form of a medication",
           "valueSetReference": {
@@ -605,7 +575,7 @@
         "mapping": [
           {
             "identity": "script10.6",
-            "map": "coding.code =  //element(*,DrugCodedType)/FormCode  coding.system = //element(*,DrugCodedType)/FormSourceCode"
+            "map": "coding.code =  //element(*,DrugCodedType)/FormCode\r\rcoding.system = //element(*,DrugCodedType)/FormSourceCode"
           },
           {
             "identity": "v2",
@@ -618,15 +588,15 @@
         ]
       },
       {
-        "id": "Medication:uscoremedication.product.ingredient",
-        "path": "Medication.product.ingredient",
+        "id": "Medication:uscoremedication.ingredient",
+        "path": "Medication.ingredient",
         "short": "Active or inactive ingredient",
         "definition": "Identifies a particular constituent of interest in the product.",
-        "comments": "The ingredients need not be a complete list; usually only active ingredients are listed.",
+        "comment": "The ingredients need not be a complete list.  If an ingredient is not specified, this does not indicate whether an ingredient is present or absent.  If an ingredient is specified it does not mean that all ingredients are specified.  It is possible to specify both inactive and active ingredients.",
         "min": 0,
         "max": "*",
         "base": {
-          "path": "Medication.product.ingredient",
+          "path": "Medication.ingredient",
           "min": 0,
           "max": "*"
         },
@@ -653,8 +623,8 @@
         ]
       },
       {
-        "id": "Medication:uscoremedication.product.ingredient.id",
-        "path": "Medication.product.ingredient.id",
+        "id": "Medication:uscoremedication.ingredient.id",
+        "path": "Medication.ingredient.id",
         "representation": [
           "xmlAttr"
         ],
@@ -680,11 +650,11 @@
         ]
       },
       {
-        "id": "Medication:uscoremedication.product.ingredient.extension",
-        "path": "Medication.product.ingredient.extension",
+        "id": "Medication:uscoremedication.ingredient.extension",
+        "path": "Medication.ingredient.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -709,11 +679,11 @@
         ]
       },
       {
-        "id": "Medication:uscoremedication.product.ingredient.modifierExtension",
-        "path": "Medication.product.ingredient.modifierExtension",
+        "id": "Medication:uscoremedication.ingredient.modifierExtension",
+        "path": "Medication.ingredient.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -741,14 +711,14 @@
         ]
       },
       {
-        "id": "Medication:uscoremedication.product.ingredient.item[x]",
-        "path": "Medication.product.ingredient.item[x]",
+        "id": "Medication:uscoremedication.ingredient.item[x]",
+        "path": "Medication.ingredient.item[x]",
         "short": "The product contained",
         "definition": "The actual ingredient - either a substance (simple ingredient) or another medication.",
         "min": 1,
         "max": "1",
         "base": {
-          "path": "Medication.product.ingredient.item[x]",
+          "path": "Medication.ingredient.item[x]",
           "min": 1,
           "max": "1"
         },
@@ -768,7 +738,7 @@
         "mapping": [
           {
             "identity": "script10.6",
-            "map": "coding.code = //element(*,MedicationType)/DrugCoded/ProductCode  coding.system = //element(*,MedicationType)/DrugCoded/ProductCodeQualifier  coding.display = //element(*,MedicationType)/DrugDescription"
+            "map": "coding.code = //element(*,MedicationType)/DrugCoded/ProductCode\r\rcoding.system = //element(*,MedicationType)/DrugCoded/ProductCodeQualifier\r\rcoding.display = //element(*,MedicationType)/DrugDescription"
           },
           {
             "identity": "v2",
@@ -781,14 +751,39 @@
         ]
       },
       {
-        "id": "Medication:uscoremedication.product.ingredient.amount",
-        "path": "Medication.product.ingredient.amount",
+        "id": "Medication:uscoremedication.ingredient.isActive",
+        "path": "Medication.ingredient.isActive",
+        "short": "Active ingredient indicator",
+        "definition": "Indication of whether this ingredient affects the therapeutic action of the drug.",
+        "requirements": "True indicates that the ingredient affects the therapeutic action of the drug (i.e. active). \rFalse indicates that the ingredient does not affect the therapeutic action of the drug (i.e. inactive).",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Medication.ingredient.isActive",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "boolean"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "NA"
+          }
+        ]
+      },
+      {
+        "id": "Medication:uscoremedication.ingredient.amount",
+        "path": "Medication.ingredient.amount",
         "short": "Quantity of ingredient present",
         "definition": "Specifies how many (or how much) of the items there are in this Medication.  For example, 250 mg per tablet.  This is expressed as a ratio where the numerator is 250mg and the denominator is 1 tablet.",
         "min": 0,
         "max": "1",
         "base": {
-          "path": "Medication.product.ingredient.amount",
+          "path": "Medication.ingredient.amount",
           "min": 0,
           "max": "1"
         },
@@ -813,16 +808,16 @@
         ]
       },
       {
-        "id": "Medication:uscoremedication.product.batch",
-        "path": "Medication.product.batch",
-        "short": "Identifies a single production run",
-        "definition": "Information about a group of medication produced or packaged from one production run.",
+        "id": "Medication:uscoremedication.package",
+        "path": "Medication.package",
+        "short": "Details about packaged medications",
+        "definition": "Information that only applies to packages (not products).",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "base": {
-          "path": "Medication.product.batch",
+          "path": "Medication.package",
           "min": 0,
-          "max": "*"
+          "max": "1"
         },
         "type": [
           {
@@ -846,13 +841,13 @@
           },
           {
             "identity": "rim",
-            "map": "participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].id"
+            "map": ".player[classCode=CONT]"
           }
         ]
       },
       {
-        "id": "Medication:uscoremedication.product.batch.id",
-        "path": "Medication.product.batch.id",
+        "id": "Medication:uscoremedication.package.id",
+        "path": "Medication.package.id",
         "representation": [
           "xmlAttr"
         ],
@@ -878,11 +873,11 @@
         ]
       },
       {
-        "id": "Medication:uscoremedication.product.batch.extension",
-        "path": "Medication.product.batch.extension",
+        "id": "Medication:uscoremedication.package.extension",
+        "path": "Medication.package.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -907,11 +902,11 @@
         ]
       },
       {
-        "id": "Medication:uscoremedication.product.batch.modifierExtension",
-        "path": "Medication.product.batch.modifierExtension",
+        "id": "Medication:uscoremedication.package.modifierExtension",
+        "path": "Medication.package.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -939,80 +934,57 @@
         ]
       },
       {
-        "id": "Medication:uscoremedication.product.batch.lotNumber",
-        "path": "Medication.product.batch.lotNumber",
-        "short": "Identifier assigned to batch",
-        "definition": "The assigned lot number of a batch of the specified product.",
+        "id": "Medication:uscoremedication.package.container",
+        "path": "Medication.package.container",
+        "short": "E.g. box, vial, blister-pack",
+        "definition": "The kind of container that this package comes as.",
         "min": 0,
         "max": "1",
         "base": {
-          "path": "Medication.product.batch.lotNumber",
+          "path": "Medication.package.container",
           "min": 0,
           "max": "1"
         },
         "type": [
           {
-            "code": "string"
+            "code": "CodeableConcept"
           }
         ],
-        "mapping": [
-          {
-            "identity": "script10.6",
-            "map": "no mapping"
-          },
-          {
-            "identity": "v2",
-            "map": "RXA-15 Substance Lot Number / RXG-19 Substance Lot Number"
-          },
-          {
-            "identity": "rim",
-            "map": "Not Mapped"
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MedicationContainer"
+            }
+          ],
+          "strength": "example",
+          "description": "A coded concept defining the kind of container a medication package is packaged in",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/medication-package-form"
           }
-        ]
-      },
-      {
-        "id": "Medication:uscoremedication.product.batch.expirationDate",
-        "path": "Medication.product.batch.expirationDate",
-        "short": "When batch will expire",
-        "definition": "When this specific batch of product will expire.",
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "Medication.product.batch.expirationDate",
-          "min": 0,
-          "max": "1"
         },
-        "type": [
-          {
-            "code": "dateTime"
-          }
-        ],
         "mapping": [
           {
             "identity": "script10.6",
             "map": "no mapping"
           },
-          {
-            "identity": "v2",
-            "map": "RXA-16 Substance Expiration Date / RXG-20 Substance Expiration Date"
-          },
           {
             "identity": "rim",
-            "map": "participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].expirationTime"
+            "map": ".code"
           }
         ]
       },
       {
-        "id": "Medication:uscoremedication.package",
-        "path": "Medication.package",
-        "short": "Details about packaged medications",
-        "definition": "Information that only applies to packages (not products).",
+        "id": "Medication:uscoremedication.package.content",
+        "path": "Medication.package.content",
+        "short": "What is  in the package",
+        "definition": "A set of components that go to make up the described item.",
         "min": 0,
-        "max": "1",
+        "max": "*",
         "base": {
-          "path": "Medication.package",
+          "path": "Medication.package.content",
           "min": 0,
-          "max": "1"
+          "max": "*"
         },
         "type": [
           {
@@ -1036,13 +1008,13 @@
           },
           {
             "identity": "rim",
-            "map": ".player[classCode=CONT]"
+            "map": ".scopesRole[typeCode=CONT]"
           }
         ]
       },
       {
-        "id": "Medication:uscoremedication.package.id",
-        "path": "Medication.package.id",
+        "id": "Medication:uscoremedication.package.content.id",
+        "path": "Medication.package.content.id",
         "representation": [
           "xmlAttr"
         ],
@@ -1068,11 +1040,11 @@
         ]
       },
       {
-        "id": "Medication:uscoremedication.package.extension",
-        "path": "Medication.package.extension",
+        "id": "Medication:uscoremedication.package.content.extension",
+        "path": "Medication.package.content.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1097,11 +1069,11 @@
         ]
       },
       {
-        "id": "Medication:uscoremedication.package.modifierExtension",
-        "path": "Medication.package.modifierExtension",
+        "id": "Medication:uscoremedication.package.content.modifierExtension",
+        "path": "Medication.package.content.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1129,29 +1101,55 @@
         ]
       },
       {
-        "id": "Medication:uscoremedication.package.container",
-        "path": "Medication.package.container",
-        "short": "E.g. box, vial, blister-pack",
-        "definition": "The kind of container that this package comes as.",
-        "min": 0,
+        "id": "Medication:uscoremedication.package.content.item[x]",
+        "path": "Medication.package.content.item[x]",
+        "short": "The item in the package",
+        "definition": "Identifies one of the items in the package.",
+        "min": 1,
         "max": "1",
         "base": {
-          "path": "Medication.package.container",
-          "min": 0,
+          "path": "Medication.package.content.item[x]",
+          "min": 1,
           "max": "1"
         },
         "type": [
           {
             "code": "CodeableConcept"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Medication"
           }
         ],
-        "binding": {
-          "strength": "example",
-          "description": "A coded concept defining the kind of container a medication package is packaged in",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/medication-package-form-codes"
+        "mapping": [
+          {
+            "identity": "script10.6",
+            "map": "no mapping"
+          },
+          {
+            "identity": "rim",
+            "map": ".player"
           }
+        ]
+      },
+      {
+        "id": "Medication:uscoremedication.package.content.amount",
+        "path": "Medication.package.content.amount",
+        "short": "Quantity present in the package",
+        "definition": "The amount of the product that is in the package.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Medication.package.content.amount",
+          "min": 0,
+          "max": "1"
         },
+        "type": [
+          {
+            "code": "Quantity",
+            "profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
+          }
+        ],
         "mapping": [
           {
             "identity": "script10.6",
@@ -1159,19 +1157,19 @@
           },
           {
             "identity": "rim",
-            "map": ".code"
+            "map": ".quantity"
           }
         ]
       },
       {
-        "id": "Medication:uscoremedication.package.content",
-        "path": "Medication.package.content",
-        "short": "What is  in the package",
-        "definition": "A set of components that go to make up the described item.",
+        "id": "Medication:uscoremedication.package.batch",
+        "path": "Medication.package.batch",
+        "short": "Identifies a single production run",
+        "definition": "Information about a group of medication produced or packaged from one production run.",
         "min": 0,
         "max": "*",
         "base": {
-          "path": "Medication.package.content",
+          "path": "Medication.package.batch",
           "min": 0,
           "max": "*"
         },
@@ -1197,13 +1195,13 @@
           },
           {
             "identity": "rim",
-            "map": ".scopesRole[typeCode=CONT]"
+            "map": "participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].id"
           }
         ]
       },
       {
-        "id": "Medication:uscoremedication.package.content.id",
-        "path": "Medication.package.content.id",
+        "id": "Medication:uscoremedication.package.batch.id",
+        "path": "Medication.package.batch.id",
         "representation": [
           "xmlAttr"
         ],
@@ -1229,11 +1227,11 @@
         ]
       },
       {
-        "id": "Medication:uscoremedication.package.content.extension",
-        "path": "Medication.package.content.extension",
+        "id": "Medication:uscoremedication.package.batch.extension",
+        "path": "Medication.package.batch.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1258,11 +1256,11 @@
         ]
       },
       {
-        "id": "Medication:uscoremedication.package.content.modifierExtension",
-        "path": "Medication.package.content.modifierExtension",
+        "id": "Medication:uscoremedication.package.batch.modifierExtension",
+        "path": "Medication.package.batch.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1290,24 +1288,20 @@
         ]
       },
       {
-        "id": "Medication:uscoremedication.package.content.item[x]",
-        "path": "Medication.package.content.item[x]",
-        "short": "The item in the package",
-        "definition": "Identifies one of the items in the package.",
-        "min": 1,
+        "id": "Medication:uscoremedication.package.batch.lotNumber",
+        "path": "Medication.package.batch.lotNumber",
+        "short": "Identifier assigned to batch",
+        "definition": "The assigned lot number of a batch of the specified product.",
+        "min": 0,
         "max": "1",
         "base": {
-          "path": "Medication.package.content.item[x]",
-          "min": 1,
+          "path": "Medication.package.batch.lotNumber",
+          "min": 0,
           "max": "1"
         },
         "type": [
           {
-            "code": "CodeableConcept"
-          },
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Medication"
+            "code": "string"
           }
         ],
         "mapping": [
@@ -1315,28 +1309,31 @@
             "identity": "script10.6",
             "map": "no mapping"
           },
+          {
+            "identity": "v2",
+            "map": "RXA-15 Substance Lot Number / RXG-19 Substance Lot Number"
+          },
           {
             "identity": "rim",
-            "map": ".player"
+            "map": ".id"
           }
         ]
       },
       {
-        "id": "Medication:uscoremedication.package.content.amount",
-        "path": "Medication.package.content.amount",
-        "short": "Quantity present in the package",
-        "definition": "The amount of the product that is in the package.",
+        "id": "Medication:uscoremedication.package.batch.expirationDate",
+        "path": "Medication.package.batch.expirationDate",
+        "short": "When batch will expire",
+        "definition": "When this specific batch of product will expire.",
         "min": 0,
         "max": "1",
         "base": {
-          "path": "Medication.package.content.amount",
+          "path": "Medication.package.batch.expirationDate",
           "min": 0,
           "max": "1"
         },
         "type": [
           {
-            "code": "Quantity",
-            "profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
+            "code": "dateTime"
           }
         ],
         "mapping": [
@@ -1344,9 +1341,38 @@
             "identity": "script10.6",
             "map": "no mapping"
           },
+          {
+            "identity": "v2",
+            "map": "RXA-16 Substance Expiration Date / RXG-20 Substance Expiration Date"
+          },
           {
             "identity": "rim",
-            "map": ".quantity"
+            "map": "participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].expirationTime"
+          }
+        ]
+      },
+      {
+        "id": "Medication:uscoremedication.image",
+        "path": "Medication.image",
+        "short": "Picture of the medication",
+        "definition": "Photo(s) or graphic representation(s) of the medication.",
+        "requirements": "Note that \"image\" is only applicable when the medication.code represents a physical item (e.g. Amoxil 250 mg capsule) and not an abstract item (e.g. amoxicillin 250 mg).",
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "Medication.image",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Attachment"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".participation[typeCode=SUBJ].role[classCode=MANU],source[classCode=OBS,moodCode=EVN,code=\"type of image\"].value(ED.image)"
           }
         ]
       }
@@ -1362,7 +1388,12 @@
         "definition": "The US Core Medication Profile is based upon the core FHIR Medication Resource and created to meet the 2015 Edition Common Clinical Data Set 'Medications' requirements.",
         "mustSupport": false,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Medication"
+          }
+        ]
       },
       {
         "id": "Medication:uscoremedication.code",
@@ -1371,15 +1402,20 @@
         "max": "1",
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false,
         "binding": {
           "strength": "extensible",
           "description": "Prescribable medications",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/us/core/ValueSet/us-core-medication-codes"
           }
-        }
+        },
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Medication.code"
+          }
+        ]
       }
     ]
   }
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/StructureDefinition-us-core-medicationrequest.json b/lib/resources/us_core/StructureDefinition-us-core-medicationrequest.json
index 98f7e39..9009fa1 100755
--- a/lib/resources/us_core/StructureDefinition-us-core-medicationrequest.json
+++ b/lib/resources/us_core/StructureDefinition-us-core-medicationrequest.json
@@ -3,12 +3,14 @@
   "id": "us-core-medicationrequest",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationrequest\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationrequest</a></p><p><b>name</b>: US Core Medication Request Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: Health Level Seven International (FHIR-Infrastructure)</p><p><b>contact</b>: </p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationrequest\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationrequest</a></p><p><b>name</b>: US Core Medication Request Profile</p><p><b>status</b>: DRAFT</p><p><b>publisher</b>: Health Level Seven International (FHIR-Infrastructure)</p><p><b>contact</b>: </p><p><b>date</b>: 01/08/2016</p><blockquote><p><b>mapping</b></p><p><b>identity</b>: script10.6</p><p><b>uri</b>: <a href=\"http://ncpdp.org/SCRIPT10_6\">http://ncpdp.org/SCRIPT10_6</a></p><p><b>name</b>: Mapping to NCPDP SCRIPT 10.6</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: rim</p><p><b>uri</b>: <a href=\"http://hl7.org/v3\">http://hl7.org/v3</a></p><p><b>name</b>: RIM Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: w5</p><p><b>uri</b>: <a href=\"http://hl7.org/fhir/w5\">http://hl7.org/fhir/w5</a></p><p><b>name</b>: W5 Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: v2</p><p><b>uri</b>: <a href=\"http://hl7.org/v2\">http://hl7.org/v2</a></p><p><b>name</b>: HL7 v2 Mapping</p></blockquote><p><b>kind</b>: RESOURCE</p><p><b>abstract</b>: false</p><p><b>type</b>: MedicationRequest</p><p><b>baseDefinition</b>: <a href=\"http://hl7.org/fhir/StructureDefinition/MedicationRequest\">http://hl7.org/fhir/StructureDefinition/MedicationRequest</a></p><p><b>derivation</b>: CONSTRAINT</p><h3>Snapshots</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table><h3>Differentials</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table></div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationrequest\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationrequest</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: US  Core MedicationRequest Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: HL7 US Realm Steering Committee</p><p><b>contact</b>: </p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationrequest\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationrequest</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: US  Core MedicationRequest Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: HL7 US Realm Steering Committee</p><p><b>contact</b>: </p><p><b>fhirVersion</b>: 3.0.0</p><blockquote><p><b>mapping</b></p><p><b>identity</b>: argonaut-dq-dstu2</p><p><b>uri</b>: <a href=\"http://unknown.org/Argonaut DQ DSTU2\">http://unknown.org/Argonaut DQ DSTU2</a></p><p><b>name</b>: Argonaut DQ DSTU2</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: workflow</p><p><b>uri</b>: <a href=\"http://hl7.org/fhir/workflow\">http://hl7.org/fhir/workflow</a></p><p><b>name</b>: Workflow Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: script10.6</p><p><b>uri</b>: <a href=\"http://ncpdp.org/SCRIPT10_6\">http://ncpdp.org/SCRIPT10_6</a></p><p><b>name</b>: Mapping to NCPDP SCRIPT 10.6</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: rim</p><p><b>uri</b>: <a href=\"http://hl7.org/v3\">http://hl7.org/v3</a></p><p><b>name</b>: RIM Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: w5</p><p><b>uri</b>: <a href=\"http://hl7.org/fhir/w5\">http://hl7.org/fhir/w5</a></p><p><b>name</b>: W5 Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: v2</p><p><b>uri</b>: <a href=\"http://hl7.org/v2\">http://hl7.org/v2</a></p><p><b>name</b>: HL7 v2 Mapping</p></blockquote><p><b>kind</b>: RESOURCE</p><p><b>abstract</b>: false</p><p><b>type</b>: MedicationRequest</p><p><b>baseDefinition</b>: <a href=\"http://hl7.org/fhir/StructureDefinition/MedicationRequest\">http://hl7.org/fhir/StructureDefinition/MedicationRequest</a></p><p><b>derivation</b>: CONSTRAINT</p><h3>Snapshots</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table><h3>Differentials</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table></div>"
   },
   "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationrequest",
-  "name": "US Core Medication Request Profile",
+  "version": "1.0.0",
+  "name": "US  Core MedicationRequest Profile",
   "status": "draft",
-  "publisher": "Health Level Seven International (FHIR-Infrastructure)",
+  "date": "2016-08-01",
+  "publisher": "HL7 US Realm Steering Committee",
   "contact": [
     {
       "telecom": [
@@ -19,8 +21,18 @@
       ]
     }
   ],
-  "date": "2016-08-01",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "argonaut-dq-dstu2",
+      "uri": "http://unknown.org/Argonaut DQ DSTU2",
+      "name": "Argonaut DQ DSTU2"
+    },
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
     {
       "identity": "script10.6",
       "uri": "http://ncpdp.org/SCRIPT10_6",
@@ -101,12 +113,15 @@
           }
         ],
         "mustSupport": false,
-        "isSummary": false,
         "mapping": [
           {
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "..Request"
+          },
           {
             "identity": "script10.6",
             "map": "Message/Body/NewRx"
@@ -118,6 +133,10 @@
           {
             "identity": "w5",
             "map": "clinical.medication"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "MedicationOrder"
           }
         ]
       },
@@ -126,7 +145,7 @@
         "path": "MedicationRequest.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -165,7 +184,7 @@
         "path": "MedicationRequest.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -186,7 +205,7 @@
         "path": "MedicationRequest.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -206,6 +225,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -220,7 +247,7 @@
         "path": "MedicationRequest.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -254,7 +281,7 @@
         "path": "MedicationRequest.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -284,7 +311,7 @@
         "path": "MedicationRequest.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -313,7 +340,7 @@
         "path": "MedicationRequest.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -341,8 +368,8 @@
       {
         "id": "MedicationRequest:uscoremedicationrequest.identifier",
         "path": "MedicationRequest.identifier",
-        "short": "External identifier",
-        "definition": "External identifier - one that would be used by another non-FHIR system - for example a re-imbursement system might issue its own id for each prescription that is created.  This is particularly important where FHIR only provides part of an entire workflow process where records have to be tracked through an entire system.",
+        "short": "External ids for this request",
+        "definition": "This records identifiers associated with this medication request that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. For example a re-imbursement system might issue its own id for each prescription that is created.  This is particularly important where FHIR only provides part of an entire workflow process where records must be tracked through an entire system.",
         "min": 0,
         "max": "*",
         "base": {
@@ -356,6 +383,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…identifer"
+          },
           {
             "identity": "script10.6",
             "map": "Message/Header/PrescriberOrderNumber"
@@ -366,7 +397,7 @@
           },
           {
             "identity": "rim",
-            "map": "id"
+            "map": ".id"
           },
           {
             "identity": "w5",
@@ -396,13 +427,23 @@
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/PlanDefinition"
           }
         ],
-        "isSummary": true
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…definition"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=DEFN].target[classCode=unspecified]"
+          }
+        ]
       },
       {
         "id": "MedicationRequest:uscoremedicationrequest.basedOn",
         "path": "MedicationRequest.basedOn",
         "short": "What request fulfills",
-        "definition": "Plan/proposal/order fulfilled by this request.",
+        "definition": "A plan or request that is fulfilled in whole or in part by this medication request.",
         "min": 0,
         "max": "*",
         "base": {
@@ -415,10 +456,6 @@
             "code": "Reference",
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
           },
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DiagnosticRequest"
-          },
           {
             "code": "Reference",
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
@@ -432,17 +469,28 @@
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
           }
         ],
-        "isSummary": true
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…basedOn"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target[classCode=SBADM or PROC or PCPR or OBS, moodCode=RQO orPLAN or PRP]"
+          }
+        ]
       },
       {
-        "id": "MedicationRequest:uscoremedicationrequest.requisition",
-        "path": "MedicationRequest.requisition",
-        "short": "Identifier of composite",
-        "definition": "Composite request this is part of.",
+        "id": "MedicationRequest:uscoremedicationrequest.groupIdentifier",
+        "path": "MedicationRequest.groupIdentifier",
+        "short": "Composite request this is part of",
+        "definition": "A shared identifier common to all requests that were authorized more or less simultaneously by a single author, representing the identifier of the requisition or prescription.",
+        "requirements": "Requests are linked either by a \"basedOn\" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation.",
         "min": 0,
         "max": "1",
         "base": {
-          "path": "MedicationRequest.requisition",
+          "path": "MedicationRequest.groupIdentifier",
           "min": 0,
           "max": "1"
         },
@@ -451,13 +499,24 @@
             "code": "Identifier"
           }
         ],
-        "isSummary": true
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…groupIdentifier"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship(typeCode=COMP].target[classCode=SBADM, moodCode=INT].id"
+          }
+        ]
       },
       {
         "id": "MedicationRequest:uscoremedicationrequest.status",
         "path": "MedicationRequest.status",
-        "short": "active | on-hold | cancelled | completed | entered-in-error | stopped | draft",
-        "definition": "A code specifying the state of the order.  Generally this will be active or completed state.",
+        "short": "active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown",
+        "definition": "A code specifying the current state of the order.  Generally this will be active or completed state.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "min": 1,
         "max": "1",
         "base": {
@@ -472,69 +531,182 @@
         ],
         "mustSupport": true,
         "isModifier": true,
-        "isSummary": false,
+        "isSummary": true,
         "binding": {
           "strength": "required",
           "description": "A code specifying the state of the prescribing event. Describes the lifecycle of the prescription.",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/medication-order-status"
+            "reference": "http://hl7.org/fhir/ValueSet/medication-request-status"
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…status"
+          },
           {
             "identity": "script10.6",
             "map": "no mapping"
           },
           {
             "identity": "rim",
-            "map": "statusCode"
+            "map": ".statusCode"
           },
           {
             "identity": "w5",
             "map": "status"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "MedicationOrder.status"
           }
         ]
       },
       {
-        "id": "MedicationRequest:uscoremedicationrequest.stage",
-        "path": "MedicationRequest.stage",
-        "short": "proposal | plan | original-order",
+        "id": "MedicationRequest:uscoremedicationrequest.intent",
+        "path": "MedicationRequest.intent",
+        "short": "proposal | plan | order | instance-order",
         "definition": "Whether the request is a proposal, plan, or an original order.",
-        "comments": "It is expected that the type of requester will be restricted for different stages of a MedicationRequest.  For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device.  Plans can be created by Practitioners, Patients, RelatedPersons and Devices.  Original orders can be created by a Practitioner only.",
+        "comment": "It is expected that the type of requester will be restricted for different stages of a MedicationRequest.  For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device.  Plans can be created by Practitioners, Patients, RelatedPersons and Devices.  Original orders can be created by a Practitioner only.\r\rAn instance-order is an instantiation of a request or order and may be used to populate Medication Administration Record.\n\nThis element is labeled as a modifier because the intent alters when and how the resource is actually applicable.",
         "min": 1,
         "max": "1",
         "base": {
-          "path": "MedicationRequest.stage",
+          "path": "MedicationRequest.intent",
           "min": 1,
           "max": "1"
         },
         "type": [
           {
-            "code": "CodeableConcept"
+            "code": "code"
           }
         ],
         "isModifier": true,
         "isSummary": true,
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MedicationRequestIntent"
+            }
+          ],
+          "strength": "required",
           "description": "The kind of medication order",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/medication-request-stage"
+            "reference": "http://hl7.org/fhir/ValueSet/medication-request-intent"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…intent"
+          },
+          {
+            "identity": "rim",
+            "map": ".moodCode (nuances beyond PRP/PLAN/RQO would need to be elsewhere)"
+          },
+          {
+            "identity": "w5",
+            "map": "class"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:uscoremedicationrequest.category",
+        "path": "MedicationRequest.category",
+        "short": "Type of medication usage",
+        "definition": "Indicates the type of medication order and where the medication is expected to be consumed or administered.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "MedicationRequest.category",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MedicationRequestCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "A coded concept identifying where the medication ordered is expected to be consumed or administered",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/medication-request-category"
           }
         },
         "mapping": [
+          {
+            "identity": "script10.6",
+            "map": "Message/Body/NewRx/MedicationPrescribed/Directions\r\ror \r\rMessage/Body/NewRx/MedicationPrescribed/StructuredSIG"
+          },
+          {
+            "identity": "rim",
+            "map": ".inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code=\"type of medication usage\"].value"
+          },
           {
             "identity": "w5",
             "map": "class"
           }
         ]
       },
+      {
+        "id": "MedicationRequest:uscoremedicationrequest.priority",
+        "path": "MedicationRequest.priority",
+        "short": "routine | urgent | stat | asap",
+        "definition": "Indicates how quickly the Medication Request should be addressed with respect to other requests.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "MedicationRequest.priority",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "code"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MedicationRequestPriority"
+            }
+          ],
+          "strength": "required",
+          "description": "Identifies the level of importance to be assigned to actioning the request",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/medication-request-priority"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…priority"
+          },
+          {
+            "identity": "rim",
+            "map": ".priorityCode"
+          },
+          {
+            "identity": "w5",
+            "map": "grade"
+          }
+        ]
+      },
       {
         "id": "MedicationRequest:uscoremedicationrequest.medication[x]",
         "path": "MedicationRequest.medication[x]",
         "short": "Medication to be taken",
-        "definition": "Identifies the medication being administered. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications.",
-        "comments": "If only a code is specified, then it needs to be a code for a specific product.  If more information is required, then the use of the medication resource is recommended.  Note: do not use Medication.name to describe the prescribed medication. When the only available information is a text description of the medication, Medication.code.text should be used.",
+        "definition": "Identifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications.",
+        "comment": "If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended.  For example, if you require form or lot number or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource. .",
         "min": 1,
         "max": "1",
         "base": {
@@ -552,7 +724,7 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "binding": {
           "strength": "extensible",
           "description": "Prescribable medications",
@@ -561,9 +733,13 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…code"
+          },
           {
             "identity": "script10.6",
-            "map": "Message/Body/NewRx/MedicationPrescribed  Medication.code.coding.code = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCode  Medication.code.coding.system = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCodeQualifier  Medication.code.coding.display = Message/Body/NewRx/MedicationPrescribed/DrugDescription"
+            "map": "Message/Body/NewRx/MedicationPrescribed\r\rMedication.code.coding.code = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCode\r\rMedication.code.coding.system = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCodeQualifier\r\rMedication.code.coding.display = Message/Body/NewRx/MedicationPrescribed/DrugDescription"
           },
           {
             "identity": "v2",
@@ -576,19 +752,23 @@
           {
             "identity": "w5",
             "map": "what"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "MedicationOrder.medication[x]"
           }
         ]
       },
       {
-        "id": "MedicationRequest:uscoremedicationrequest.patient",
-        "path": "MedicationRequest.patient",
-        "short": "Who prescription is for",
-        "definition": "A link to a resource representing the person to whom the medication will be given.",
-        "comments": "The patient on a medicationRequest is mandatory.  For the secondary use case where the actual patient is not provided, there still must be an anonymyzed patient specified.",
+        "id": "MedicationRequest:uscoremedicationrequest.subject",
+        "path": "MedicationRequest.subject",
+        "short": "Who or group medication request is for",
+        "definition": "A link to a resource representing the person or set of individuals to whom the medication will be given.",
+        "comment": "The subject on a medication request is mandatory.  For the secondary use case where the actual subject is not provided, there still must be an anonymized subject specified.",
         "min": 1,
         "max": "1",
         "base": {
-          "path": "MedicationRequest.patient",
+          "path": "MedicationRequest.subject",
           "min": 1,
           "max": "1"
         },
@@ -599,11 +779,15 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…subject"
+          },
           {
             "identity": "script10.6",
-            "map": "Message/Body/NewRx/Patient  (need detail to link to specific patient … Patient.Identification in SCRIPT)"
+            "map": "Message/Body/NewRx/Patient\r\r(need detail to link to specific patient … Patient.Identification in SCRIPT)"
           },
           {
             "identity": "v2",
@@ -611,11 +795,15 @@
           },
           {
             "identity": "rim",
-            "map": "subject.role"
+            "map": ".participation[typeCode=AUT].role"
           },
           {
             "identity": "w5",
             "map": "who.focus"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "MedicationOrder.patient"
           }
         ]
       },
@@ -623,8 +811,8 @@
         "id": "MedicationRequest:uscoremedicationrequest.context",
         "path": "MedicationRequest.context",
         "short": "Created during encounter/admission/stay",
-        "definition": "A link to a resource that identifies the particular occurrence or set oc occurences of contact between patient and health care provider.",
-        "comments": "SubstanceAdministration->component->EncounterEvent.",
+        "definition": "A link to an encounter, or episode of care, that identifies the particular occurrence or set occurrences of contact between patient and health care provider.",
+        "comment": "SubstanceAdministration->component->EncounterEvent.",
         "min": 0,
         "max": "1",
         "base": {
@@ -643,6 +831,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…context"
+          },
           {
             "identity": "script10.6",
             "map": "no mapping"
@@ -653,7 +845,7 @@
           },
           {
             "identity": "rim",
-            "map": "componentOf.patientEncounter"
+            "map": ".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code=\"type of encounter or episode\"]"
           },
           {
             "identity": "w5",
@@ -680,6 +872,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS, RQO, PRP, APT, ARQ, GOL)]"
+          },
           {
             "identity": "w5",
             "map": "context"
@@ -687,14 +883,14 @@
         ]
       },
       {
-        "id": "MedicationRequest:uscoremedicationrequest.dateWritten",
-        "path": "MedicationRequest.dateWritten",
-        "short": "When prescription was initially authorized",
-        "definition": "The date (and perhaps time) when the prescription was initially written.",
+        "id": "MedicationRequest:uscoremedicationrequest.authoredOn",
+        "path": "MedicationRequest.authoredOn",
+        "short": "When request was initially authored",
+        "definition": "The date (and perhaps time) when the prescription was initially written or authored on.",
         "min": 1,
         "max": "1",
         "base": {
-          "path": "MedicationRequest.dateWritten",
+          "path": "MedicationRequest.authoredOn",
           "min": 0,
           "max": "1"
         },
@@ -704,8 +900,12 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…authoredOn"
+          },
           {
             "identity": "script10.6",
             "map": "Message/Body/NewRx/MedicationPrescribed/WrittenDate"
@@ -721,15 +921,18 @@
           {
             "identity": "w5",
             "map": "when.recorded"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "MedicationOrder.dateWritten"
           }
         ]
       },
       {
         "id": "MedicationRequest:uscoremedicationrequest.requester",
         "path": "MedicationRequest.requester",
-        "short": "Who ordered the initial medication(s)",
-        "definition": "The healthcare professional responsible for authorizing the initial prescription.",
-        "comments": "It is expected that the type of requester will be restricted for different stages of a MedicationRequest.  For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device.  Plans can be created by Practitioners, Patients, RelatedPersons and Devices.  Original orders can be created by a Practitioner only.",
+        "short": "Who/What requested the Request",
+        "definition": "The individual, organization or device that initiated the request and has responsibility for its activation.",
         "min": 1,
         "max": "1",
         "base": {
@@ -737,18 +940,167 @@
           "min": 0,
           "max": "1"
         },
+        "type": [
+          {
+            "code": "BackboneElement"
+          }
+        ],
+        "constraint": [
+          {
+            "key": "ele-1",
+            "severity": "error",
+            "human": "All FHIR elements must have a @value or children",
+            "expression": "children().count() > id.count()",
+            "xpath": "@value|f:*|h:div",
+            "source": "Element"
+          },
+          {
+            "key": "mps-1",
+            "severity": "error",
+            "human": "onBehalfOf can only be specified if agent is practitioner or device",
+            "expression": "(agent.resolve().empty()) or (agent.resolve() is Device) or (agent.resolve() is Practitioner) or onBehalfOf.exists().not()",
+            "xpath": "contains(f:agent, '/Practitioner') or contains(f:agent, '/Device') or not(exists(f:onBehalfOf))",
+            "source": "MedicationRequest.requester"
+          }
+        ],
+        "mustSupport": true,
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…requester"
+          },
+          {
+            "identity": "rim",
+            "map": ".participation[typeCode=AUT].role"
+          },
+          {
+            "identity": "w5",
+            "map": "who.author"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "NA (new element in STU3)"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:uscoremedicationrequest.requester.id",
+        "path": "MedicationRequest.requester.id",
+        "representation": [
+          "xmlAttr"
+        ],
+        "short": "xml:id (or equivalent in JSON)",
+        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Element.id",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:uscoremedicationrequest.requester.extension",
+        "path": "MedicationRequest.requester.extension",
+        "short": "Additional Content defined by implementations",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "Element.extension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:uscoremedicationrequest.requester.modifierExtension",
+        "path": "MedicationRequest.requester.modifierExtension",
+        "short": "Extensions that cannot be ignored",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content",
+          "modifiers"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "BackboneElement.modifierExtension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "isModifier": true,
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "N/A"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:uscoremedicationrequest.requester.agent",
+        "path": "MedicationRequest.requester.agent",
+        "short": "Who ordered the initial medication(s)",
+        "definition": "The healthcare professional responsible for authorizing the initial prescription.",
+        "comment": "It is expected that the type of requester will be restricted for different stages of a MedicationRequest.  For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device.  Plans can be created by Practitioners, Patients, RelatedPersons and Devices.  Original orders can be created by a Practitioner only.",
+        "min": 1,
+        "max": "1",
+        "base": {
+          "path": "MedicationRequest.requester.agent",
+          "min": 1,
+          "max": "1"
+        },
         "type": [
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-pract"
+            "targetProfile": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner"
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "….agent"
+          },
           {
             "identity": "script10.6",
-            "map": "Message/Body/NewRx/Prescriber  (need detail to link to specific prescriber … Prescriber.Identification in SCRIPT)"
+            "map": "Message/Body/NewRx/Prescriber\r\r(need detail to link to specific prescriber … Prescriber.Identification in SCRIPT)"
           },
           {
             "identity": "v2",
@@ -756,11 +1108,74 @@
           },
           {
             "identity": "rim",
-            "map": "author.role"
+            "map": ".player"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "MedicationOrder.prescriber"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:uscoremedicationrequest.requester.onBehalfOf",
+        "path": "MedicationRequest.requester.onBehalfOf",
+        "short": "Organization agent is acting for",
+        "definition": "The organization the device or practitioner was acting on behalf of.",
+        "requirements": "Practitioners and Devices can be associated with multiple organizations. This element indicates which organization they were acting on behalf of when authoring the request.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "MedicationRequest.requester.onBehalfOf",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
+          }
+        ],
+        "condition": [
+          "mps-1"
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "….onBehalfOf"
+          },
+          {
+            "identity": "rim",
+            "map": ".scoper"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:uscoremedicationrequest.recorder",
+        "path": "MedicationRequest.recorder",
+        "short": "Person who entered the request",
+        "definition": "The person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "MedicationRequest.recorder",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".participation[typeCode=TRANS].role[classCode=ASSIGNED].code (HealthcareProviderType)"
           },
           {
             "identity": "w5",
-            "map": "who.actor"
+            "map": "who"
           }
         ]
       },
@@ -768,8 +1183,8 @@
         "id": "MedicationRequest:uscoremedicationrequest.reasonCode",
         "path": "MedicationRequest.reasonCode",
         "short": "Reason or indication for writing the prescription",
-        "definition": "Can be the reason or the indication for writing the prescription.",
-        "comments": "This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonReference.",
+        "definition": "The reason or the indication for ordering the medication.",
+        "comment": "This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonReference.",
         "min": 0,
         "max": "*",
         "base": {
@@ -783,6 +1198,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MedicationRequestReason"
+            }
+          ],
           "strength": "example",
           "description": "A coded concept indicating why the medication was ordered.",
           "valueSetReference": {
@@ -790,6 +1211,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…reasonCode"
+          },
           {
             "identity": "script10.6",
             "map": "Message/Body/NewRx/MedicationPrescribed/Diagnosis/Primary/Value"
@@ -812,8 +1237,8 @@
         "id": "MedicationRequest:uscoremedicationrequest.reasonReference",
         "path": "MedicationRequest.reasonReference",
         "short": "Condition or Observation that supports why the prescription is being written",
-        "definition": "Condition or observation that supports why the prescription is being written.",
-        "comments": "This is a reference to a condition that is the reason for the medication order.  If only a code exists, use reasonCode.",
+        "definition": "Condition or observation that supports why the medication was ordered.",
+        "comment": "This is a reference to a condition or observation that is the reason for the medication order.  If only a code exists, use reasonCode.",
         "min": 0,
         "max": "*",
         "base": {
@@ -832,6 +1257,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…reasonReference"
+          },
           {
             "identity": "script10.6",
             "map": "no mapping"
@@ -865,47 +1294,16 @@
         ],
         "mapping": [
           {
-            "identity": "script10.6",
-            "map": "Message/Body/NewRx/MedicationPrescribed/Note"
+            "identity": "workflow",
+            "map": "…note"
           },
-          {
-            "identity": "rim",
-            "map": ".inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code=\"annotation\"].value"
-          }
-        ]
-      },
-      {
-        "id": "MedicationRequest:uscoremedicationrequest.category",
-        "path": "MedicationRequest.category",
-        "short": "Type of medication usage",
-        "definition": "Indicates where type of medication order and where the medication is expected to be consumed or administered.",
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "MedicationRequest.category",
-          "min": 0,
-          "max": "1"
-        },
-        "type": [
-          {
-            "code": "CodeableConcept"
-          }
-        ],
-        "binding": {
-          "strength": "example",
-          "description": "A coded concept identifying where the medication ordered is expected to be consumed or administered",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/medication-request-category"
-          }
-        },
-        "mapping": [
           {
             "identity": "script10.6",
-            "map": "Message/Body/NewRx/MedicationPrescribed/Directions  or   Message/Body/NewRx/MedicationPrescribed/StructuredSIG"
+            "map": "Message/Body/NewRx/MedicationPrescribed/Note"
           },
           {
             "identity": "rim",
-            "map": "not mapped"
+            "map": ".inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code=\"annotation\"].value"
           }
         ]
       },
@@ -914,6 +1312,7 @@
         "path": "MedicationRequest.dosageInstruction",
         "short": "How the medication should be taken",
         "definition": "Indicates how the medication is to be used by the patient.",
+        "comment": "There are examples where a medication request may include the option of an oral dose or an Intravenous or Intramuscular dose.  For example, \"Ondansetron 8mg orally or IV twice a day as needed for nausea\" or \"Compazine® (prochlorperazine) 5-10mg PO or 25mg PR bid prn nausea or vomiting\".  In these cases, two medication requests would be created that could be grouped together.  The decision on which dose and route of administration to use is based on the patient's condition at the time the dose is needed.",
         "min": 0,
         "max": "*",
         "base": {
@@ -923,7 +1322,17 @@
         },
         "type": [
           {
-            "code": "DosageInstruction"
+            "code": "Dosage"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…occurrence[x]"
+          },
+          {
+            "identity": "rim",
+            "map": "see dosageInstruction mapping"
           }
         ]
       },
@@ -931,7 +1340,7 @@
         "id": "MedicationRequest:uscoremedicationrequest.dispenseRequest",
         "path": "MedicationRequest.dispenseRequest",
         "short": "Medication supply authorization",
-        "definition": "Indicates the specific details for the dispense or medication supply part of a medication order (also known as a Medication Prescription).  Note that this information is NOT always sent with the order.  There may be in some settings (e.g. hospitals) institutional or system support for completing the dispense details in the pharmacy department.",
+        "definition": "Indicates the specific details for the dispense or medication supply part of a medication request (also known as a Medication Prescription or Medication Order).  Note that this information is not always sent with the order.  There may be in some settings (e.g. hospitals) institutional or system support for completing the dispense details in the pharmacy department.",
         "min": 0,
         "max": "1",
         "base": {
@@ -997,7 +1406,7 @@
         "path": "MedicationRequest.dispenseRequest.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1026,7 +1435,7 @@
         "path": "MedicationRequest.dispenseRequest.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1058,7 +1467,7 @@
         "path": "MedicationRequest.dispenseRequest.validityPeriod",
         "short": "Time period supply is authorized for",
         "definition": "This indicates the validity period of a prescription (stale dating the Prescription).",
-        "comments": "It reflects the prescriber perspective for the validity of the prescription. Dispenses must not be made against the prescription outside of this period. The lower-bound of the Dispensing Window signifies the earliest date that the prescription can be filled for the first time. If an upper-bound is not specified then the Prescription is open-ended or will default to a stale-date based on regulations.",
+        "comment": "It reflects the prescribers' perspective for the validity of the prescription. Dispenses must not be made against the prescription outside of this period. The lower-bound of the Dispensing Window signifies the earliest date that the prescription can be filled for the first time. If an upper-bound is not specified then the Prescription is open-ended or will default to a stale-date based on regulations.",
         "requirements": "Indicates when the Prescription becomes valid, and when it ceases to be a dispensable Prescription.",
         "min": 0,
         "max": "1",
@@ -1087,8 +1496,8 @@
         "id": "MedicationRequest:uscoremedicationrequest.dispenseRequest.numberOfRepeatsAllowed",
         "path": "MedicationRequest.dispenseRequest.numberOfRepeatsAllowed",
         "short": "Number of refills authorized",
-        "definition": "An integer indicating the number of times, in addition to the original dispense, (aka refills or repeats) that the patient can receive the prescribed medication. Usage Notes: This integer does NOT include the original order dispense. This means that if an order indicates dispense 30 tablets plus \"3 repeats\", then the order can be dispensed a total of 4 times and the patient can receive a total of 120 tablets.",
-        "comments": "If displaying \"number of authorized fills\", add 1 to this number.",
+        "definition": "An integer indicating the number of times, in addition to the original dispense, (aka refills or repeats) that the patient can receive the prescribed medication. Usage Notes: This integer does not include the original order dispense. This means that if an order indicates dispense 30 tablets plus \"3 repeats\", then the order can be dispensed a total of 4 times and the patient can receive a total of 120 tablets.",
+        "comment": "If displaying \"number of authorized fills\", add 1 to this number.",
         "min": 0,
         "max": "1",
         "base": {
@@ -1154,7 +1563,7 @@
         "path": "MedicationRequest.dispenseRequest.expectedSupplyDuration",
         "short": "Number of days supply per dispense",
         "definition": "Identifies the period time over which the supplied product is expected to be used, or the length of time the dispense is expected to last.",
-        "comments": "In some situations, this attribute may be used instead of quantity to identify the amount supplied by how long it is expected to last, rather than the physical quantity issued, e.g. 90 days supply of medication (based on an ordered dosage) When possible, it is always better to specify quantity, as this tends to be more precise. expectedSupplyDuration will always be an estimate that can be influenced by external factors.",
+        "comment": "In some situations, this attribute may be used instead of quantity to identify the amount supplied by how long it is expected to last, rather than the physical quantity issued, e.g. 90 days supply of medication (based on an ordered dosage) When possible, it is always better to specify quantity, as this tends to be more precise. expectedSupplyDuration will always be an estimate that can be influenced by external factors.",
         "min": 0,
         "max": "1",
         "base": {
@@ -1197,6 +1606,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=COMP].target[classCode=SPLY, moodCode=RQO] .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]"
+          },
           {
             "identity": "w5",
             "map": "who"
@@ -1207,7 +1620,7 @@
         "id": "MedicationRequest:uscoremedicationrequest.substitution",
         "path": "MedicationRequest.substitution",
         "short": "Any restrictions on medication substitution",
-        "definition": "Indicates whether or not substitution can or should be part of the dispense. In some cases substitution must happen, in other cases substitution must not happen, and in others it does not matter. This block explains the prescriber's intent. If nothing is specified substitution may be done.",
+        "definition": "Indicates whether or not substitution can or should be part of the dispense. In some cases substitution must happen, in other cases substitution must not happen. This block explains the prescriber's intent. If nothing is specified substitution may be done.",
         "min": 0,
         "max": "1",
         "base": {
@@ -1273,7 +1686,7 @@
         "path": "MedicationRequest.substitution.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1302,7 +1715,7 @@
         "path": "MedicationRequest.substitution.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1334,6 +1747,7 @@
         "path": "MedicationRequest.substitution.allowed",
         "short": "Whether substitution is allowed or not",
         "definition": "True if the prescriber allows a different drug to be dispensed from what was prescribed.",
+        "comment": "This element is labeled as a modifer because whether substitution is allow or not cannot be ignored.",
         "min": 1,
         "max": "1",
         "base": {
@@ -1380,6 +1794,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MedicationIntendedSubstitutionReason"
+            }
+          ],
           "strength": "example",
           "description": "A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.",
           "valueSetReference": {
@@ -1404,7 +1824,7 @@
       {
         "id": "MedicationRequest:uscoremedicationrequest.priorPrescription",
         "path": "MedicationRequest.priorPrescription",
-        "short": "An order/prescription that this supersedes",
+        "short": "An order/prescription that is being replaced",
         "definition": "A link to a resource representing an earlier order related order or prescription.",
         "min": 0,
         "max": "1",
@@ -1420,6 +1840,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…replaces"
+          },
           {
             "identity": "script10.6",
             "map": "not mapped"
@@ -1430,12 +1854,42 @@
           }
         ]
       },
+      {
+        "id": "MedicationRequest:uscoremedicationrequest.detectedIssue",
+        "path": "MedicationRequest.detectedIssue",
+        "short": "Clinical Issue with action",
+        "definition": "Indicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. Drug-drug interaction, duplicate therapy, dosage alert etc.",
+        "alias": [
+          "Contraindication",
+          "Drug Utilization Review (DUR)",
+          "Alert"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "MedicationRequest.detectedIssue",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DetectedIssue"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".inboundRelationship[typeCode=SUBJ]/source[classCode=ALRT,moodCode=EVN].value"
+          }
+        ]
+      },
       {
         "id": "MedicationRequest:uscoremedicationrequest.eventHistory",
         "path": "MedicationRequest.eventHistory",
         "short": "A list of events of interest in the lifecycle",
-        "definition": "A summary of the events of interest that have occurred as the request is processed; e.g. when the order was verified or when it was completed.",
-        "comments": "See usage notes in Request pattern in request history.",
+        "definition": "Links to Provenance records for past versions of this resource or fulfilling request or event resources that identify key state transitions or updates that are likely to be relevant to a user looking at the current version of the resource.",
+        "comment": "This may not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.).",
         "min": 0,
         "max": "*",
         "base": {
@@ -1448,6 +1902,16 @@
             "code": "Reference",
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/Provenance"
           }
+        ],
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…relevantHistory"
+          },
+          {
+            "identity": "rim",
+            "map": ".inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]"
+          }
         ]
       }
     ]
@@ -1462,7 +1926,12 @@
         "definition": "The US Core Medication Request (Order) Profile is based upon the core FHIR MedicationRequest Resource and created to meet the 2015 Edition Common Clinical Data Set 'Medications' requirements.",
         "mustSupport": false,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "MedicationOrder"
+          }
+        ]
       },
       {
         "id": "MedicationRequest:uscoremedicationrequest.status",
@@ -1476,14 +1945,19 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false,
         "binding": {
           "strength": "required",
           "description": "A code specifying the state of the prescribing event. Describes the lifecycle of the prescription.",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/medication-order-status"
+            "reference": "http://hl7.org/fhir/ValueSet/medication-request-status"
           }
-        }
+        },
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "MedicationOrder.status"
+          }
+        ]
       },
       {
         "id": "MedicationRequest:uscoremedicationrequest.medication[x]",
@@ -1501,18 +1975,23 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false,
         "binding": {
           "strength": "extensible",
           "description": "Prescribable medications",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/us/core/ValueSet/us-core-medication-codes"
           }
-        }
+        },
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "MedicationOrder.medication[x]"
+          }
+        ]
       },
       {
-        "id": "MedicationRequest:uscoremedicationrequest.patient",
-        "path": "MedicationRequest.patient",
+        "id": "MedicationRequest:uscoremedicationrequest.subject",
+        "path": "MedicationRequest.subject",
         "min": 1,
         "max": "1",
         "type": [
@@ -1523,32 +2002,61 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "MedicationOrder.patient"
+          }
+        ]
       },
       {
-        "id": "MedicationRequest:uscoremedicationrequest.dateWritten",
-        "path": "MedicationRequest.dateWritten",
+        "id": "MedicationRequest:uscoremedicationrequest.authoredOn",
+        "path": "MedicationRequest.authoredOn",
         "min": 1,
         "max": "1",
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "MedicationOrder.dateWritten"
+          }
+        ]
       },
       {
         "id": "MedicationRequest:uscoremedicationrequest.requester",
         "path": "MedicationRequest.requester",
         "min": 1,
         "max": "1",
+        "mustSupport": true,
+        "isModifier": false,
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "NA (new element in STU3)"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:uscoremedicationrequest.requester.agent",
+        "path": "MedicationRequest.requester.agent",
+        "min": 1,
+        "max": "1",
         "type": [
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-pract"
+            "targetProfile": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner"
           }
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "MedicationOrder.prescriber"
+          }
+        ]
       }
     ]
   }
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/StructureDefinition-us-core-medicationstatement.json b/lib/resources/us_core/StructureDefinition-us-core-medicationstatement.json
index 6c90b2b..0e26030 100755
--- a/lib/resources/us_core/StructureDefinition-us-core-medicationstatement.json
+++ b/lib/resources/us_core/StructureDefinition-us-core-medicationstatement.json
@@ -3,12 +3,14 @@
   "id": "us-core-medicationstatement",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationstatement\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationstatement</a></p><p><b>name</b>: US Core Medication Statement Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: Health Level Seven International (FHIR-Infrastructure)</p><p><b>contact</b>: </p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationstatement\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationstatement</a></p><p><b>name</b>: US Core Medication Statement Profile</p><p><b>status</b>: DRAFT</p><p><b>publisher</b>: Health Level Seven International (FHIR-Infrastructure)</p><p><b>contact</b>: </p><p><b>date</b>: 01/08/2016</p><blockquote><p><b>mapping</b></p><p><b>identity</b>: rim</p><p><b>uri</b>: <a href=\"http://hl7.org/v3\">http://hl7.org/v3</a></p><p><b>name</b>: RIM Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: w5</p><p><b>uri</b>: <a href=\"http://hl7.org/fhir/w5\">http://hl7.org/fhir/w5</a></p><p><b>name</b>: W5 Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: v2</p><p><b>uri</b>: <a href=\"http://hl7.org/v2\">http://hl7.org/v2</a></p><p><b>name</b>: HL7 v2 Mapping</p></blockquote><p><b>kind</b>: RESOURCE</p><p><b>abstract</b>: false</p><p><b>type</b>: MedicationStatement</p><p><b>baseDefinition</b>: <a href=\"http://hl7.org/fhir/StructureDefinition/MedicationStatement\">http://hl7.org/fhir/StructureDefinition/MedicationStatement</a></p><p><b>derivation</b>: CONSTRAINT</p><h3>Snapshots</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table><h3>Differentials</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table></div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationstatement\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationstatement</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: US  Core MedicationStatement Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: HL7 US Realm Steering Committee</p><p><b>contact</b>: </p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationstatement\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationstatement</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: US  Core MedicationStatement Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: HL7 US Realm Steering Committee</p><p><b>contact</b>: </p><p><b>fhirVersion</b>: 3.0.0</p><blockquote><p><b>mapping</b></p><p><b>identity</b>: argonaut-dq-dstu2</p><p><b>uri</b>: <a href=\"http://unknown.org/Argonaut DQ DSTU2\">http://unknown.org/Argonaut DQ DSTU2</a></p><p><b>name</b>: Argonaut DQ DSTU2</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: workflow</p><p><b>uri</b>: <a href=\"http://hl7.org/fhir/workflow\">http://hl7.org/fhir/workflow</a></p><p><b>name</b>: Workflow Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: rim</p><p><b>uri</b>: <a href=\"http://hl7.org/v3\">http://hl7.org/v3</a></p><p><b>name</b>: RIM Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: w5</p><p><b>uri</b>: <a href=\"http://hl7.org/fhir/w5\">http://hl7.org/fhir/w5</a></p><p><b>name</b>: W5 Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: v2</p><p><b>uri</b>: <a href=\"http://hl7.org/v2\">http://hl7.org/v2</a></p><p><b>name</b>: HL7 v2 Mapping</p></blockquote><p><b>kind</b>: RESOURCE</p><p><b>abstract</b>: false</p><p><b>type</b>: MedicationStatement</p><p><b>baseDefinition</b>: <a href=\"http://hl7.org/fhir/StructureDefinition/MedicationStatement\">http://hl7.org/fhir/StructureDefinition/MedicationStatement</a></p><p><b>derivation</b>: CONSTRAINT</p><h3>Snapshots</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table><h3>Differentials</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table></div>"
   },
   "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationstatement",
-  "name": "US Core Medication Statement Profile",
+  "version": "1.0.0",
+  "name": "US  Core MedicationStatement Profile",
   "status": "draft",
-  "publisher": "Health Level Seven International (FHIR-Infrastructure)",
+  "date": "2016-08-01",
+  "publisher": "HL7 US Realm Steering Committee",
   "contact": [
     {
       "telecom": [
@@ -19,8 +21,18 @@
       ]
     }
   ],
-  "date": "2016-08-01",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "argonaut-dq-dstu2",
+      "uri": "http://unknown.org/Argonaut DQ DSTU2",
+      "name": "Argonaut DQ DSTU2"
+    },
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
     {
       "identity": "rim",
       "uri": "http://hl7.org/v3",
@@ -50,7 +62,7 @@
         "sliceName": "USCoreMedicationStatement",
         "short": "US Core Medication Statement Profile",
         "definition": "The US Core Medication Statement Profile is based upon the core FHIR MedicationStatement Resource and created to meet the 2015 Edition Common Clinical Data Set 'Medications' requirements.",
-        "comments": "When interpreting a medicationStatement, the value of the status and NotTaken needed to be considered: MedicationStatement.status + MedicationStatement.wasNotTaken Status=Active + NotTaken=T = Not currently taking Status=Completed + NotTaken=T = Not taken in the past Status=Intended + NotTaken=T = No intention of taking Status=Active + NotTaken=F = Taking, but not as prescribed Status=Active + NotTaken=F = Taking Status=Intended +NotTaken= F = Will be taking (not started) Status=Completed + NotTaken=F = Taken in past Status=In Error + NotTaken=N/A = In Error.",
+        "comment": "When interpreting a medicationStatement, the value of the status and NotTaken needed to be considered:\rMedicationStatement.status + MedicationStatement.wasNotTaken\rStatus=Active + NotTaken=T = Not currently taking\rStatus=Completed + NotTaken=T = Not taken in the past\rStatus=Intended + NotTaken=T = No intention of taking\rStatus=Active + NotTaken=F = Taking, but not as prescribed\rStatus=Active + NotTaken=F = Taking\rStatus=Intended +NotTaken= F = Will be taking (not started)\rStatus=Completed + NotTaken=F = Taken in past\rStatus=In Error + NotTaken=N/A = In Error.",
         "min": 0,
         "max": "*",
         "base": {
@@ -94,19 +106,22 @@
           {
             "key": "mst-1",
             "severity": "error",
-            "human": "Reason not taken is only permitted if notTaken is Yes",
-            "expression": "reasonNotTaken.empty() or notTaken='y'",
-            "xpath": "not(exists(f:reasonNotTaken) and (f:notTaken/@value='n' or f:notTaken/@value='unk'))",
+            "human": "Reason not taken is only permitted if Taken is No",
+            "expression": "reasonNotTaken.exists().not() or (taken = 'n')",
+            "xpath": "not(exists(f:reasonNotTaken)) or f:taken/@value='n'",
             "source": "MedicationStatement"
           }
         ],
         "mustSupport": false,
-        "isSummary": false,
         "mapping": [
           {
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "..Event"
+          },
           {
             "identity": "rim",
             "map": "SubstanceAdministration"
@@ -114,6 +129,10 @@
           {
             "identity": "w5",
             "map": "clinical.medication"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "MedicationStatement"
           }
         ]
       },
@@ -122,7 +141,7 @@
         "path": "MedicationStatement.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -161,7 +180,7 @@
         "path": "MedicationStatement.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -182,7 +201,7 @@
         "path": "MedicationStatement.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -202,6 +221,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -216,7 +243,7 @@
         "path": "MedicationStatement.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -250,7 +277,7 @@
         "path": "MedicationStatement.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -280,7 +307,7 @@
         "path": "MedicationStatement.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -309,7 +336,7 @@
         "path": "MedicationStatement.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -351,10 +378,15 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…identifer"
+          },
           {
             "identity": "rim",
-            "map": "SubstanceAdministration.id"
+            "map": ".id"
           },
           {
             "identity": "w5",
@@ -362,12 +394,136 @@
           }
         ]
       },
+      {
+        "id": "MedicationStatement:uscoremedicationstatement.basedOn",
+        "path": "MedicationStatement.basedOn",
+        "short": "Fulfils plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "MedicationStatement.basedOn",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…basedOn"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target[classCode=SBADM or PROC or PCPR or OBS, moodCode=RQO orPLAN or PRP]"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:uscoremedicationstatement.partOf",
+        "path": "MedicationStatement.partOf",
+        "short": "Part of referenced event",
+        "definition": "A larger event of which this particular event is a component or step.",
+        "requirements": "This should not be used when indicating which resource a MedicationStatement has been derived from.  If that is the use case, then MedicationStatement.derivedFrom should be used.",
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "MedicationStatement.partOf",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationAdministration"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationDispense"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationStatement"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Procedure"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Observation"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…part of"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=COMP]/target[classCode=SPLY or SBADM or PROC or OBS,moodCode=EVN]"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:uscoremedicationstatement.context",
+        "path": "MedicationStatement.context",
+        "short": "Encounter / Episode associated with MedicationStatement",
+        "definition": "The encounter or episode of care that establishes the context for this MedicationStatement.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "MedicationStatement.context",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…context"
+          },
+          {
+            "identity": "rim",
+            "map": ".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code=\"type of encounter or episode\"]"
+          }
+        ]
+      },
       {
         "id": "MedicationStatement:uscoremedicationstatement.status",
         "path": "MedicationStatement.status",
         "short": "active | completed | entered-in-error | intended | stopped | on-hold",
         "definition": "A code representing the patient or other source's judgment about the state of the medication used that this statement is about.  Generally this will be active or completed.",
-        "comments": "MedicationStatement is a statement at a point in time.  The status is only representative at the point when it was asserted.  The value set for MedicationStatement.status contains codes that assert the status of the use of the medication by the patient (for example, stopped or on hold) as well as codes that assert the status of the medication statement itself (for example, entered in error).",
+        "comment": "MedicationStatement is a statement at a point in time.  The status is only representative at the point when it was asserted.  The value set for MedicationStatement.status contains codes that assert the status of the use of the medication by the patient (for example, stopped or on hold) as well as codes that assert the status of the medication statement itself (for example, entered in error).\n\nThis element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "min": 1,
         "max": "1",
         "base": {
@@ -382,7 +538,7 @@
         ],
         "mustSupport": true,
         "isModifier": true,
-        "isSummary": false,
+        "isSummary": true,
         "binding": {
           "strength": "required",
           "description": "A set of codes indicating the current status of a MedicationStatement.",
@@ -391,6 +547,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…status"
+          },
           {
             "identity": "rim",
             "map": ".statusCode"
@@ -398,6 +558,52 @@
           {
             "identity": "w5",
             "map": "status"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "MedicationStatement.status"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:uscoremedicationstatement.category",
+        "path": "MedicationStatement.category",
+        "short": "Type of medication usage",
+        "definition": "Indicates where type of medication statement and where the medication is expected to be consumed or administered.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "MedicationStatement.category",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MedicationStatementCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "A coded concept identifying where the medication included in the medicationstatement is expected to be consumed or administered",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/medication-statement-category"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code=\"type of medication usage\"].value"
+          },
+          {
+            "identity": "w5",
+            "map": "class"
           }
         ]
       },
@@ -406,7 +612,7 @@
         "path": "MedicationStatement.medication[x]",
         "short": "What medication was taken",
         "definition": "Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.",
-        "comments": "If only a code is specified, then it needs to be a code for a specific product.  If more information is required, then the use of the medication resource is recommended.  Note: do not use Medication.name to describe the medication this statement concerns. When the only available information is a text description of the medication, Medication.code.text should be used.",
+        "comment": "If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended.  For example if you require form or lot number, then you must reference the Medication resource. .",
         "min": 1,
         "max": "1",
         "base": {
@@ -424,7 +630,7 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "binding": {
           "strength": "extensible",
           "description": "Prescribable medications",
@@ -433,82 +639,97 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…code"
+          },
           {
             "identity": "rim",
-            "map": "SubstanceAdministration>Component>SubstanceAdministrationRequest.consumable"
+            "map": ".participation[typeCode=CSM].role[classCode=ADMM or MANU]"
           },
           {
             "identity": "w5",
             "map": "what"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "MedicationStatement.medication[x]"
           }
         ]
       },
       {
-        "id": "MedicationStatement:uscoremedicationstatement.subject",
-        "path": "MedicationStatement.subject",
-        "short": "Who is/was taking  the medication",
-        "definition": "The person, animal or group who is/was taking the medication.",
-        "min": 1,
+        "id": "MedicationStatement:uscoremedicationstatement.effective[x]",
+        "path": "MedicationStatement.effective[x]",
+        "short": "The date/time or interval when the medication was taken",
+        "definition": "The interval of time during which it is being asserted that the patient was taking the medication (or was not taking, when the wasNotGiven element is true).",
+        "comment": "This attribute reflects the period over which the patient consumed the medication and is expected to be populated on the majority of Medication Statements. If the medication is still being taken at the time the statement is recorded, the \"end\" date will be omitted.",
+        "min": 0,
         "max": "1",
         "base": {
-          "path": "MedicationStatement.subject",
-          "min": 1,
+          "path": "MedicationStatement.effective[x]",
+          "min": 0,
           "max": "1"
         },
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"
+            "code": "dateTime"
+          },
+          {
+            "code": "Period"
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
           {
-            "identity": "v2",
-            "map": "PID-3-Patient ID List"
+            "identity": "workflow",
+            "map": "…occurrence[x]"
           },
           {
             "identity": "rim",
-            "map": "SubstanceAdministration->subject->Patient"
+            "map": ".effectiveTime"
           },
           {
             "identity": "w5",
-            "map": "who.focus"
+            "map": "when.done"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "MedicationStatement.effective[x]"
           }
         ]
       },
       {
-        "id": "MedicationStatement:uscoremedicationstatement.effective[x]",
-        "path": "MedicationStatement.effective[x]",
-        "short": "Over what period was medication consumed?",
-        "definition": "The interval of time during which it is being asserted that the patient was taking the medication (or was not taking, when the wasNotGiven element is true).",
-        "comments": "If the medication is still being taken at the time the statement is recorded, the \"end\" date will be omitted.",
-        "min": 0,
+        "id": "MedicationStatement:uscoremedicationstatement.dateAsserted",
+        "path": "MedicationStatement.dateAsserted",
+        "short": "When the statement was asserted?",
+        "definition": "The date when the medication statement was asserted by the information source.",
+        "min": 1,
         "max": "1",
         "base": {
-          "path": "MedicationStatement.effective[x]",
+          "path": "MedicationStatement.dateAsserted",
           "min": 0,
           "max": "1"
         },
         "type": [
           {
             "code": "dateTime"
-          },
-          {
-            "code": "Period"
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
           {
             "identity": "rim",
-            "map": "SubstanceAdministration.effectiveTime"
+            "map": ".participation[typeCode=AUT].time"
           },
           {
             "identity": "w5",
-            "map": "when.done"
+            "map": "when.recorded"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "MedicationStatement.dateAsserted"
           }
         ]
       },
@@ -545,7 +766,7 @@
         "mapping": [
           {
             "identity": "rim",
-            "map": ".participation[typeCode=INF].role[classCode=PAT, or  codes for Practioner or Related Person (if PAT is the informer, then syntax for self-reported =true)"
+            "map": ".participation[typeCode=INF].role[classCode=PAT, or codes for Practioner or Related Person (if PAT is the informer, then syntax for self-reported =true)"
           },
           {
             "identity": "w5",
@@ -554,67 +775,90 @@
         ]
       },
       {
-        "id": "MedicationStatement:uscoremedicationstatement.derivedFrom",
-        "path": "MedicationStatement.derivedFrom",
-        "short": "Additional supporting information",
-        "definition": "Allows linking the MedicationStatement to the underlying MedicationRequest, or to other information that supports or is used to derive the MedicationStatement.",
-        "comments": "Likely references would be to MedicationRequest, MedicationDispense, Claim, Observation or QuestionnaireAnswers.",
-        "min": 0,
-        "max": "*",
+        "id": "MedicationStatement:uscoremedicationstatement.subject",
+        "path": "MedicationStatement.subject",
+        "short": "Who is/was taking  the medication",
+        "definition": "The person, animal or group who is/was taking the medication.",
+        "min": 1,
+        "max": "1",
         "base": {
-          "path": "MedicationStatement.derivedFrom",
-          "min": 0,
-          "max": "*"
+          "path": "MedicationStatement.subject",
+          "min": 1,
+          "max": "1"
         },
         "type": [
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Resource"
+            "targetProfile": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"
           }
         ],
+        "mustSupport": true,
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…subject"
+          },
+          {
+            "identity": "v2",
+            "map": "PID-3-Patient ID List"
+          },
           {
             "identity": "rim",
-            "map": ".outboundRelationship[typeCode=SPRT]/target[classCode=ACT,moodCode=EVN]"
+            "map": ".participation[typeCode=SBJ].role[classCode=PAT]"
+          },
+          {
+            "identity": "w5",
+            "map": "who"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "MedicationStatement.patient"
           }
         ]
       },
       {
-        "id": "MedicationStatement:uscoremedicationstatement.dateAsserted",
-        "path": "MedicationStatement.dateAsserted",
-        "short": "When the statement was asserted?",
-        "definition": "The date when the medication statement was asserted by the information source.",
-        "min": 1,
-        "max": "1",
+        "id": "MedicationStatement:uscoremedicationstatement.derivedFrom",
+        "path": "MedicationStatement.derivedFrom",
+        "short": "Additional supporting information",
+        "definition": "Allows linking the MedicationStatement to the underlying MedicationRequest, or to other information that supports or is used to derive the MedicationStatement.",
+        "comment": "Likely references would be to [US Core MedicationRequest Profile](http://hl7.org/fhir/us/core/StructureDefinition-us-core-medicationrequest.html), MedicationDispense, Claim, Observation or QuestionnaireAnswers.  The most common use cases for deriving a MedicationStatement comes from creating a MedicationStatement from a MedicationRequest or from a lab observation or a claim.  it should be noted that the amount of information that is available varies from the type resource that you derive the MedicationStatement from.",
+        "min": 0,
+        "max": "*",
         "base": {
-          "path": "MedicationStatement.dateAsserted",
+          "path": "MedicationStatement.derivedFrom",
           "min": 0,
-          "max": "1"
+          "max": "*"
         },
         "type": [
           {
-            "code": "dateTime"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Resource"
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
         "mapping": [
           {
             "identity": "rim",
-            "map": ".participation[typeCode=AUT].time"
+            "map": ".outboundRelationship[typeCode=SPRT]/target[classCode=ACT,moodCode=EVN]"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "NA (new element in STU3)"
           }
         ]
       },
       {
-        "id": "MedicationStatement:uscoremedicationstatement.notTaken",
-        "path": "MedicationStatement.notTaken",
-        "short": "y | n | unk",
+        "id": "MedicationStatement:uscoremedicationstatement.taken",
+        "path": "MedicationStatement.taken",
+        "short": "y | n | unk | na",
         "definition": "Indicator of the certainty of whether the medication was taken by the patient.",
-        "min": 0,
+        "comment": "This element is labeled as a modifier because it indicates that the medication was not taken.",
+        "min": 1,
         "max": "1",
         "base": {
-          "path": "MedicationStatement.notTaken",
-          "min": 0,
+          "path": "MedicationStatement.taken",
+          "min": 1,
           "max": "1"
         },
         "type": [
@@ -622,15 +866,29 @@
             "code": "code"
           }
         ],
+        "mustSupport": true,
         "isModifier": true,
         "isSummary": true,
         "binding": {
           "strength": "required",
-          "description": "A coded concept identifying level of certainty if patient has taken or has not taken the medication",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/medication-statement-nottaken"
+            "reference": "http://hl7.org/fhir/ValueSet/medication-statement-taken"
           }
-        }
+        },
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…notDone"
+          },
+          {
+            "identity": "rim",
+            "map": ".actionNegationInd"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "NA (new element in STU3)"
+          }
+        ]
       },
       {
         "id": "MedicationStatement:uscoremedicationstatement.reasonNotTaken",
@@ -653,6 +911,12 @@
           "mst-1"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MedicationStatementNotTakenReason"
+            }
+          ],
           "strength": "example",
           "description": "A coded concept indicating the reason why the medication was not taken",
           "valueSetReference": {
@@ -662,20 +926,20 @@
         "mapping": [
           {
             "identity": "rim",
-            "map": "SubstanceAdministration->Reason->Observation->Value"
+            "map": ".outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code=\"reason not taken\"].value"
           }
         ]
       },
       {
-        "id": "MedicationStatement:uscoremedicationstatement.reasonForUseCodeableConcept",
-        "path": "MedicationStatement.reasonForUseCodeableConcept",
+        "id": "MedicationStatement:uscoremedicationstatement.reasonCode",
+        "path": "MedicationStatement.reasonCode",
         "short": "Reason for why the medication is being/was taken",
         "definition": "A reason for why the medication is being/was taken.",
-        "comments": "This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonForUseReference.",
+        "comment": "This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonForUseReference.",
         "min": 0,
         "max": "*",
         "base": {
-          "path": "MedicationStatement.reasonForUseCodeableConcept",
+          "path": "MedicationStatement.reasonCode",
           "min": 0,
           "max": "*"
         },
@@ -685,6 +949,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MedicationReason"
+            }
+          ],
           "strength": "example",
           "description": "A coded concept identifying why the medication is being taken.",
           "valueSetReference": {
@@ -692,22 +962,30 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…reasoneCodeableConcept"
+          },
           {
             "identity": "rim",
             "map": ".reasonCode"
+          },
+          {
+            "identity": "w5",
+            "map": "why"
           }
         ]
       },
       {
-        "id": "MedicationStatement:uscoremedicationstatement.reasonForUseReference",
-        "path": "MedicationStatement.reasonForUseReference",
+        "id": "MedicationStatement:uscoremedicationstatement.reasonReference",
+        "path": "MedicationStatement.reasonReference",
         "short": "Condition or observation that supports why the medication is being/was taken",
         "definition": "Condition or observation that supports why the medication is being/was taken.",
-        "comments": "This is a reference to a condition that is the reason why the medication is being/was taken.  If only a code exists, use reasonForUseCode.",
+        "comment": "This is a reference to a condition that is the reason why the medication is being/was taken.  If only a code exists, use reasonForUseCode.",
         "min": 0,
         "max": "*",
         "base": {
-          "path": "MedicationStatement.reasonForUseReference",
+          "path": "MedicationStatement.reasonReference",
           "min": 0,
           "max": "*"
         },
@@ -722,9 +1000,17 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…reasonReference"
+          },
           {
             "identity": "rim",
-            "map": "not mapped"
+            "map": ".outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code=\"reason for use\"].value"
+          },
+          {
+            "identity": "w5",
+            "map": "why"
           }
         ]
       },
@@ -747,47 +1033,21 @@
         ],
         "mapping": [
           {
-            "identity": "rim",
-            "map": ".inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code=\"annotation\"].value"
-          }
-        ]
-      },
-      {
-        "id": "MedicationStatement:uscoremedicationstatement.category",
-        "path": "MedicationStatement.category",
-        "short": "Type of medication usage",
-        "definition": "Indicates where type of medication statement and where the medication is expected to be consumed or administered.",
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "MedicationStatement.category",
-          "min": 0,
-          "max": "1"
-        },
-        "type": [
-          {
-            "code": "code"
-          }
-        ],
-        "binding": {
-          "strength": "example",
-          "description": "A coded concept identifying where the medication included in the medicationstatement is expected to be consumed or administered",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/medication-statement-category"
-          }
-        },
-        "mapping": [
+            "identity": "workflow",
+            "map": "…note"
+          },
           {
             "identity": "rim",
-            "map": "not mapped"
+            "map": ".inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code=\"annotation\"].value"
           }
         ]
       },
       {
         "id": "MedicationStatement:uscoremedicationstatement.dosage",
         "path": "MedicationStatement.dosage",
-        "short": "Details of how medication was taken",
-        "definition": "Indicates how the medication is/was used by the patient.",
+        "short": "Details of how medication is/was taken or should be taken",
+        "definition": "Indicates how the medication is/was or should be taken by the patient.",
+        "comment": "The dates included in the dosage on a Medication Statement reflect the dates for a given dose.  For example, \"from November 1, 2016 to November 3, 2016, take one tablet daily and from November 4, 2016 to November 7, 2016, take two tablets daily.\"  It is expected that this specificity may only be populated where the patient brings in their labeled container or where the Medication Statement is derived from a MedicationRequest.",
         "min": 0,
         "max": "*",
         "base": {
@@ -797,13 +1057,13 @@
         },
         "type": [
           {
-            "code": "DosageInstruction"
+            "code": "Dosage"
           }
         ],
         "mapping": [
           {
             "identity": "rim",
-            "map": "SubstanceAdministration>Component>SubstanceAdministrationRequest"
+            "map": "refer dosageInstruction mapping"
           }
         ]
       }
@@ -819,7 +1079,12 @@
         "definition": "The US Core Medication Statement Profile is based upon the core FHIR MedicationStatement Resource and created to meet the 2015 Edition Common Clinical Data Set 'Medications' requirements.",
         "mustSupport": false,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "MedicationStatement"
+          }
+        ]
       },
       {
         "id": "MedicationStatement:uscoremedicationstatement.status",
@@ -833,14 +1098,19 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false,
         "binding": {
           "strength": "required",
           "description": "A set of codes indicating the current status of a MedicationStatement.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/medication-statement-status"
           }
-        }
+        },
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "MedicationStatement.status"
+          }
+        ]
       },
       {
         "id": "MedicationStatement:uscoremedicationstatement.medication[x]",
@@ -858,29 +1128,19 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false,
         "binding": {
           "strength": "extensible",
           "description": "Prescribable medications",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/us/core/ValueSet/us-core-medication-codes"
           }
-        }
-      },
-      {
-        "id": "MedicationStatement:uscoremedicationstatement.subject",
-        "path": "MedicationStatement.subject",
-        "min": 1,
-        "max": "1",
-        "type": [
+        },
+        "mapping": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"
+            "identity": "argonaut-dq-dstu2",
+            "map": "MedicationStatement.medication[x]"
           }
-        ],
-        "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false
+        ]
       },
       {
         "id": "MedicationStatement:uscoremedicationstatement.effective[x]",
@@ -897,7 +1157,12 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "MedicationStatement.effective[x]"
+          }
+        ]
       },
       {
         "id": "MedicationStatement:uscoremedicationstatement.dateAsserted",
@@ -911,8 +1176,73 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "MedicationStatement.dateAsserted"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:uscoremedicationstatement.subject",
+        "path": "MedicationStatement.subject",
+        "min": 1,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"
+          }
+        ],
+        "mustSupport": true,
+        "isModifier": false,
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "MedicationStatement.patient"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:uscoremedicationstatement.derivedFrom",
+        "path": "MedicationStatement.derivedFrom",
+        "comment": "Likely references would be to [US Core MedicationRequest Profile](http://hl7.org/fhir/us/core/StructureDefinition-us-core-medicationrequest.html), MedicationDispense, Claim, Observation or QuestionnaireAnswers.  The most common use cases for deriving a MedicationStatement comes from creating a MedicationStatement from a MedicationRequest or from a lab observation or a claim.  it should be noted that the amount of information that is available varies from the type resource that you derive the MedicationStatement from.",
+        "min": 0,
+        "max": "*",
+        "mustSupport": true,
+        "isModifier": false,
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "NA (new element in STU3)"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:uscoremedicationstatement.taken",
+        "path": "MedicationStatement.taken",
+        "min": 1,
+        "max": "1",
+        "type": [
+          {
+            "code": "code"
+          }
+        ],
+        "mustSupport": true,
+        "isModifier": false,
+        "binding": {
+          "strength": "required",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/medication-statement-taken"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "NA (new element in STU3)"
+          }
+        ]
       }
     ]
   }
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/StructureDefinition-us-core-observationresults.json b/lib/resources/us_core/StructureDefinition-us-core-observationresults.json
index 696a3aa..397c2c8 100755
--- a/lib/resources/us_core/StructureDefinition-us-core-observationresults.json
+++ b/lib/resources/us_core/StructureDefinition-us-core-observationresults.json
@@ -3,12 +3,14 @@
   "id": "us-core-observationresults",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-observationresults\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-observationresults</a></p><p><b>name</b>: US Core Result Observation</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: Health Level Seven International (FHIR-Infrastructure)</p><p><b>contact</b>: </p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-observationresults\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-observationresults</a></p><p><b>name</b>: US Core Result Observation</p><p><b>status</b>: DRAFT</p><p><b>publisher</b>: Health Level Seven International (FHIR-Infrastructure)</p><p><b>contact</b>: </p><p><b>date</b>: 01/08/2016</p><blockquote><p><b>mapping</b></p><p><b>identity</b>: v2</p><p><b>uri</b>: <a href=\"http://hl7.org/v2\">http://hl7.org/v2</a></p><p><b>name</b>: HL7 v2 Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: rim</p><p><b>uri</b>: <a href=\"http://hl7.org/v3\">http://hl7.org/v3</a></p><p><b>name</b>: RIM Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: w5</p><p><b>uri</b>: <a href=\"http://hl7.org/fhir/w5\">http://hl7.org/fhir/w5</a></p><p><b>name</b>: W5 Mapping</p></blockquote><p><b>kind</b>: RESOURCE</p><p><b>abstract</b>: false</p><p><b>type</b>: Observation</p><p><b>baseDefinition</b>: <a href=\"http://hl7.org/fhir/StructureDefinition/Observation\">http://hl7.org/fhir/StructureDefinition/Observation</a></p><p><b>derivation</b>: CONSTRAINT</p><h3>Snapshots</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table><h3>Differentials</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table></div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-observationresults\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-observationresults</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: US  Core Results Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: HL7 US Realm Steering Committee</p><p><b>contact</b>: </p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-observationresults\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-observationresults</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: US  Core Results Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: HL7 US Realm Steering Committee</p><p><b>contact</b>: </p><p><b>fhirVersion</b>: 3.0.0</p><blockquote><p><b>mapping</b></p><p><b>identity</b>: argonaut-dq-dstu2</p><p><b>uri</b>: <a href=\"http://unknown.org/Argonaut DQ DSTU2\">http://unknown.org/Argonaut DQ DSTU2</a></p><p><b>name</b>: Argonaut DQ DSTU2</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: workflow</p><p><b>uri</b>: <a href=\"http://hl7.org/fhir/workflow\">http://hl7.org/fhir/workflow</a></p><p><b>name</b>: Workflow Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: sct-concept</p><p><b>uri</b>: <a href=\"http://snomed.info/conceptdomain\">http://snomed.info/conceptdomain</a></p><p><b>name</b>: SNOMED CT Concept Domain Binding</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: v2</p><p><b>uri</b>: <a href=\"http://hl7.org/v2\">http://hl7.org/v2</a></p><p><b>name</b>: HL7 v2 Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: rim</p><p><b>uri</b>: <a href=\"http://hl7.org/v3\">http://hl7.org/v3</a></p><p><b>name</b>: RIM Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: w5</p><p><b>uri</b>: <a href=\"http://hl7.org/fhir/w5\">http://hl7.org/fhir/w5</a></p><p><b>name</b>: W5 Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: sct-attr</p><p><b>uri</b>: <a href=\"http://snomed.info/sct\">http://snomed.info/sct</a></p><p><b>name</b>: SNOMED CT Attribute Binding</p></blockquote><p><b>kind</b>: RESOURCE</p><p><b>abstract</b>: false</p><p><b>type</b>: Observation</p><p><b>baseDefinition</b>: <a href=\"http://hl7.org/fhir/StructureDefinition/Observation\">http://hl7.org/fhir/StructureDefinition/Observation</a></p><p><b>derivation</b>: CONSTRAINT</p><h3>Snapshots</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table><h3>Differentials</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table></div>"
   },
   "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observationresults",
-  "name": "US Core Result Observation",
+  "version": "1.0.0",
+  "name": "US  Core Results Profile",
   "status": "draft",
-  "publisher": "Health Level Seven International (FHIR-Infrastructure)",
+  "date": "2016-08-01",
+  "publisher": "HL7 US Realm Steering Committee",
   "contact": [
     {
       "telecom": [
@@ -19,8 +21,23 @@
       ]
     }
   ],
-  "date": "2016-08-01",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "argonaut-dq-dstu2",
+      "uri": "http://unknown.org/Argonaut DQ DSTU2",
+      "name": "Argonaut DQ DSTU2"
+    },
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -35,6 +52,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -45,12 +67,12 @@
   "snapshot": {
     "element": [
       {
-        "id": "Observation:uscoreobss",
+        "id": "Observation:uscoreobs",
         "path": "Observation",
-        "sliceName": "USCoreObss",
+        "sliceName": "USCoreObs",
         "short": "US Core Result Observation",
-        "definition": "US Realm clinical coded results.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "definition": "The US Core Observation Result Profile is based upon the core FHIR Observation Resource and created to meet the 2015 Edition Common Clinical Data Set 'Laboratory test(s) and Laboratory value(s)/result(s)' requirements.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -118,17 +140,24 @@
             "key": "us-core-2",
             "severity": "error",
             "human": "If there is no component or related element then either a value[x] or a data absent reason must be present",
-            "expression": "(component.empty() or related.empty()) implies (value.exists() or dataAbsentReason.exists())",
+            "expression": "(component.empty() and related.empty()) implies (dataAbsentReason or value)",
             "xpath": "exists(f:component) or exists(f:related) or exists(f:*[starts-with(local-name(.), 'value)]) or exists(f:dataAbsentReason)"
           }
         ],
         "mustSupport": false,
-        "isSummary": false,
         "mapping": [
           {
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -140,15 +169,19 @@
           {
             "identity": "w5",
             "map": "clinical.diagnostics"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Observation"
           }
         ]
       },
       {
-        "id": "Observation:uscoreobss.id",
+        "id": "Observation:uscoreobs.id",
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -164,7 +197,7 @@
         "isSummary": true
       },
       {
-        "id": "Observation:uscoreobss.meta",
+        "id": "Observation:uscoreobs.meta",
         "path": "Observation.meta",
         "short": "Metadata about the resource",
         "definition": "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.",
@@ -183,11 +216,11 @@
         "isSummary": true
       },
       {
-        "id": "Observation:uscoreobss.implicitRules",
+        "id": "Observation:uscoreobs.implicitRules",
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -204,11 +237,11 @@
         "isSummary": true
       },
       {
-        "id": "Observation:uscoreobss.language",
+        "id": "Observation:uscoreobs.language",
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -228,6 +261,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -238,11 +279,11 @@
         }
       },
       {
-        "id": "Observation:uscoreobss.text",
+        "id": "Observation:uscoreobs.text",
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -272,11 +313,11 @@
         ]
       },
       {
-        "id": "Observation:uscoreobss.contained",
+        "id": "Observation:uscoreobs.contained",
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -302,11 +343,11 @@
         ]
       },
       {
-        "id": "Observation:uscoreobss.extension",
+        "id": "Observation:uscoreobs.extension",
         "path": "Observation.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -331,11 +372,11 @@
         ]
       },
       {
-        "id": "Observation:uscoreobss.modifierExtension",
+        "id": "Observation:uscoreobs.modifierExtension",
         "path": "Observation.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -361,10 +402,10 @@
         ]
       },
       {
-        "id": "Observation:uscoreobss.identifier",
+        "id": "Observation:uscoreobs.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -378,7 +419,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -394,7 +440,69 @@
         ]
       },
       {
-        "id": "Observation:uscoreobss.status",
+        "id": "Observation:uscoreobs.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "Observation.basedOn",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
+      {
+        "id": "Observation:uscoreobs.status",
         "extension": [
           {
             "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint",
@@ -404,6 +512,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -419,7 +528,7 @@
         ],
         "mustSupport": true,
         "isModifier": true,
-        "isSummary": false,
+        "isSummary": true,
         "binding": {
           "strength": "required",
           "valueSetReference": {
@@ -427,6 +536,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -438,18 +555,22 @@
           {
             "identity": "w5",
             "map": "status"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Observation.status"
           }
         ]
       },
       {
-        "id": "Observation:uscoreobss.category",
+        "id": "Observation:uscoreobs.category",
         "path": "Observation.category",
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 1,
-        "max": "1",
+        "max": "*",
         "base": {
           "path": "Observation.category",
           "min": 0,
@@ -460,19 +581,25 @@
             "code": "CodeableConcept"
           }
         ],
-        "patternCodeableConcept": {
-          "coding": [
-            {
-              "system": "http://hl7.org/fhir/observation-category",
-              "code": "laboratory"
-            }
-          ]
-        },
+        "constraint": [
+          {
+            "key": "us-core-5",
+            "severity": "error",
+            "human": "Must have a category of 'laboratory' and a code system 'http://hl7.org/fhir/observation-category'",
+            "expression": "where(coding.system='http://hl7.org/fhir/observation-category' and coding.code='laboratory').exists()",
+            "xpath": "exists(f:coding/code[@value='laboratory']) and exists(f:coding/system[@value='http://hl7.org/fhir/observation-category'])"
+          }
+        ],
         "mustSupport": true,
-        "isSummary": false,
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -485,17 +612,22 @@
           {
             "identity": "w5",
             "map": "class"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Observation.category"
           }
         ]
       },
       {
-        "id": "Observation:uscoreobss.code",
+        "id": "Observation:uscoreobs.code",
         "path": "Observation.code",
-        "short": "US Realm Laboratory Test Name",
-        "definition": "The test that was performed.  This is element is bound to LOINC.",
-        "comments": "UsageNote= The typical patterns for codes are:  1)  a LOINC code either as a  translation from a \"local\" code or as a primary code, or 2)  a local code only if no suitable LOINC exists,  or 3)  both the local and the LOINC translation.   Systems SHALL be capable of sending the local code if one exists.",
+        "short": "Laboratory Test Name",
+        "definition": "The test that was performed.  A LOINC **SHALL** be used if the concept is present in LOINC.",
+        "comment": "The typical patterns for codes are:  1)  a LOINC code either as a  translation from a \"local\" code or as a primary code, or 2)  a local code only if no suitable LOINC exists,  or 3)  both the local and the LOINC translation.   Systems SHALL be capable of sending the local code if one exists.  When using LOINC , Use either the SHORTNAME or LONG_COMMON_NAME field for the display.",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
         "alias": [
+          "Name",
           "Test Name",
           "Observation Identifer"
         ],
@@ -512,7 +644,7 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "binding": {
           "strength": "extensible",
           "description": "LOINC codes",
@@ -522,386 +654,41 @@
         },
         "mapping": [
           {
-            "identity": "v2",
-            "map": "OBX-3"
-          },
-          {
-            "identity": "rim",
-            "map": "code"
-          },
-          {
-            "identity": "w5",
-            "map": "what"
-          }
-        ]
-      },
-      {
-        "id": "Observation:uscoreobss.code.id",
-        "path": "Observation.code.id",
-        "representation": [
-          "xmlAttr"
-        ],
-        "short": "xml:id (or equivalent in JSON)",
-        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "Element.id",
-          "min": 0,
-          "max": "1"
-        },
-        "type": [
-          {
-            "code": "string"
-          }
-        ],
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "n/a"
-          }
-        ]
-      },
-      {
-        "id": "Observation:uscoreobss.code.extension",
-        "path": "Observation.code.extension",
-        "short": "Additional Content defined by implementations",
-        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
-        "alias": [
-          "extensions",
-          "user content"
-        ],
-        "min": 0,
-        "max": "*",
-        "base": {
-          "path": "Element.extension",
-          "min": 0,
-          "max": "*"
-        },
-        "type": [
-          {
-            "code": "Extension"
-          }
-        ],
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "n/a"
-          }
-        ]
-      },
-      {
-        "id": "Observation:uscoreobss.code.coding",
-        "path": "Observation.code.coding",
-        "short": "Standard and local codes may be included here by repeating the coding element with a different coding.system.",
-        "definition": "A reference to a code defined by a terminology system.",
-        "comments": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true.",
-        "requirements": "Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings.",
-        "min": 1,
-        "max": "*",
-        "base": {
-          "path": "CodeableConcept.coding",
-          "min": 0,
-          "max": "*"
-        },
-        "type": [
-          {
-            "code": "Coding"
-          }
-        ],
-        "mustSupport": true,
-        "isSummary": false,
-        "mapping": [
-          {
-            "identity": "v2",
-            "map": "C*E.1-8, C*E.10-22"
+            "identity": "workflow",
+            "map": "Event.code"
           },
           {
-            "identity": "rim",
-            "map": "union(., ./translation)"
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
           },
-          {
-            "identity": "orim",
-            "map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"
-          }
-        ]
-      },
-      {
-        "id": "Observation:uscoreobss.code.coding.id",
-        "path": "Observation.code.coding.id",
-        "representation": [
-          "xmlAttr"
-        ],
-        "short": "xml:id (or equivalent in JSON)",
-        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "Element.id",
-          "min": 0,
-          "max": "1"
-        },
-        "type": [
-          {
-            "code": "string"
-          }
-        ],
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "n/a"
-          }
-        ]
-      },
-      {
-        "id": "Observation:uscoreobss.code.coding.extension",
-        "path": "Observation.code.coding.extension",
-        "short": "Additional Content defined by implementations",
-        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
-        "alias": [
-          "extensions",
-          "user content"
-        ],
-        "min": 0,
-        "max": "*",
-        "base": {
-          "path": "Element.extension",
-          "min": 0,
-          "max": "*"
-        },
-        "type": [
-          {
-            "code": "Extension"
-          }
-        ],
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "n/a"
-          }
-        ]
-      },
-      {
-        "id": "Observation:uscoreobss.code.coding.system",
-        "path": "Observation.code.coding.system",
-        "short": "Identity of the terminology system",
-        "definition": "The identification of the code system that defines the meaning of the symbol in the code.",
-        "comments": "The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.",
-        "requirements": "Need to be unambiguous about the source of the definition of the symbol.",
-        "min": 1,
-        "max": "1",
-        "base": {
-          "path": "Coding.system",
-          "min": 0,
-          "max": "1"
-        },
-        "type": [
-          {
-            "code": "uri"
-          }
-        ],
-        "mustSupport": true,
-        "isSummary": false,
-        "mapping": [
           {
             "identity": "v2",
-            "map": "C*E.3"
-          },
-          {
-            "identity": "rim",
-            "map": "./codeSystem"
-          },
-          {
-            "identity": "orim",
-            "map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"
-          }
-        ]
-      },
-      {
-        "id": "Observation:uscoreobss.code.coding.version",
-        "path": "Observation.code.coding.version",
-        "short": "Version of the system - if relevant",
-        "definition": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.",
-        "comments": "Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.",
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "Coding.version",
-          "min": 0,
-          "max": "1"
-        },
-        "type": [
-          {
-            "code": "string"
-          }
-        ],
-        "isSummary": true,
-        "mapping": [
-          {
-            "identity": "v2",
-            "map": "C*E.7"
-          },
-          {
-            "identity": "rim",
-            "map": "./codeSystemVersion"
-          },
-          {
-            "identity": "orim",
-            "map": "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"
-          }
-        ]
-      },
-      {
-        "id": "Observation:uscoreobss.code.coding.code",
-        "path": "Observation.code.coding.code",
-        "short": "Symbol in syntax defined by the system",
-        "definition": "A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).",
-        "comments": "Logical Observation Identifiers Names and Codes (LOINC) is a database and universal standard for identifying medical laboratory observations.",
-        "requirements": "Need to refer to a particular code in the system.",
-        "min": 1,
-        "max": "1",
-        "base": {
-          "path": "Coding.code",
-          "min": 0,
-          "max": "1"
-        },
-        "type": [
-          {
-            "code": "code"
-          }
-        ],
-        "mustSupport": true,
-        "isSummary": false,
-        "mapping": [
-          {
-            "identity": "v2",
-            "map": "C*E.1"
-          },
-          {
-            "identity": "rim",
-            "map": "./code"
-          },
-          {
-            "identity": "orim",
-            "map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"
-          }
-        ]
-      },
-      {
-        "id": "Observation:uscoreobss.code.coding.display",
-        "path": "Observation.code.coding.display",
-        "short": "Representation defined by the system",
-        "definition": "A representation of the meaning of the code in the system, following the rules of the system.",
-        "comments": "When using LOINC  'long common name' is preferred although the LOINC 'short name' or the LOINC 'fully-specified name can also be used.  ( http://lionc.org.terms-of-use).",
-        "requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know  the system.",
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "Coding.display",
-          "min": 0,
-          "max": "1"
-        },
-        "type": [
-          {
-            "code": "string"
-          }
-        ],
-        "mustSupport": true,
-        "isSummary": false,
-        "mapping": [
-          {
-            "identity": "v2",
-            "map": "C*E.2 - but note this is not well followed"
-          },
-          {
-            "identity": "rim",
-            "map": "CV.displayName"
-          },
-          {
-            "identity": "orim",
-            "map": "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"
-          }
-        ]
-      },
-      {
-        "id": "Observation:uscoreobss.code.coding.userSelected",
-        "path": "Observation.code.coding.userSelected",
-        "short": "If this coding was chosen directly by the user",
-        "definition": "Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).",
-        "comments": "Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.",
-        "requirements": "This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.",
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "Coding.userSelected",
-          "min": 0,
-          "max": "1"
-        },
-        "type": [
-          {
-            "code": "boolean"
-          }
-        ],
-        "isSummary": true,
-        "mapping": [
-          {
-            "identity": "v2",
-            "map": "Sometimes implied by being first"
+            "map": "OBX-3"
           },
           {
             "identity": "rim",
-            "map": "CD.codingRationale"
+            "map": "code"
           },
           {
-            "identity": "orim",
-            "map": "fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\\#true a [     fhir:source \"true\";     fhir:target dt:CDCoding.codingRationale\\#O   ]"
-          }
-        ]
-      },
-      {
-        "id": "Observation:uscoreobss.code.text",
-        "path": "Observation.code.text",
-        "short": "Display text",
-        "definition": "This is the laboratory defined display text for the lab test if different from the code display text(s).",
-        "comments": "If this exists, this is the text to be used for display.",
-        "requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.",
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "CodeableConcept.text",
-          "min": 0,
-          "max": "1"
-        },
-        "type": [
-          {
-            "code": "string"
-          }
-        ],
-        "mustSupport": true,
-        "isSummary": false,
-        "mapping": [
-          {
-            "identity": "v2",
-            "map": "C*E.9. But note many systems use C*E.2 for this"
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
           },
           {
-            "identity": "rim",
-            "map": "./originalText[mediaType/code=\"text/plain\"]/data"
+            "identity": "w5",
+            "map": "what"
           },
           {
-            "identity": "orim",
-            "map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"
+            "identity": "argonaut-dq-dstu2",
+            "map": "Observation.code"
           }
         ]
       },
       {
-        "id": "Observation:uscoreobss.subject",
+        "id": "Observation:uscoreobs.subject",
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.  If the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -917,8 +704,12 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -930,19 +721,27 @@
           {
             "identity": "w5",
             "map": "who.focus"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Observation.subject"
           }
         ]
       },
       {
-        "id": "Observation:uscoreobss.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:uscoreobs.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "base": {
-          "path": "Observation.encounter",
+          "path": "Observation.context",
           "min": 0,
           "max": "1"
         },
@@ -950,9 +749,17 @@
           {
             "code": "Reference",
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -968,12 +775,15 @@
         ]
       },
       {
-        "id": "Observation:uscoreobss.effective[x]",
+        "id": "Observation:uscoreobs.effective[x]",
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "For lab tests this is the specimen collection date.  For Ask at Order Entry Questions (AOE)'s this is the date the question was asked.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "base": {
@@ -994,13 +804,17 @@
             "key": "us-core-1",
             "severity": "error",
             "human": "Datetime must be at least to day.",
-            "expression": "length() >= 8",
+            "expression": "($this as dateTime).toString().length() >= 8",
             "xpath": "f:matches(effectiveDateTime,/\\d{4}-[01]\\d-[0-3]\\dT[0-2]\\d:[0-5]\\d([+-][0-2]\\d:[0-5]\\d|Z)/)"
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -1012,15 +826,19 @@
           {
             "identity": "w5",
             "map": "when.done"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Observation.effective[x]"
           }
         ]
       },
       {
-        "id": "Observation:uscoreobss.issued",
+        "id": "Observation:uscoreobs.issued",
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 0,
         "max": "1",
         "base": {
@@ -1050,7 +868,7 @@
         ]
       },
       {
-        "id": "Observation:uscoreobss.performer",
+        "id": "Observation:uscoreobs.performer",
         "path": "Observation.performer",
         "short": "Who is responsible for the observation",
         "definition": "Who was responsible for asserting the observed value as \"true\".",
@@ -1082,6 +900,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -1097,18 +919,12 @@
         ]
       },
       {
-        "id": "Observation:uscoreobss.value[x]",
+        "id": "Observation:uscoreobs.value[x]",
         "path": "Observation.value[x]",
-        "slicing": {
-          "discriminator": [
-            "@type"
-          ],
-          "rules": "open"
-        },
-        "short": "Actual result",
-        "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).   If the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "short": "Result Value",
+        "definition": "The Laboratory result value.  If a coded value,  the valueCodeableConcept.code **SHOULD**  be selected from [SNOMED CT](http://hl7.org/fhir/ValueSet/uslab-obs-codedresults).  If a numeric value, valueQuantity.code **SHALL** be selected from [UCUM](http://unitsofmeasure.org).  A FHIR [UCUM Codes value set](http://hl7.org/fhir/STU3/valueset-ucum-units.html) that defines all UCUM codes is in the FHIR specification.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "base": {
@@ -1127,60 +943,7 @@
             "code": "string"
           },
           {
-            "code": "Range"
-          },
-          {
-            "code": "Ratio"
-          },
-          {
-            "code": "SampledData"
-          },
-          {
-            "code": "Attachment"
-          },
-          {
-            "code": "time"
-          },
-          {
-            "code": "dateTime"
-          },
-          {
-            "code": "Period"
-          }
-        ],
-        "condition": [
-          "obs-7"
-        ],
-        "isSummary": true,
-        "mapping": [
-          {
-            "identity": "v2",
-            "map": "OBX.2, OBX.5, OBX.6"
-          },
-          {
-            "identity": "rim",
-            "map": "value"
-          }
-        ]
-      },
-      {
-        "id": "Observation:uscoreobss.value[x]:uscorevaluetype",
-        "path": "Observation.value[x]",
-        "sliceName": "USCoreValueType",
-        "short": "Actual result",
-        "definition": "If codeableConcept, valueCodeableConcept *SHOULD*  be selected from [SNOMED CT](http://hl7.org/fhir/ValueSet/uslab-obs-codedresults).  If Quantity, valueQuantity units *SHALL* be selected from [UCUM](http://unitsofmeasure.org).",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).   If the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "Observation.value[x]",
-          "min": 0,
-          "max": "1"
-        },
-        "type": [
-          {
-            "code": "string"
+            "code": "boolean"
           },
           {
             "code": "Range"
@@ -1207,95 +970,39 @@
         "condition": [
           "obs-7"
         ],
-        "mustSupport": true,
-        "isSummary": false,
-        "mapping": [
+        "constraint": [
           {
-            "identity": "v2",
-            "map": "OBX.2, OBX.5, OBX.6"
+            "extension": [
+              {
+                "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice",
+                "valueBoolean": true
+              }
+            ],
+            "key": "us-core-4",
+            "severity": "warning",
+            "human": "SHOULD use Snomed CT for coded Results",
+            "expression": "valueCodeableConcept.coding.system.empty() or valueCodeableConcept.coding.system = 'http://snomed.info/sct'",
+            "xpath": "not(exists(f:valueCodeableConcept/f:coding/f:system) ) or  f:valueCodeableConcept/f:coding/f:system[@value='http://snomed.info/sct']"
           },
           {
-            "identity": "rim",
-            "map": "value"
-          }
-        ]
-      },
-      {
-        "id": "Observation:uscoreobss.valueQuantity:uscorevaluequantity",
-        "path": "Observation.valueQuantity",
-        "sliceName": "USCoreValueQuantity",
-        "short": "Actual result",
-        "definition": "If codeableConcept, valueCodeableConcept *SHOULD*  be selected from [SNOMED CT](http://hl7.org/fhir/ValueSet/uslab-obs-codedresults).  If Quantity, valueQuantity units *SHALL* be selected from [UCUM](http://unitsofmeasure.org).",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).   If the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "Observation.value[x]",
-          "min": 0,
-          "max": "1"
-        },
-        "type": [
-          {
-            "code": "Quantity"
+            "key": "us-core-3",
+            "severity": "error",
+            "human": "SHALL use UCUM for coded quantity units.",
+            "expression": "valueQuantity.system.empty() or valueQuantity.system = 'http://unitsofmeasure.org'",
+            "xpath": "not(exists(f:valueQuantity/f:system) ) or  f:valueQuantity/f:system[@value='http://unitsofmeasure.org']"
           }
         ],
-        "condition": [
-          "obs-7"
-        ],
         "mustSupport": true,
-        "isSummary": false,
-        "binding": {
-          "strength": "required",
-          "description": "UCUM Codes for units of measure",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/us/core/ValueSet/us-core-ucum"
-          }
-        },
+        "isSummary": true,
         "mapping": [
           {
-            "identity": "v2",
-            "map": "OBX.2, OBX.5, OBX.6"
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
           },
           {
-            "identity": "rim",
-            "map": "value"
-          }
-        ]
-      },
-      {
-        "id": "Observation:uscoreobss.valueCodeableConcept:uscorevaluecode",
-        "path": "Observation.valueCodeableConcept",
-        "sliceName": "USCoreValueCode",
-        "short": "Actual result",
-        "definition": "If codeableConcept, valueCodeableConcept *SHOULD*  be selected from [SNOMED CT](http://hl7.org/fhir/ValueSet/uslab-obs-codedresults).  If Quantity, valueQuantity units *SHALL* be selected from [UCUM](http://unitsofmeasure.org).",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).   If the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "Observation.value[x]",
-          "min": 0,
-          "max": "1"
-        },
-        "type": [
-          {
-            "code": "CodeableConcept"
-          }
-        ],
-        "condition": [
-          "obs-7"
-        ],
-        "mustSupport": true,
-        "isSummary": false,
-        "binding": {
-          "strength": "preferred",
-          "description": "SNOMED CT for coded results",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/us/core/ValueSet/us-core-observation-value-codes"
-          }
-        },
-        "mapping": [
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1303,15 +1010,23 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Observation.value[x]"
           }
         ]
       },
       {
-        "id": "Observation:uscoreobss.dataAbsentReason",
+        "id": "Observation:uscoreobs.dataAbsentReason",
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1329,7 +1044,6 @@
           "obs-6"
         ],
         "mustSupport": true,
-        "isSummary": false,
         "binding": {
           "strength": "extensible",
           "valueSetReference": {
@@ -1337,6 +1051,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -1344,11 +1062,15 @@
           {
             "identity": "rim",
             "map": "value.nullFlavor"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Observation.dataAbsentReason"
           }
         ]
       },
       {
-        "id": "Observation:uscoreobss.interpretation",
+        "id": "Observation:uscoreobs.interpretation",
         "path": "Observation.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
@@ -1369,6 +1091,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1376,6 +1104,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1383,11 +1115,15 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
       {
-        "id": "Observation:uscoreobss.comment",
+        "id": "Observation:uscoreobs.comment",
         "path": "Observation.comment",
         "short": "Comments about result",
         "definition": "May include statements about significant, unexpected or unreliable values, or information about the source of the value where this may be relevant to the interpretation of the result.",
@@ -1405,6 +1141,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -1416,12 +1156,11 @@
         ]
       },
       {
-        "id": "Observation:uscoreobss.bodySite",
+        "id": "Observation:uscoreobs.bodySite",
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "base": {
@@ -1435,6 +1174,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -1442,6 +1187,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -1449,15 +1198,19 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
       {
-        "id": "Observation:uscoreobss.method",
+        "id": "Observation:uscoreobs.method",
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1472,6 +1225,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1490,11 +1249,11 @@
         ]
       },
       {
-        "id": "Observation:uscoreobss.specimen",
+        "id": "Observation:uscoreobs.specimen",
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "base": {
@@ -1509,6 +1268,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1516,15 +1279,19 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
       {
-        "id": "Observation:uscoreobss.device",
+        "id": "Observation:uscoreobs.device",
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "base": {
@@ -1543,6 +1310,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1550,15 +1321,19 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
       {
-        "id": "Observation:uscoreobss.referenceRange",
+        "id": "Observation:uscoreobs.referenceRange",
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1601,7 +1376,7 @@
         ]
       },
       {
-        "id": "Observation:uscoreobss.referenceRange.id",
+        "id": "Observation:uscoreobs.referenceRange.id",
         "path": "Observation.referenceRange.id",
         "representation": [
           "xmlAttr"
@@ -1628,11 +1403,11 @@
         ]
       },
       {
-        "id": "Observation:uscoreobss.referenceRange.extension",
+        "id": "Observation:uscoreobs.referenceRange.extension",
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1657,11 +1432,11 @@
         ]
       },
       {
-        "id": "Observation:uscoreobss.referenceRange.modifierExtension",
+        "id": "Observation:uscoreobs.referenceRange.modifierExtension",
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1689,7 +1464,7 @@
         ]
       },
       {
-        "id": "Observation:uscoreobss.referenceRange.low",
+        "id": "Observation:uscoreobs.referenceRange.low",
         "path": "Observation.referenceRange.low",
         "short": "Low Range, if relevant",
         "definition": "The value of the low bound of the reference range.  The low bound of the reference range endpoint is inclusive of the value (e.g.  reference range is >=5 - <=9).   If the low bound is omitted,  it is assumed to be meaningless (e.g. reference range is <=2.3).",
@@ -1721,7 +1496,7 @@
         ]
       },
       {
-        "id": "Observation:uscoreobss.referenceRange.high",
+        "id": "Observation:uscoreobs.referenceRange.high",
         "path": "Observation.referenceRange.high",
         "short": "High Range, if relevant",
         "definition": "The value of the high bound of the reference range.  The high bound of the reference range endpoint is inclusive of the value (e.g.  reference range is >=5 - <=9).   If the high bound is omitted,  it is assumed to be meaningless (e.g. reference range is >= 2.3).",
@@ -1753,16 +1528,63 @@
         ]
       },
       {
-        "id": "Observation:uscoreobss.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:uscoreobs.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Observation.referenceRange.type",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
+          "description": "Code for the meaning of a reference range.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:uscoreobs.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
         "min": 0,
         "max": "*",
         "base": {
-          "path": "Observation.referenceRange.meaning",
+          "path": "Observation.referenceRange.appliesTo",
           "min": 0,
           "max": "*"
         },
@@ -1772,16 +1594,26 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
           "strength": "example",
-          "description": "Code for the meaning of a reference range.",
+          "description": "Codes identifying the population the reference range applies to.",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1790,7 +1622,7 @@
         ]
       },
       {
-        "id": "Observation:uscoreobss.referenceRange.age",
+        "id": "Observation:uscoreobs.referenceRange.age",
         "path": "Observation.referenceRange.age",
         "short": "Applicable age range, if relevant",
         "definition": "The age at which this reference range is applicable. This is a neonatal age (e.g. number of weeks at term) if the meaning says so.",
@@ -1815,7 +1647,7 @@
         ]
       },
       {
-        "id": "Observation:uscoreobss.referenceRange.text",
+        "id": "Observation:uscoreobs.referenceRange.text",
         "path": "Observation.referenceRange.text",
         "short": "Text based reference range in an observation",
         "definition": "Text based reference range in an observation which may be used when a quantitative range is not appropriate for an observation.  An example would be a reference value of \"Negative\" or a list or table of 'normals'.",
@@ -1843,12 +1675,12 @@
         ]
       },
       {
-        "id": "Observation:uscoreobss.related",
+        "id": "Observation:uscoreobs.related",
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "base": {
@@ -1884,7 +1716,7 @@
         ]
       },
       {
-        "id": "Observation:uscoreobss.related.id",
+        "id": "Observation:uscoreobs.related.id",
         "path": "Observation.related.id",
         "representation": [
           "xmlAttr"
@@ -1911,11 +1743,11 @@
         ]
       },
       {
-        "id": "Observation:uscoreobss.related.extension",
+        "id": "Observation:uscoreobs.related.extension",
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1940,11 +1772,11 @@
         ]
       },
       {
-        "id": "Observation:uscoreobss.related.modifierExtension",
+        "id": "Observation:uscoreobs.related.modifierExtension",
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1972,11 +1804,11 @@
         ]
       },
       {
-        "id": "Observation:uscoreobss.related.type",
+        "id": "Observation:uscoreobs.related.type",
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1991,6 +1823,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -2009,7 +1847,7 @@
         ]
       },
       {
-        "id": "Observation:uscoreobss.related.target",
+        "id": "Observation:uscoreobs.related.target",
         "path": "Observation.related.target",
         "short": "Resource that is related to this one",
         "definition": "A reference to the observation or [QuestionnaireResponse](questionnaireresponse.html#) resource that is related to this observation.",
@@ -2042,11 +1880,11 @@
         ]
       },
       {
-        "id": "Observation:uscoreobss.component",
+        "id": "Observation:uscoreobs.component",
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -2083,7 +1921,7 @@
         ]
       },
       {
-        "id": "Observation:uscoreobss.component.id",
+        "id": "Observation:uscoreobs.component.id",
         "path": "Observation.component.id",
         "representation": [
           "xmlAttr"
@@ -2110,11 +1948,11 @@
         ]
       },
       {
-        "id": "Observation:uscoreobss.component.extension",
+        "id": "Observation:uscoreobs.component.extension",
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -2139,11 +1977,11 @@
         ]
       },
       {
-        "id": "Observation:uscoreobss.component.modifierExtension",
+        "id": "Observation:uscoreobs.component.modifierExtension",
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -2171,7 +2009,7 @@
         ]
       },
       {
-        "id": "Observation:uscoreobss.component.code",
+        "id": "Observation:uscoreobs.component.code",
         "path": "Observation.component.code",
         "short": "Type of component observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"code\".",
@@ -2190,6 +2028,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -2197,6 +2041,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -2212,12 +2060,12 @@
         ]
       },
       {
-        "id": "Observation:uscoreobss.component.value[x]",
+        "id": "Observation:uscoreobs.component.value[x]",
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "base": {
@@ -2259,6 +2107,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -2266,15 +2118,19 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
       {
-        "id": "Observation:uscoreobss.component.dataAbsentReason",
+        "id": "Observation:uscoreobs.component.dataAbsentReason",
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -2292,6 +2148,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -2310,11 +2172,11 @@
         ]
       },
       {
-        "id": "Observation:uscoreobss.component.interpretation",
+        "id": "Observation:uscoreobs.component.interpretation",
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -2332,6 +2194,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -2339,6 +2207,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -2346,15 +2218,19 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
       {
-        "id": "Observation:uscoreobss.component.referenceRange",
+        "id": "Observation:uscoreobs.component.referenceRange",
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -2363,7 +2239,7 @@
           "min": 0,
           "max": "*"
         },
-        "contentReference": "#Observation:uscoreobss.referenceRange",
+        "contentReference": "#Observation:uscoreobs.referenceRange",
         "mapping": [
           {
             "identity": "v2",
@@ -2380,11 +2256,11 @@
   "differential": {
     "element": [
       {
-        "id": "Observation:uscoreobss",
+        "id": "Observation:uscoreobs",
         "path": "Observation",
-        "sliceName": "USCoreObss",
+        "sliceName": "USCoreObs",
         "short": "US Core Result Observation",
-        "definition": "US Realm clinical coded results.",
+        "definition": "The US Core Observation Result Profile is based upon the core FHIR Observation Resource and created to meet the 2015 Edition Common Clinical Data Set 'Laboratory test(s) and Laboratory value(s)/result(s)' requirements.",
         "alias": [
           "Obs"
         ],
@@ -2393,16 +2269,21 @@
             "key": "us-core-2",
             "severity": "error",
             "human": "If there is no component or related element then either a value[x] or a data absent reason must be present",
-            "expression": "(component.empty() or related.empty()) implies (value.exists() or dataAbsentReason.exists())",
+            "expression": "(component.empty() and related.empty()) implies (dataAbsentReason or value)",
             "xpath": "exists(f:component) or exists(f:related) or exists(f:*[starts-with(local-name(.), 'value)]) or exists(f:dataAbsentReason)"
           }
         ],
         "mustSupport": false,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Observation"
+          }
+        ]
       },
       {
-        "id": "Observation:uscoreobss.status",
+        "id": "Observation:uscoreobs.status",
         "path": "Observation.status",
         "min": 1,
         "max": "1",
@@ -2413,42 +2294,53 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false,
         "binding": {
           "strength": "required",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-status"
           }
-        }
+        },
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Observation.status"
+          }
+        ]
       },
       {
-        "id": "Observation:uscoreobss.category",
+        "id": "Observation:uscoreobs.category",
         "path": "Observation.category",
         "min": 1,
-        "max": "1",
+        "max": "*",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
-        "patternCodeableConcept": {
-          "coding": [
-            {
-              "system": "http://hl7.org/fhir/observation-category",
-              "code": "laboratory"
-            }
-          ]
-        },
+        "constraint": [
+          {
+            "key": "us-core-5",
+            "severity": "error",
+            "human": "Must have a category of 'laboratory' and a code system 'http://hl7.org/fhir/observation-category'",
+            "expression": "where(coding.system='http://hl7.org/fhir/observation-category' and coding.code='laboratory').exists()",
+            "xpath": "exists(f:coding/code[@value='laboratory']) and exists(f:coding/system[@value='http://hl7.org/fhir/observation-category'])"
+          }
+        ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Observation.category"
+          }
+        ]
       },
       {
-        "id": "Observation:uscoreobss.code",
+        "id": "Observation:uscoreobs.code",
         "path": "Observation.code",
-        "short": "US Realm Laboratory Test Name",
-        "definition": "The test that was performed.  This is element is bound to LOINC.",
-        "comments": "UsageNote= The typical patterns for codes are:  1)  a LOINC code either as a  translation from a \"local\" code or as a primary code, or 2)  a local code only if no suitable LOINC exists,  or 3)  both the local and the LOINC translation.   Systems SHALL be capable of sending the local code if one exists.",
+        "short": "Laboratory Test Name",
+        "definition": "The test that was performed.  A LOINC **SHALL** be used if the concept is present in LOINC.",
+        "comment": "The typical patterns for codes are:  1)  a LOINC code either as a  translation from a \"local\" code or as a primary code, or 2)  a local code only if no suitable LOINC exists,  or 3)  both the local and the LOINC translation.   Systems SHALL be capable of sending the local code if one exists.  When using LOINC , Use either the SHORTNAME or LONG_COMMON_NAME field for the display.",
         "alias": [
           "Test Name",
           "Observation Identifer"
@@ -2462,93 +2354,22 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false,
         "binding": {
           "strength": "extensible",
           "description": "LOINC codes",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-codes"
           }
-        }
-      },
-      {
-        "id": "Observation:uscoreobss.code.coding",
-        "path": "Observation.code.coding",
-        "short": "Standard and local codes may be included here by repeating the coding element with a different coding.system.",
-        "min": 1,
-        "max": "*",
-        "type": [
-          {
-            "code": "Coding"
-          }
-        ],
-        "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false
-      },
-      {
-        "id": "Observation:uscoreobss.code.coding.system",
-        "path": "Observation.code.coding.system",
-        "min": 1,
-        "max": "1",
-        "type": [
-          {
-            "code": "uri"
-          }
-        ],
-        "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false
-      },
-      {
-        "id": "Observation:uscoreobss.code.coding.code",
-        "path": "Observation.code.coding.code",
-        "comments": "Logical Observation Identifiers Names and Codes (LOINC) is a database and universal standard for identifying medical laboratory observations.",
-        "min": 1,
-        "max": "1",
-        "type": [
-          {
-            "code": "code"
-          }
-        ],
-        "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false
-      },
-      {
-        "id": "Observation:uscoreobss.code.coding.display",
-        "path": "Observation.code.coding.display",
-        "comments": "When using LOINC  'long common name' is preferred although the LOINC 'short name' or the LOINC 'fully-specified name can also be used.  ( http://lionc.org.terms-of-use).",
-        "min": 0,
-        "max": "1",
-        "type": [
-          {
-            "code": "string"
-          }
-        ],
-        "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false
-      },
-      {
-        "id": "Observation:uscoreobss.code.text",
-        "path": "Observation.code.text",
-        "short": "Display text",
-        "definition": "This is the laboratory defined display text for the lab test if different from the code display text(s).",
-        "comments": "If this exists, this is the text to be used for display.",
-        "min": 0,
-        "max": "1",
-        "type": [
+        },
+        "mapping": [
           {
-            "code": "string"
+            "identity": "argonaut-dq-dstu2",
+            "map": "Observation.code"
           }
-        ],
-        "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false
+        ]
       },
       {
-        "id": "Observation:uscoreobss.subject",
+        "id": "Observation:uscoreobs.subject",
         "path": "Observation.subject",
         "min": 1,
         "max": "1",
@@ -2560,10 +2381,15 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Observation.subject"
+          }
+        ]
       },
       {
-        "id": "Observation:uscoreobss.effective[x]",
+        "id": "Observation:uscoreobs.effective[x]",
         "path": "Observation.effective[x]",
         "definition": "For lab tests this is the specimen collection date.  For Ask at Order Entry Questions (AOE)'s this is the date the question was asked.",
         "min": 0,
@@ -2581,105 +2407,59 @@
             "key": "us-core-1",
             "severity": "error",
             "human": "Datetime must be at least to day.",
-            "expression": "length() >= 8",
+            "expression": "($this as dateTime).toString().length() >= 8",
             "xpath": "f:matches(effectiveDateTime,/\\d{4}-[01]\\d-[0-3]\\dT[0-2]\\d:[0-5]\\d([+-][0-2]\\d:[0-5]\\d|Z)/)"
           }
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Observation.effective[x]"
+          }
+        ]
       },
       {
-        "id": "Observation:uscoreobss.value[x]:uscorevaluetype",
+        "id": "Observation:uscoreobs.value[x]",
         "path": "Observation.value[x]",
-        "sliceName": "USCoreValueType",
-        "slicing": {
-          "discriminator": [
-            "@type"
-          ],
-          "rules": "open"
-        },
-        "definition": "If codeableConcept, valueCodeableConcept *SHOULD*  be selected from [SNOMED CT](http://hl7.org/fhir/ValueSet/uslab-obs-codedresults).  If Quantity, valueQuantity units *SHALL* be selected from [UCUM](http://unitsofmeasure.org).",
+        "short": "Result Value",
+        "definition": "The Laboratory result value.  If a coded value,  the valueCodeableConcept.code **SHOULD**  be selected from [SNOMED CT](http://hl7.org/fhir/ValueSet/uslab-obs-codedresults).  If a numeric value, valueQuantity.code **SHALL** be selected from [UCUM](http://unitsofmeasure.org).  A FHIR [UCUM Codes value set](http://hl7.org/fhir/STU3/valueset-ucum-units.html) that defines all UCUM codes is in the FHIR specification.",
         "min": 0,
         "max": "1",
-        "type": [
-          {
-            "code": "string"
-          },
-          {
-            "code": "Range"
-          },
-          {
-            "code": "Ratio"
-          },
-          {
-            "code": "SampledData"
-          },
-          {
-            "code": "Attachment"
-          },
-          {
-            "code": "time"
-          },
+        "constraint": [
           {
-            "code": "dateTime"
+            "extension": [
+              {
+                "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice",
+                "valueBoolean": true
+              }
+            ],
+            "key": "us-core-4",
+            "severity": "warning",
+            "human": "SHOULD use Snomed CT for coded Results",
+            "expression": "valueCodeableConcept.coding.system.empty() or valueCodeableConcept.coding.system = 'http://snomed.info/sct'",
+            "xpath": "not(exists(f:valueCodeableConcept/f:coding/f:system) ) or  f:valueCodeableConcept/f:coding/f:system[@value='http://snomed.info/sct']"
           },
           {
-            "code": "Period"
-          }
-        ],
-        "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false
-      },
-      {
-        "id": "Observation:uscoreobss.valueQuantity:uscorevaluequantity",
-        "path": "Observation.valueQuantity",
-        "sliceName": "USCoreValueQuantity",
-        "definition": "If codeableConcept, valueCodeableConcept *SHOULD*  be selected from [SNOMED CT](http://hl7.org/fhir/ValueSet/uslab-obs-codedresults).  If Quantity, valueQuantity units *SHALL* be selected from [UCUM](http://unitsofmeasure.org).",
-        "min": 0,
-        "max": "1",
-        "type": [
-          {
-            "code": "Quantity"
+            "key": "us-core-3",
+            "severity": "error",
+            "human": "SHALL use UCUM for coded quantity units.",
+            "expression": "valueQuantity.system.empty() or valueQuantity.system = 'http://unitsofmeasure.org'",
+            "xpath": "not(exists(f:valueQuantity/f:system) ) or  f:valueQuantity/f:system[@value='http://unitsofmeasure.org']"
           }
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false,
-        "binding": {
-          "strength": "required",
-          "description": "UCUM Codes for units of measure",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/us/core/ValueSet/us-core-ucum"
-          }
-        }
-      },
-      {
-        "id": "Observation:uscoreobss.valueCodeableConcept:uscorevaluecode",
-        "path": "Observation.valueCodeableConcept",
-        "sliceName": "USCoreValueCode",
-        "definition": "If codeableConcept, valueCodeableConcept *SHOULD*  be selected from [SNOMED CT](http://hl7.org/fhir/ValueSet/uslab-obs-codedresults).  If Quantity, valueQuantity units *SHALL* be selected from [UCUM](http://unitsofmeasure.org).",
-        "min": 0,
-        "max": "1",
-        "type": [
+        "mapping": [
           {
-            "code": "CodeableConcept"
-          }
-        ],
-        "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false,
-        "binding": {
-          "strength": "preferred",
-          "description": "SNOMED CT for coded results",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/us/core/ValueSet/us-core-observation-value-codes"
+            "identity": "argonaut-dq-dstu2",
+            "map": "Observation.value[x]"
           }
-        }
+        ]
       },
       {
-        "id": "Observation:uscoreobss.dataAbsentReason",
+        "id": "Observation:uscoreobs.dataAbsentReason",
         "path": "Observation.dataAbsentReason",
         "min": 0,
         "max": "1",
@@ -2690,14 +2470,19 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false,
         "binding": {
           "strength": "extensible",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-valueabsentreason"
           }
-        }
+        },
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Observation.dataAbsentReason"
+          }
+        ]
       }
     ]
   }
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/StructureDefinition-us-core-organization.json b/lib/resources/us_core/StructureDefinition-us-core-organization.json
index 5a66df0..e349b4e 100755
--- a/lib/resources/us_core/StructureDefinition-us-core-organization.json
+++ b/lib/resources/us_core/StructureDefinition-us-core-organization.json
@@ -3,12 +3,14 @@
   "id": "us-core-organization",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization</a></p><p><b>name</b>: US Core Organization Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: Health Level Seven International (FHIR-Infrastructure)</p><p><b>contact</b>: </p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization</a></p><p><b>name</b>: US Core Organization Profile</p><p><b>status</b>: DRAFT</p><p><b>publisher</b>: Health Level Seven International (FHIR-Infrastructure)</p><p><b>contact</b>: </p><p><b>date</b>: 01/08/2016</p><blockquote><p><b>mapping</b></p><p><b>identity</b>: servd</p><p><b>uri</b>: <a href=\"http://www.omg.org/spec/ServD/1.0/\">http://www.omg.org/spec/ServD/1.0/</a></p><p><b>name</b>: ServD</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: v2</p><p><b>uri</b>: <a href=\"http://hl7.org/v2\">http://hl7.org/v2</a></p><p><b>name</b>: HL7 v2 Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: rim</p><p><b>uri</b>: <a href=\"http://hl7.org/v3\">http://hl7.org/v3</a></p><p><b>name</b>: RIM Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: w5</p><p><b>uri</b>: <a href=\"http://hl7.org/fhir/w5\">http://hl7.org/fhir/w5</a></p><p><b>name</b>: W5 Mapping</p></blockquote><p><b>kind</b>: RESOURCE</p><p><b>abstract</b>: false</p><p><b>type</b>: Organization</p><p><b>baseDefinition</b>: <a href=\"http://hl7.org/fhir/StructureDefinition/Organization\">http://hl7.org/fhir/StructureDefinition/Organization</a></p><p><b>derivation</b>: CONSTRAINT</p><h3>Snapshots</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table><h3>Differentials</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table></div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: US Core Organization Core Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: HL7 US Realm Steering Committee</p><p><b>contact</b>: </p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: US Core Organization Core Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: HL7 US Realm Steering Committee</p><p><b>contact</b>: </p><p><b>fhirVersion</b>: 3.0.0</p><blockquote><p><b>mapping</b></p><p><b>identity</b>: servd</p><p><b>uri</b>: <a href=\"http://www.omg.org/spec/ServD/1.0/\">http://www.omg.org/spec/ServD/1.0/</a></p><p><b>name</b>: ServD</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: v2</p><p><b>uri</b>: <a href=\"http://hl7.org/v2\">http://hl7.org/v2</a></p><p><b>name</b>: HL7 v2 Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: rim</p><p><b>uri</b>: <a href=\"http://hl7.org/v3\">http://hl7.org/v3</a></p><p><b>name</b>: RIM Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: w5</p><p><b>uri</b>: <a href=\"http://hl7.org/fhir/w5\">http://hl7.org/fhir/w5</a></p><p><b>name</b>: W5 Mapping</p></blockquote><p><b>kind</b>: RESOURCE</p><p><b>abstract</b>: false</p><p><b>type</b>: Organization</p><p><b>baseDefinition</b>: <a href=\"http://hl7.org/fhir/StructureDefinition/Organization\">http://hl7.org/fhir/StructureDefinition/Organization</a></p><p><b>derivation</b>: CONSTRAINT</p><h3>Snapshots</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table><h3>Differentials</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table></div>"
   },
   "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization",
-  "name": "US Core Organization Profile",
+  "version": "1.0.0",
+  "name": "US Core Organization Core Profile",
   "status": "draft",
-  "publisher": "Health Level Seven International (FHIR-Infrastructure)",
+  "date": "2016-08-01",
+  "publisher": "HL7 US Realm Steering Committee",
   "contact": [
     {
       "telecom": [
@@ -19,7 +21,7 @@
       ]
     }
   ],
-  "date": "2016-08-01",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "servd",
@@ -105,7 +107,6 @@
           }
         ],
         "mustSupport": false,
-        "isSummary": false,
         "mapping": [
           {
             "identity": "rim",
@@ -134,7 +135,7 @@
         "path": "Organization.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -173,7 +174,7 @@
         "path": "Organization.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -194,7 +195,7 @@
         "path": "Organization.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -214,6 +215,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -228,7 +237,7 @@
         "path": "Organization.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -262,7 +271,7 @@
         "path": "Organization.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -292,7 +301,7 @@
         "path": "Organization.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -321,7 +330,7 @@
         "path": "Organization.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -368,7 +377,7 @@
           "org-1"
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -392,12 +401,321 @@
           }
         ]
       },
+      {
+        "id": "Organization:uscoreorganization.identifier.id",
+        "path": "Organization.identifier.id",
+        "representation": [
+          "xmlAttr"
+        ],
+        "short": "xml:id (or equivalent in JSON)",
+        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Element.id",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "Organization:uscoreorganization.identifier.extension",
+        "path": "Organization.identifier.extension",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
+        "short": "Additional Content defined by implementations",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "Element.extension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "Organization:uscoreorganization.identifier.use",
+        "path": "Organization.identifier.use",
+        "short": "usual | official | temp | secondary (If known)",
+        "definition": "The purpose of this identifier.",
+        "comment": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.",
+        "requirements": "Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Identifier.use",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "code"
+          }
+        ],
+        "isModifier": true,
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "IdentifierUse"
+            }
+          ],
+          "strength": "required",
+          "description": "Identifies the purpose for this identifier, if known .",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/identifier-use"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "v2",
+            "map": "N/A"
+          },
+          {
+            "identity": "rim",
+            "map": "Role.code or implied by context"
+          }
+        ]
+      },
+      {
+        "id": "Organization:uscoreorganization.identifier.type",
+        "path": "Organization.identifier.type",
+        "short": "Description of identifier",
+        "definition": "A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.",
+        "comment": "This element deals only with general categories of identifiers.  It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. \n\nWhere the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.",
+        "requirements": "Allows users to make use of identifiers when the identifier system is not known.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Identifier.type",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "IdentifierType"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
+            }
+          ],
+          "strength": "extensible",
+          "description": "A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/identifier-type"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "v2",
+            "map": "CX.5"
+          },
+          {
+            "identity": "rim",
+            "map": "Role.code or implied by context"
+          }
+        ]
+      },
+      {
+        "id": "Organization:uscoreorganization.identifier.system",
+        "path": "Organization.identifier.system",
+        "short": "The namespace for the identifier value",
+        "definition": "Establishes the namespace for the value - that is, a URL that describes a set values that are unique.",
+        "comment": "NPI preferred (http://hl7.org/fhir/sid/us-npi), Tax id is allowed (http://hl7.org/fhir/sid/us-tin), Local id is allowed in addition to 'authoritative' identifier.",
+        "requirements": "There are many sets  of identifiers.  To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.",
+        "min": 1,
+        "max": "1",
+        "base": {
+          "path": "Identifier.system",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "uri"
+          }
+        ],
+        "example": [
+          {
+            "label": "General",
+            "valueUri": "http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri"
+          }
+        ],
+        "mustSupport": true,
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "v2",
+            "map": "CX.4 / EI-2-4"
+          },
+          {
+            "identity": "rim",
+            "map": "II.root or Role.id.root"
+          },
+          {
+            "identity": "servd",
+            "map": "./IdentifierType"
+          }
+        ]
+      },
+      {
+        "id": "Organization:uscoreorganization.identifier.value",
+        "path": "Organization.identifier.value",
+        "short": "The value that is unique",
+        "definition": "The portion of the identifier typically relevant to the user and which is unique within the context of the system.",
+        "comment": "If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986.  The value's primary purpose is computational mapping.  As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.)  A value formatted for human display can be conveyed using the [Rendered Value extension](extension-rendered-value.html).",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Identifier.value",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "example": [
+          {
+            "label": "General",
+            "valueString": "123456"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "v2",
+            "map": "CX.1 / EI.1"
+          },
+          {
+            "identity": "rim",
+            "map": "II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)"
+          },
+          {
+            "identity": "servd",
+            "map": "./Value"
+          }
+        ]
+      },
+      {
+        "id": "Organization:uscoreorganization.identifier.period",
+        "path": "Organization.identifier.period",
+        "short": "Time period when id is/was valid for use",
+        "definition": "Time period during which identifier is/was valid for use.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Identifier.period",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "Period"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "v2",
+            "map": "CX.7 + CX.8"
+          },
+          {
+            "identity": "rim",
+            "map": "Role.effectiveTime or implied by context"
+          },
+          {
+            "identity": "servd",
+            "map": "./StartDate and ./EndDate"
+          }
+        ]
+      },
+      {
+        "id": "Organization:uscoreorganization.identifier.assigner",
+        "path": "Organization.identifier.assigner",
+        "short": "Organization that issued id (may be just text)",
+        "definition": "Organization that issued/manages the identifier.",
+        "comment": "The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Identifier.assigner",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "v2",
+            "map": "CX.4 / (CX.4,CX.9,CX.10)"
+          },
+          {
+            "identity": "rim",
+            "map": "II.assigningAuthorityName but note that this is an improper use by the definition of the field.  Also Role.scoper"
+          },
+          {
+            "identity": "servd",
+            "map": "./IdentifierIssuingAuthority"
+          }
+        ]
+      },
       {
         "id": "Organization:uscoreorganization.active",
         "path": "Organization.active",
         "short": "Whether the organization's record is still in active use",
         "definition": "Whether the organization's record is still in active use.",
-        "comments": "Default is true.  This active flag is not intended to be used to mark an organizations as temporarily closed or under construction. Instead the Location(s) within the Organization should have the suspended status. If further details of the reason for the suspension are required, then an extension on this element should be used.",
+        "comment": "Default is true.\n\nThis active flag is not intended to be used to mark an organizations as temporarily closed or under construction. Instead the Location(s) within the Organization should have the suspended status. If further details of the reason for the suspension are required, then an extension on this element should be used.\n\nThis element is labeled as a modifier because it may be used to mark that the resource was created in error.",
         "requirements": "Need a flag to indicate a record is no longer to be used and should generally be hidden for the user in the UI.",
         "min": 1,
         "max": "1",
@@ -414,7 +732,7 @@
         "defaultValueBoolean": true,
         "mustSupport": true,
         "isModifier": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -438,15 +756,15 @@
         "id": "Organization:uscoreorganization.type",
         "path": "Organization.type",
         "short": "Kind of organization",
-        "definition": "The kind of organization that this is.",
-        "comments": "Organizations can be corporations, wards, sections, clinical teams, government departments, etc. Note that code is generally a classifier of the type of organization; in many applications, codes are used to identity a particular organization (say, ward) as opposed to another of the same type - these are identifiers, not codes.",
+        "definition": "The kind(s) of organization that this is.",
+        "comment": "Organizations can be corporations, wards, sections, clinical teams, government departments, etc. Note that code is generally a classifier of the type of organization; in many applications, codes are used to identity a particular organization (say, ward) as opposed to another of the same type - these are identifiers, not codes\n\nWhen considering if multiple types are appropriate, you should evaluate if child organizations would be a more appropriate use of the concept, as different types likely are in different sub-areas of the organization. This is most likely to be used where type values have orthogonal values, such as a religious, academic and medical center.\n\nWe expect that some jurisdictions will profile this optionality to be a single cardinality.",
         "requirements": "Need to be able to track the kind of organization that this is - different organization types have different uses.",
         "min": 0,
-        "max": "1",
+        "max": "*",
         "base": {
           "path": "Organization.type",
           "min": 0,
-          "max": "1"
+          "max": "*"
         },
         "type": [
           {
@@ -455,6 +773,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "OrganizationType"
+            }
+          ],
           "strength": "example",
           "description": "Used to categorize the organization",
           "valueSetReference": {
@@ -485,7 +809,7 @@
         "path": "Organization.name",
         "short": "Name used for the organization",
         "definition": "A name associated with the organization.",
-        "comments": "If the name of an organization changes, consider putting the old name in the alias column so that it can still be located through searches.",
+        "comment": "If the name of an organization changes, consider putting the old name in the alias column so that it can still be located through searches.",
         "requirements": "Need to use the name as the label of the organization.",
         "min": 1,
         "max": "1",
@@ -503,7 +827,7 @@
           "org-1"
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -528,8 +852,8 @@
         "path": "Organization.alias",
         "short": "A list of alternate names that the organization is known as, or was known as in the past",
         "definition": "A list of alternate names that the organization is known as, or was known as in the past.",
-        "comments": "There are no dates associated with the alias/historic names, as this is not intended to track when names were used, but to assist in searching so that older names can still result in identifying the organization.",
-        "requirements": "Over time locations and organizations go through many changes and can be known by different names.  For searching knowing previous names that the location was known by can be very useful.",
+        "comment": "There are no dates associated with the alias/historic names, as this is not intended to track when names were used, but to assist in searching so that older names can still result in identifying the organization.",
+        "requirements": "Over time locations and organizations go through many changes and can be known by different names.\n\nFor searching knowing previous names that the organization was known by can be very useful.",
         "min": 0,
         "max": "*",
         "base": {
@@ -554,7 +878,7 @@
         "path": "Organization.telecom",
         "short": "A contact detail for the organization",
         "definition": "A contact detail for the organization.",
-        "comments": "The use code home is not to be used. Note that these contacts are not the contact details of people who are employed by or represent the organization, but official contacts for the organization itself.",
+        "comment": "The use code home is not to be used. Note that these contacts are not the contact details of people who are employed by or represent the organization, but official contacts for the organization itself.",
         "requirements": "Human contact for the organization.",
         "min": 1,
         "max": "*",
@@ -582,7 +906,6 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
         "mapping": [
           {
             "identity": "v2",
@@ -603,7 +926,7 @@
         "path": "Organization.address",
         "short": "An address for the organization",
         "definition": "An address for the organization.",
-        "comments": "Organization may have multiple addresses with different uses or applicable periods. The use code home is not to be used.",
+        "comment": "Organization may have multiple addresses with different uses or applicable periods. The use code home is not to be used.",
         "requirements": "May need to keep track of the organization's addresses for contacting, billing or reporting requirements.",
         "min": 1,
         "max": "*",
@@ -631,7 +954,6 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
         "mapping": [
           {
             "identity": "v2",
@@ -681,9 +1003,19 @@
       {
         "id": "Organization:uscoreorganization.address.extension",
         "path": "Organization.address.extension",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -712,7 +1044,7 @@
         "path": "Organization.address.use",
         "short": "home | work | temp | old - purpose of this address",
         "definition": "The purpose of this address.",
-        "comments": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary or old address etc.for a current/permanent one. Applications can assume that an address is current unless it explicitly says that it is temporary or old.",
+        "comment": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary or old address etc.for a current/permanent one. Applications can assume that an address is current unless it explicitly says that it is temporary or old.",
         "requirements": "Allows an appropriate address to be chosen from a list of many.",
         "min": 0,
         "max": "1",
@@ -735,6 +1067,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AddressUse"
+            }
+          ],
           "strength": "required",
           "description": "The use of an address",
           "valueSetReference": {
@@ -781,6 +1119,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AddressType"
+            }
+          ],
           "strength": "required",
           "description": "The type of an address (physical / postal)",
           "valueSetReference": {
@@ -807,7 +1151,7 @@
         "path": "Organization.address.text",
         "short": "Text representation of the address",
         "definition": "A full text representation of the address.",
-        "comments": "Can provide both a text representation and parts.",
+        "comment": "Can provide both a text representation and parts.",
         "requirements": "A renderable, unencoded form.",
         "min": 0,
         "max": "1",
@@ -861,6 +1205,7 @@
             "code": "string"
           }
         ],
+        "orderMeaning": "The order in which lines should appear in an address label",
         "example": [
           {
             "label": "General",
@@ -868,7 +1213,7 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -915,7 +1260,7 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -940,7 +1285,7 @@
         "path": "Organization.address.district",
         "short": "District name (aka county)",
         "definition": "The name of the administrative area (county).",
-        "comments": "District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead.",
+        "comment": "District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead.",
         "alias": [
           "County"
         ],
@@ -996,7 +1341,7 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "binding": {
           "strength": "required",
           "description": "Two letter USPS alphabetic codes.",
@@ -1054,7 +1399,7 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -1079,7 +1424,7 @@
         "path": "Organization.address.country",
         "short": "Country (e.g. can be ISO 3166 2 or 3 letter code)",
         "definition": "Country - a nation as commonly understood or generally accepted.",
-        "comments": "ISO 3166 3 letter codes can be used in place of a full country name.",
+        "comment": "ISO 3166 3 letter codes can be used in place of a full country name.",
         "min": 0,
         "max": "1",
         "base": {
@@ -1195,7 +1540,7 @@
         "path": "Organization.contact",
         "short": "Contact for the organization for a certain purpose",
         "definition": "Contact for the organization for a certain purpose.",
-        "comments": "Where multiple contacts for the same purpose are provided there is a standard extension that can be used to determine which one is the preferred contact to use.",
+        "comment": "Where multiple contacts for the same purpose are provided there is a standard extension that can be used to determine which one is the preferred contact to use.",
         "requirements": "Need to keep track of assigned contact points within bigger organization.",
         "min": 0,
         "max": "*",
@@ -1258,7 +1603,7 @@
         "path": "Organization.contact.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1287,7 +1632,7 @@
         "path": "Organization.contact.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1333,6 +1678,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ContactPartyType"
+            }
+          ],
           "strength": "extensible",
           "description": "The purpose for which you would contact a contact party",
           "valueSetReference": {
@@ -1453,7 +1804,6 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
         "mapping": [
           {
             "identity": "rim",
@@ -1472,7 +1822,6 @@
         "short": "US Core Organization Profile",
         "mustSupport": false,
         "isModifier": false,
-        "isSummary": false,
         "mapping": [
           {
             "identity": "servd",
@@ -1492,7 +1841,6 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false,
         "mapping": [
           {
             "identity": "servd",
@@ -1501,38 +1849,31 @@
         ]
       },
       {
-        "id": "Organization:uscoreorganization.active",
-        "path": "Organization.active",
+        "id": "Organization:uscoreorganization.identifier.system",
+        "path": "Organization.identifier.system",
+        "comment": "NPI preferred (http://hl7.org/fhir/sid/us-npi), Tax id is allowed (http://hl7.org/fhir/sid/us-tin), Local id is allowed in addition to 'authoritative' identifier.",
         "min": 1,
         "max": "1",
         "type": [
           {
-            "code": "boolean"
+            "code": "uri"
           }
         ],
         "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false
+        "isModifier": false
       },
       {
-        "id": "Organization:uscoreorganization.active.system",
-        "path": "Organization.identifier.system",
+        "id": "Organization:uscoreorganization.active",
+        "path": "Organization.active",
         "min": 1,
         "max": "1",
         "type": [
           {
-            "code": "uri"
-          }
-        ],
-        "example": [
-          {
-            "label": "General",
-            "valueUri": "NPI preferred, Tax id is allowed, Local id is allowed in addition to 'authoritative' identifier"
+            "code": "boolean"
           }
         ],
         "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false
+        "isModifier": false
       },
       {
         "id": "Organization:uscoreorganization.name",
@@ -1546,7 +1887,6 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false,
         "mapping": [
           {
             "identity": "servd",
@@ -1565,8 +1905,7 @@
           }
         ],
         "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false
+        "isModifier": false
       },
       {
         "id": "Organization:uscoreorganization.address",
@@ -1580,7 +1919,6 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false,
         "mapping": [
           {
             "identity": "servd",
@@ -1599,8 +1937,7 @@
           }
         ],
         "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false
+        "isModifier": false
       },
       {
         "id": "Organization:uscoreorganization.address.city",
@@ -1613,8 +1950,7 @@
           }
         ],
         "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false
+        "isModifier": false
       },
       {
         "id": "Organization:uscoreorganization.address.state",
@@ -1628,7 +1964,6 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false,
         "binding": {
           "strength": "required",
           "description": "Two letter USPS alphabetic codes.",
@@ -1655,8 +1990,7 @@
           }
         ],
         "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false
+        "isModifier": false
       },
       {
         "id": "Organization:uscoreorganization.endpoint",
@@ -1670,9 +2004,8 @@
           }
         ],
         "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false
+        "isModifier": false
       }
     ]
   }
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/StructureDefinition-us-core-patient.json b/lib/resources/us_core/StructureDefinition-us-core-patient.json
index d95610f..14a67ad 100755
--- a/lib/resources/us_core/StructureDefinition-us-core-patient.json
+++ b/lib/resources/us_core/StructureDefinition-us-core-patient.json
@@ -3,12 +3,14 @@
   "id": "us-core-patient",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient</a></p><p><b>name</b>: US Core Patient Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: Health Level Seven International (FHIR-Infrastructure)</p><p><b>contact</b>: </p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient</a></p><p><b>name</b>: US Core Patient Profile</p><p><b>status</b>: DRAFT</p><p><b>publisher</b>: Health Level Seven International (FHIR-Infrastructure)</p><p><b>contact</b>: </p><p><b>date</b>: 01/08/2016</p><blockquote><p><b>mapping</b></p><p><b>identity</b>: rim</p><p><b>uri</b>: <a href=\"http://hl7.org/v3\">http://hl7.org/v3</a></p><p><b>name</b>: RIM Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: cda</p><p><b>uri</b>: <a href=\"http://hl7.org/v3/cda\">http://hl7.org/v3/cda</a></p><p><b>name</b>: CDA (R2)</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: w5</p><p><b>uri</b>: <a href=\"http://hl7.org/fhir/w5\">http://hl7.org/fhir/w5</a></p><p><b>name</b>: W5 Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: v2</p><p><b>uri</b>: <a href=\"http://hl7.org/v2\">http://hl7.org/v2</a></p><p><b>name</b>: HL7 v2 Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: loinc</p><p><b>uri</b>: <a href=\"http://loinc.org\">http://loinc.org</a></p><p><b>name</b>: LOINC code for the element</p></blockquote><p><b>kind</b>: RESOURCE</p><p><b>abstract</b>: false</p><p><b>type</b>: Patient</p><p><b>baseDefinition</b>: <a href=\"http://hl7.org/fhir/StructureDefinition/Patient\">http://hl7.org/fhir/StructureDefinition/Patient</a></p><p><b>derivation</b>: CONSTRAINT</p><h3>Snapshots</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table><h3>Differentials</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table></div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: US Core Patient Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: HL7 US Realm Steering Committee</p><p><b>contact</b>: </p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: US Core Patient Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: HL7 US Realm Steering Committee</p><p><b>contact</b>: </p><p><b>fhirVersion</b>: 3.0.0</p><blockquote><p><b>mapping</b></p><p><b>identity</b>: argonaut-dq-dstu2</p><p><b>uri</b>: <a href=\"http://unknown.org/Argonaut DQ DSTU2\">http://unknown.org/Argonaut DQ DSTU2</a></p><p><b>name</b>: Argonaut DQ DSTU2</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: rim</p><p><b>uri</b>: <a href=\"http://hl7.org/v3\">http://hl7.org/v3</a></p><p><b>name</b>: RIM Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: cda</p><p><b>uri</b>: <a href=\"http://hl7.org/v3/cda\">http://hl7.org/v3/cda</a></p><p><b>name</b>: CDA (R2)</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: w5</p><p><b>uri</b>: <a href=\"http://hl7.org/fhir/w5\">http://hl7.org/fhir/w5</a></p><p><b>name</b>: W5 Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: v2</p><p><b>uri</b>: <a href=\"http://hl7.org/v2\">http://hl7.org/v2</a></p><p><b>name</b>: HL7 v2 Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: loinc</p><p><b>uri</b>: <a href=\"http://loinc.org\">http://loinc.org</a></p><p><b>name</b>: LOINC code for the element</p></blockquote><p><b>kind</b>: RESOURCE</p><p><b>abstract</b>: false</p><p><b>type</b>: Patient</p><p><b>baseDefinition</b>: <a href=\"http://hl7.org/fhir/StructureDefinition/Patient\">http://hl7.org/fhir/StructureDefinition/Patient</a></p><p><b>derivation</b>: CONSTRAINT</p><h3>Snapshots</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table><h3>Differentials</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table></div>"
   },
   "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient",
+  "version": "1.0.0",
   "name": "US Core Patient Profile",
   "status": "draft",
-  "publisher": "Health Level Seven International (FHIR-Infrastructure)",
+  "date": "2016-08-01",
+  "publisher": "HL7 US Realm Steering Committee",
   "contact": [
     {
       "telecom": [
@@ -19,8 +21,13 @@
       ]
     }
   ],
-  "date": "2016-08-01",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "argonaut-dq-dstu2",
+      "uri": "http://unknown.org/Argonaut DQ DSTU2",
+      "name": "Argonaut DQ DSTU2"
+    },
     {
       "identity": "rim",
       "uri": "http://hl7.org/v3",
@@ -105,7 +112,6 @@
           }
         ],
         "mustSupport": false,
-        "isSummary": false,
         "mapping": [
           {
             "identity": "rim",
@@ -122,6 +128,10 @@
           {
             "identity": "w5",
             "map": "administrative.individual"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Patient"
           }
         ]
       },
@@ -130,7 +140,7 @@
         "path": "Patient.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -169,7 +179,7 @@
         "path": "Patient.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -190,7 +200,7 @@
         "path": "Patient.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -210,6 +220,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -224,7 +242,7 @@
         "path": "Patient.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -258,7 +276,7 @@
         "path": "Patient.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -287,9 +305,12 @@
         "id": "Patient:uscorepatient.extension",
         "path": "Patient.extension",
         "slicing": {
-          "id": "3",
+          "id": "1",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -328,30 +349,14 @@
             "profile": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race"
           }
         ],
-        "condition": [
-          "ele-1"
-        ],
-        "constraint": [
-          {
-            "key": "ele-1",
-            "severity": "error",
-            "human": "All FHIR elements must have a @value or children",
-            "expression": "children().count() > id.count()",
-            "xpath": "@value|f:*|h:div",
-            "source": "Element"
-          },
-          {
-            "key": "ext-1",
-            "severity": "error",
-            "human": "Must have either extensions or value[x], not both",
-            "expression": "extension.exists() != value.exists()",
-            "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
-            "source": "Extension"
-          }
-        ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Patient.extension"
+          }
+        ]
       },
       {
         "id": "Patient:uscorepatient.extension:ethnicity",
@@ -372,30 +377,14 @@
             "profile": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity"
           }
         ],
-        "condition": [
-          "ele-1"
-        ],
-        "constraint": [
-          {
-            "key": "ele-1",
-            "severity": "error",
-            "human": "All FHIR elements must have a @value or children",
-            "expression": "children().count() > id.count()",
-            "xpath": "@value|f:*|h:div",
-            "source": "Element"
-          },
-          {
-            "key": "ext-1",
-            "severity": "error",
-            "human": "Must have either extensions or value[x], not both",
-            "expression": "extension.exists() != value.exists()",
-            "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
-            "source": "Extension"
-          }
-        ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Patient.extension"
+          }
+        ]
       },
       {
         "id": "Patient:uscorepatient.extension:birthsex",
@@ -416,37 +405,21 @@
             "profile": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex"
           }
         ],
-        "condition": [
-          "ele-1"
-        ],
-        "constraint": [
-          {
-            "key": "ele-1",
-            "severity": "error",
-            "human": "All FHIR elements must have a @value or children",
-            "expression": "children().count() > id.count()",
-            "xpath": "@value|f:*|h:div",
-            "source": "Element"
-          },
-          {
-            "key": "ext-1",
-            "severity": "error",
-            "human": "Must have either extensions or value[x], not both",
-            "expression": "extension.exists() != value.exists()",
-            "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
-            "source": "Extension"
-          }
-        ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Patient.extension"
+          }
+        ]
       },
       {
         "id": "Patient:uscorepatient.modifierExtension",
         "path": "Patient.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -490,7 +463,7 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -507,6 +480,10 @@
           {
             "identity": "w5",
             "map": "id"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Patient.identifier"
           }
         ]
       },
@@ -540,9 +517,19 @@
       {
         "id": "Patient:uscorepatient.identifier.extension",
         "path": "Patient.identifier.extension",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -571,7 +558,7 @@
         "path": "Patient.identifier.use",
         "short": "usual | official | temp | secondary (If known)",
         "definition": "The purpose of this identifier.",
-        "comments": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.",
+        "comment": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.",
         "requirements": "Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.",
         "min": 0,
         "max": "1",
@@ -588,6 +575,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "IdentifierUse"
+            }
+          ],
           "strength": "required",
           "description": "Identifies the purpose for this identifier, if known .",
           "valueSetReference": {
@@ -610,7 +603,7 @@
         "path": "Patient.identifier.type",
         "short": "Description of identifier",
         "definition": "A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.",
-        "comments": "This element deals only with general categories of identifiers.  It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage.   Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.",
+        "comment": "This element deals only with general categories of identifiers.  It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. \n\nWhere the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.",
         "requirements": "Allows users to make use of identifiers when the identifier system is not known.",
         "min": 0,
         "max": "1",
@@ -626,6 +619,16 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "IdentifierType"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
+            }
+          ],
           "strength": "extensible",
           "description": "A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.",
           "valueSetReference": {
@@ -646,9 +649,9 @@
       {
         "id": "Patient:uscorepatient.identifier.system",
         "path": "Patient.identifier.system",
-        "short": "The namespace for the identifier",
-        "definition": "Establishes the namespace in which set of possible id values is unique.",
-        "requirements": "There are many sequences of identifiers.  To perform matching, we need to know what sequence we're dealing with. The system identifies a particular sequence or set of unique identifiers.",
+        "short": "The namespace for the identifier value",
+        "definition": "Establishes the namespace for the value - that is, a URL that describes a set values that are unique.",
+        "requirements": "There are many sets  of identifiers.  To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.",
         "min": 1,
         "max": "1",
         "base": {
@@ -668,7 +671,7 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -681,6 +684,10 @@
           {
             "identity": "servd",
             "map": "./IdentifierType"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Patient.identifier.system"
           }
         ]
       },
@@ -689,7 +696,7 @@
         "path": "Patient.identifier.value",
         "short": "The value that is unique within the system.",
         "definition": "The portion of the identifier typically relevant to the user and which is unique within the context of the system.",
-        "comments": "If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986.  The value's primary purpose is computational mapping.  As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.)  A value formatted for human display can be conveyed using the [Rendered Value extension](extension-rendered-value.html).",
+        "comment": "If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986.  The value's primary purpose is computational mapping.  As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.)  A value formatted for human display can be conveyed using the [Rendered Value extension](extension-rendered-value.html).",
         "min": 1,
         "max": "1",
         "base": {
@@ -709,7 +716,7 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -722,6 +729,10 @@
           {
             "identity": "servd",
             "map": "./Value"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Patient.identifier.value"
           }
         ]
       },
@@ -763,7 +774,7 @@
         "path": "Patient.identifier.assigner",
         "short": "Organization that issued id (may be just text)",
         "definition": "Organization that issued/manages the identifier.",
-        "comments": "The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.",
+        "comment": "The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.",
         "min": 0,
         "max": "1",
         "base": {
@@ -798,7 +809,7 @@
         "path": "Patient.active",
         "short": "Whether this patient's record is in active use",
         "definition": "Whether this patient record is in active use.",
-        "comments": "Default is true. If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient.",
+        "comment": "Default is true. If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient\n\nThis element is labeled as a modifier because when the patient record is marked as not active it is not expected to be used/referenced without being changed back to active.",
         "requirements": "Need to be able to mark a patient record as not to be used because it was created in error.",
         "min": 0,
         "max": "1",
@@ -835,7 +846,7 @@
         "path": "Patient.name",
         "short": "A name associated with the patient",
         "definition": "A name associated with the individual.",
-        "comments": "A patient may have multiple names with different uses or applicable periods. For animals, the name is a \"HumanName\" in the sense that is assigned and used by humans and has the same patterns.",
+        "comment": "A patient may have multiple names with different uses or applicable periods. For animals, the name is a \"HumanName\" in the sense that is assigned and used by humans and has the same patterns.",
         "requirements": "Need to be able to track the patient by multiple names. Examples are your official name and a partner name.",
         "min": 1,
         "max": "*",
@@ -850,7 +861,7 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -863,6 +874,10 @@
           {
             "identity": "cda",
             "map": ".patient.name"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Patient.name"
           }
         ]
       },
@@ -896,9 +911,19 @@
       {
         "id": "Patient:uscorepatient.name.extension",
         "path": "Patient.name.extension",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -927,7 +952,7 @@
         "path": "Patient.name.use",
         "short": "usual | official | temp | nickname | anonymous | old | maiden",
         "definition": "Identifies the purpose for this name.",
-        "comments": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary or old name etc.for a current/permanent one. Applications can assume that a name is current unless it explicitly says that it is temporary or old.",
+        "comment": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary or old name etc.for a current/permanent one. Applications can assume that a name is current unless it explicitly says that it is temporary or old.",
         "requirements": "Allows the appropriate name for a particular context of use to be selected from among a set of names.",
         "min": 0,
         "max": "1",
@@ -944,6 +969,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "NameUse"
+            }
+          ],
           "strength": "required",
           "description": "The use of a human name",
           "valueSetReference": {
@@ -970,7 +1001,7 @@
         "path": "Patient.name.text",
         "short": "Text representation of the full name",
         "definition": "A full text representation of the name.",
-        "comments": "Can provide both a text representation and structured parts.",
+        "comment": "Can provide both a text representation and structured parts.",
         "requirements": "A renderable, unencoded form.",
         "min": 0,
         "max": "1",
@@ -1001,7 +1032,7 @@
         "path": "Patient.name.family",
         "short": "Family name (often called 'Surname')",
         "definition": "The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.",
-        "comments": "Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).",
+        "comment": "Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).",
         "alias": [
           "surname"
         ],
@@ -1018,7 +1049,7 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -1031,6 +1062,10 @@
           {
             "identity": "servd",
             "map": "./FamilyName"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Patient.name.family"
           }
         ]
       },
@@ -1039,7 +1074,7 @@
         "path": "Patient.name.given",
         "short": "Given names (not always 'first'). Includes middle names",
         "definition": "Given name.",
-        "comments": "If only initials are recorded, they may be used in place of the full name.  Not called \"first name\" since given names do not always come first.",
+        "comment": "If only initials are recorded, they may be used in place of the full name.  Not called \"first name\" since given names do not always come first.",
         "alias": [
           "first name",
           "middle name"
@@ -1056,8 +1091,9 @@
             "code": "string"
           }
         ],
+        "orderMeaning": "Given Names appear in the correct order for presenting the name",
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -1070,6 +1106,10 @@
           {
             "identity": "servd",
             "map": "./GivenNames"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Patient.name.given"
           }
         ]
       },
@@ -1090,6 +1130,7 @@
             "code": "string"
           }
         ],
+        "orderMeaning": "Prefixes appear in the correct order for presenting the name",
         "isSummary": true,
         "mapping": [
           {
@@ -1123,6 +1164,7 @@
             "code": "string"
           }
         ],
+        "orderMeaning": "Suffixes appear in the correct order for presenting the name",
         "isSummary": true,
         "mapping": [
           {
@@ -1174,7 +1216,7 @@
         "path": "Patient.telecom",
         "short": "A contact detail for the individual",
         "definition": "A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted.",
-        "comments": "A Patient may have multiple ways to be contacted with different uses or applicable periods.  May need to have options for contacting the person urgently and also to help with identification. The address may not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).",
+        "comment": "A Patient may have multiple ways to be contacted with different uses or applicable periods.  May need to have options for contacting the person urgently and also to help with identification. The address may not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).",
         "requirements": "People have (primary) ways to contact them in some way such as phone, email.",
         "min": 0,
         "max": "*",
@@ -1209,7 +1251,7 @@
         "path": "Patient.gender",
         "short": "male | female | other | unknown",
         "definition": "Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes.",
-        "comments": "The gender may not match the biological sex as determined by genetics, or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than M and F, though the vast majority of systems and contexts only support M and F.  Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific gender aspect of interest (anatomical, chromosonal, social, etc.)  However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice.  Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosonal and other gender aspects.  For example, an alert about a hysterectomy on a male should be handled as a warning or overrideable error, not a \"hard\" error.",
+        "comment": "The gender may not match the biological sex as determined by genetics, or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than M and F, though the vast majority of systems and contexts only support M and F.  Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific gender aspect of interest (anatomical, chromosonal, social, etc.)  However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice.  Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosonal and other gender aspects.  For example, an alert about a hysterectomy on a male should be handled as a warning or overrideable error, not a \"hard\" error.",
         "requirements": "Needed for identification of the individual, in combination with (at least) name and birth date. Gender of individual drives many clinical processes.",
         "min": 1,
         "max": "1",
@@ -1224,7 +1266,7 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "binding": {
           "strength": "required",
           "valueSetReference": {
@@ -1243,6 +1285,10 @@
           {
             "identity": "cda",
             "map": ".patient.administrativeGenderCode"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Patient.gender"
           }
         ]
       },
@@ -1251,7 +1297,7 @@
         "path": "Patient.birthDate",
         "short": "The date of birth for the individual",
         "definition": "The date of birth for the individual.",
-        "comments": "At least an estimated year should be provided as a guess if the real DOB is unknown  There is a standard extension \"patient-birthTime\" available that should be used where Time is required (such as in maternaty/infant care systems).",
+        "comment": "At least an estimated year should be provided as a guess if the real DOB is unknown  There is a standard extension \"patient-birthTime\" available that should be used where Time is required (such as in maternaty/infant care systems).",
         "requirements": "Age of the individual drives many clinical processes.",
         "min": 0,
         "max": "1",
@@ -1266,7 +1312,7 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -1283,6 +1329,10 @@
           {
             "identity": "loinc",
             "map": "21112-8"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Patient.birthDate"
           }
         ]
       },
@@ -1291,7 +1341,7 @@
         "path": "Patient.deceased[x]",
         "short": "Indicates if the individual is deceased or not",
         "definition": "Indicates if the individual is deceased or not.",
-        "comments": "If there's no value in the instance it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.",
+        "comment": "If there's no value in the instance it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.\n\nThis element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.",
         "requirements": "The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive.",
         "min": 0,
         "max": "1",
@@ -1330,7 +1380,7 @@
         "path": "Patient.address",
         "short": "Addresses for the individual",
         "definition": "Addresses for the individual.",
-        "comments": "Patient may have multiple addresses with different uses or applicable periods.",
+        "comment": "Patient may have multiple addresses with different uses or applicable periods.",
         "requirements": "May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification.",
         "min": 0,
         "max": "*",
@@ -1379,6 +1429,16 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MaritalStatus"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
+            }
+          ],
           "strength": "extensible",
           "description": "The domestic partnership status of a person.",
           "valueSetReference": {
@@ -1405,7 +1465,7 @@
         "path": "Patient.multipleBirth[x]",
         "short": "Whether patient is part of a multiple birth",
         "definition": "Indicates whether the patient is part of a multiple (bool) or indicates the actual birth order (integer).",
-        "comments": "Where the valueInteger is provided, the number is the birth number in the sequence. E.g. The middle birth in tripplets would be valueInteger=2 and the third born would have valueInteger=3 If a bool value was provided for this tripplets examle, then all 3 patient records would have valueBool=true (the ordering is not indicated).",
+        "comment": "Where the valueInteger is provided, the number is the birth number in the sequence.\nE.g. The middle birth in tripplets would be valueInteger=2 and the third born would have valueInteger=3\nIf a bool value was provided for this tripplets examle, then all 3 patient records would have valueBool=true (the ordering is not indicated).",
         "requirements": "For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs.",
         "min": 0,
         "max": "1",
@@ -1481,7 +1541,7 @@
         "path": "Patient.contact",
         "short": "A contact party (e.g. guardian, partner, friend) for the patient",
         "definition": "A contact party (e.g. guardian, partner, friend) for the patient.",
-        "comments": "Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact.",
+        "comment": "Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact.",
         "requirements": "Need to track people you can contact about the patient.",
         "min": 0,
         "max": "*",
@@ -1555,7 +1615,7 @@
         "path": "Patient.contact.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1584,7 +1644,7 @@
         "path": "Patient.contact.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1630,6 +1690,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ContactRelationship"
+            }
+          ],
           "strength": "extensible",
           "description": "The nature of the relationship between a patient and a contact person for that patient.",
           "valueSetReference": {
@@ -1689,7 +1755,7 @@
         "path": "Patient.contact.telecom",
         "short": "A contact detail for the person",
         "definition": "A contact detail for the person, e.g. a telephone number or an email address.",
-        "comments": "Contact may have multiple ways to be contacted with different uses or applicable periods.  May need to have options for contacting the person urgently, and also to help with identification.",
+        "comment": "Contact may have multiple ways to be contacted with different uses or applicable periods.  May need to have options for contacting the person urgently, and also to help with identification.",
         "requirements": "People have (primary) ways to contact them in some way such as phone, email.",
         "min": 0,
         "max": "*",
@@ -1770,6 +1836,16 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AdministrativeGender"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
+            }
+          ],
           "strength": "required",
           "description": "The gender of a person used for administrative purposes.",
           "valueSetReference": {
@@ -1867,7 +1943,7 @@
         "path": "Patient.animal",
         "short": "This patient is known to be an animal (non-human)",
         "definition": "This patient is known to be an animal.",
-        "comments": "The animal element is labeled \"Is Modifier\" since patients may be non-human. Systems SHALL either handle patient details appropriately (e.g. inform users patient is not human) or reject declared animal records.   The absense of the animal element does not imply that the patient is a human. If a system requires such a positive assertion that the patient is human, an extension will be required.  (Do not use a species of homo-sapiens in animal species, as this would incorrectly infer that the patient is an animal).",
+        "comment": "The animal element is labeled \"Is Modifier\" since patients may be non-human. Systems SHALL either handle patient details appropriately (e.g. inform users patient is not human) or reject declared animal records.   The absense of the animal element does not imply that the patient is a human. If a system requires such a positive assertion that the patient is human, an extension will be required.  (Do not use a species of homo-sapiens in animal species, as this would incorrectly infer that the patient is an animal).",
         "requirements": "Many clinical systems are extended to care for animal patients as well as human.",
         "min": 0,
         "max": "0",
@@ -1893,7 +1969,7 @@
         ],
         "mustSupport": false,
         "isModifier": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
           {
             "identity": "rim",
@@ -1902,6 +1978,10 @@
           {
             "identity": "cda",
             "map": "n/a"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Patient.animal"
           }
         ]
       },
@@ -1937,7 +2017,7 @@
         "path": "Patient.animal.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1966,7 +2046,7 @@
         "path": "Patient.animal.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1998,7 +2078,7 @@
         "path": "Patient.animal.species",
         "short": "E.g. Dog, Cow",
         "definition": "Identifies the high level taxonomic categorization of the kind of animal.",
-        "comments": "If the patient is non-human, at least a species SHALL be specified. Species SHALL be a widely recognised taxonomic classification.  It may or may not be Linnaean taxonomy and may or may not be at the level of species. If the level is finer than species--such as a breed code--the code system used SHALL allow inference of the species.  (The common example is that the word \"Hereford\" does not allow inference of the species Bos taurus, because there is a Hereford pig breed, but the SNOMED CT code for \"Hereford Cattle Breed\" does.).",
+        "comment": "If the patient is non-human, at least a species SHALL be specified. Species SHALL be a widely recognised taxonomic classification.  It may or may not be Linnaean taxonomy and may or may not be at the level of species. If the level is finer than species--such as a breed code--the code system used SHALL allow inference of the species.  (The common example is that the word \"Hereford\" does not allow inference of the species Bos taurus, because there is a Hereford pig breed, but the SNOMED CT code for \"Hereford Cattle Breed\" does.).",
         "requirements": "Need to know what kind of animal.",
         "min": 1,
         "max": "1",
@@ -2014,6 +2094,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AnimalSpecies"
+            }
+          ],
           "strength": "example",
           "description": "The species of an animal.",
           "valueSetReference": {
@@ -2040,7 +2126,7 @@
         "path": "Patient.animal.breed",
         "short": "E.g. Poodle, Angus",
         "definition": "Identifies the detailed categorization of the kind of animal.",
-        "comments": "Breed MAY be used to provide further taxonomic or non-taxonomic classification.  It may involve local or proprietary designation--such as commercial strain--and/or additional information such as production type.",
+        "comment": "Breed MAY be used to provide further taxonomic or non-taxonomic classification.  It may involve local or proprietary designation--such as commercial strain--and/or additional information such as production type.",
         "requirements": "May need to know the specific kind within the species.",
         "min": 0,
         "max": "1",
@@ -2056,6 +2142,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AnimalBreed"
+            }
+          ],
           "strength": "example",
           "description": "The breed of an animal.",
           "valueSetReference": {
@@ -2097,6 +2189,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AnimalGenderStatus"
+            }
+          ],
           "strength": "example",
           "description": "The state of the animal's reproductive organs.",
           "valueSetReference": {
@@ -2123,7 +2221,7 @@
         "path": "Patient.communication",
         "short": "A list of Languages which may be used to communicate with the patient about his or her health",
         "definition": "Languages which may be used to communicate with the patient about his or her health.",
-        "comments": "If no language is specified, this *implies* that the default local language is spoken.  If you need to convey proficiency for multiple modes then you need multiple Patient.Communication associations.   For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required.",
+        "comment": "If no language is specified, this *implies* that the default local language is spoken.  If you need to convey proficiency for multiple modes then you need multiple Patient.Communication associations.   For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required.",
         "requirements": "If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency is an important things to keep track of both for patient and other persons of interest.",
         "min": 0,
         "max": "*",
@@ -2148,7 +2246,6 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
         "mapping": [
           {
             "identity": "rim",
@@ -2157,6 +2254,10 @@
           {
             "identity": "cda",
             "map": "patient.languageCommunication"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Patient.communication"
           }
         ]
       },
@@ -2192,7 +2293,7 @@
         "path": "Patient.communication.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -2221,7 +2322,7 @@
         "path": "Patient.communication.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -2253,7 +2354,7 @@
         "path": "Patient.communication.language",
         "short": "The language which can be used to communicate with the patient about his or her health",
         "definition": "The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. \"en\" for English, or \"en-US\" for American English versus \"en-EN\" for England English.",
-        "comments": "The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.",
+        "comment": "The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.",
         "requirements": "Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect.",
         "min": 1,
         "max": "1",
@@ -2268,11 +2369,18 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
+              "valueReference": {
+                "reference": "http://hl7.org/fhir/us/core/ValueSet/simple-language"
+              }
+            }
+          ],
           "strength": "extensible",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/languages"
+            "reference": "http://hl7.org/fhir/us/core/ValueSet/simple-language"
           }
         },
         "mapping": [
@@ -2287,6 +2395,10 @@
           {
             "identity": "cda",
             "map": ".languageCode"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Patient.communication.language"
           }
         ]
       },
@@ -2295,7 +2407,7 @@
         "path": "Patient.communication.preferred",
         "short": "Language preference indicator",
         "definition": "Indicates whether or not the patient prefers this language (over other languages he masters up a certain level).",
-        "comments": "This language is specifically identified for communicating healthcare information.",
+        "comment": "This language is specifically identified for communicating healthcare information.",
         "requirements": "People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method.",
         "min": 0,
         "max": "1",
@@ -2329,7 +2441,7 @@
         "path": "Patient.generalPractitioner",
         "short": "Patient's nominated primary care provider",
         "definition": "Patient's nominated care provider.",
-        "comments": "This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disablity setting, or even organization that will provide people to perform the care provider roles.  It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources.",
+        "comment": "This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disablity setting, or even organization that will provide people to perform the care provider roles.\n\nIt is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources.",
         "alias": [
           "careProvider"
         ],
@@ -2370,7 +2482,7 @@
         "path": "Patient.managingOrganization",
         "short": "Organization that is the custodian of the patient record",
         "definition": "Organization that is the custodian of the patient record.",
-        "comments": "There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association).",
+        "comment": "There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association).",
         "requirements": "Need to know who recognizes this patient record, manages and updates it.",
         "min": 0,
         "max": "1",
@@ -2402,8 +2514,8 @@
         "path": "Patient.link",
         "short": "Link to another patient resource that concerns the same actual person",
         "definition": "Link to another patient resource that concerns the same actual patient.",
-        "comments": "There is no assumption that linked patient records have mutual links.",
-        "requirements": "There are multiple usecases:   * Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and * Distribution of patient information across multiple servers.",
+        "comment": "There is no assumption that linked patient records have mutual links. \n\nThis element is labelled as a modifier because it may not be the main Patient resource, and the referenced patient should be used instead of this Patient record. This is when the link.type value is 'replaced-by'.",
+        "requirements": "There are multiple usecases: \n\n* Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and * Distribution of patient information across multiple servers.",
         "min": 0,
         "max": "*",
         "base": {
@@ -2471,7 +2583,7 @@
         "path": "Patient.link.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -2500,7 +2612,7 @@
         "path": "Patient.link.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -2532,7 +2644,7 @@
         "path": "Patient.link.other",
         "short": "The other patient or related person resource that the link refers to",
         "definition": "The other patient resource that the link refers to.",
-        "comments": "Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual.",
+        "comment": "Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual.",
         "min": 1,
         "max": "1",
         "base": {
@@ -2550,7 +2662,6 @@
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
           }
         ],
-        "isModifier": true,
         "isSummary": true,
         "mapping": [
           {
@@ -2570,7 +2681,7 @@
       {
         "id": "Patient:uscorepatient.link.type",
         "path": "Patient.link.type",
-        "short": "replace | refer | seealso - type of link",
+        "short": "replaced-by | replaces | refer | seealso - type of link",
         "definition": "The type of link between this patient resource and another patient resource.",
         "min": 1,
         "max": "1",
@@ -2584,9 +2695,14 @@
             "code": "code"
           }
         ],
-        "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "LinkType"
+            }
+          ],
           "strength": "required",
           "description": "The type of link between this patient resource and another patient resource.",
           "valueSetReference": {
@@ -2616,7 +2732,12 @@
         "definition": "The US Core Patient Profile is based upon the core FHIR Patient Resource and designed to meet the applicable patient demographic data elements from the 2015 Edition Common Clinical Data Set.",
         "mustSupport": false,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Patient"
+          }
+        ]
       },
       {
         "id": "Patient:uscorepatient.extension:race",
@@ -2632,7 +2753,12 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Patient.extension"
+          }
+        ]
       },
       {
         "id": "Patient:uscorepatient.extension:ethnicity",
@@ -2648,7 +2774,12 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Patient.extension"
+          }
+        ]
       },
       {
         "id": "Patient:uscorepatient.extension:birthsex",
@@ -2664,14 +2795,19 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false,
         "binding": {
           "strength": "required",
           "description": "Code for sex assigned at birth",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/us/core/ValueSet/us-core-birthsex"
           }
-        }
+        },
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Patient.extension"
+          }
+        ]
       },
       {
         "id": "Patient:uscorepatient.identifier",
@@ -2685,7 +2821,12 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Patient.identifier"
+          }
+        ]
       },
       {
         "id": "Patient:uscorepatient.identifier.system",
@@ -2699,7 +2840,12 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Patient.identifier.system"
+          }
+        ]
       },
       {
         "id": "Patient:uscorepatient.identifier.value",
@@ -2714,7 +2860,12 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Patient.identifier.value"
+          }
+        ]
       },
       {
         "id": "Patient:uscorepatient.name",
@@ -2728,7 +2879,12 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Patient.name"
+          }
+        ]
       },
       {
         "id": "Patient:uscorepatient.name.family",
@@ -2742,7 +2898,12 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Patient.name.family"
+          }
+        ]
       },
       {
         "id": "Patient:uscorepatient.name.given",
@@ -2756,7 +2917,12 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Patient.name.given"
+          }
+        ]
       },
       {
         "id": "Patient:uscorepatient.gender",
@@ -2770,13 +2936,18 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false,
         "binding": {
           "strength": "required",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/administrative-gender"
           }
-        }
+        },
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Patient.gender"
+          }
+        ]
       },
       {
         "id": "Patient:uscorepatient.birthDate",
@@ -2790,7 +2961,12 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Patient.birthDate"
+          }
+        ]
       },
       {
         "id": "Patient:uscorepatient.animal",
@@ -2810,7 +2986,12 @@
         ],
         "mustSupport": false,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Patient.animal"
+          }
+        ]
       },
       {
         "id": "Patient:uscorepatient.communication",
@@ -2819,7 +3000,12 @@
         "max": "*",
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Patient.communication"
+          }
+        ]
       },
       {
         "id": "Patient:uscorepatient.communication.language",
@@ -2833,14 +3019,27 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
+              "valueReference": {
+                "reference": "http://hl7.org/fhir/us/core/ValueSet/simple-language"
+              }
+            }
+          ],
           "strength": "extensible",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/languages"
+            "reference": "http://hl7.org/fhir/us/core/ValueSet/simple-language"
           }
-        }
+        },
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Patient.communication.language"
+          }
+        ]
       }
     ]
   }
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/StructureDefinition-us-core-pract.json b/lib/resources/us_core/StructureDefinition-us-core-practitioner.json
similarity index 61%
rename from lib/resources/us_core/StructureDefinition-us-core-pract.json
rename to lib/resources/us_core/StructureDefinition-us-core-practitioner.json
index e6a6124..92ec762 100755
--- a/lib/resources/us_core/StructureDefinition-us-core-pract.json
+++ b/lib/resources/us_core/StructureDefinition-us-core-practitioner.json
@@ -1,14 +1,16 @@
 {
   "resourceType": "StructureDefinition",
-  "id": "us-core-pract",
+  "id": "us-core-practitioner",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-pract\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-pract</a></p><p><b>name</b>: US Core Practitioner</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: Health Level Seven International (FHIR-Infrastructure)</p><p><b>contact</b>: </p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-pract\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-pract</a></p><p><b>name</b>: US Core Practitioner</p><p><b>status</b>: DRAFT</p><p><b>publisher</b>: Health Level Seven International (FHIR-Infrastructure)</p><p><b>contact</b>: </p><p><b>date</b>: 01/08/2016</p><blockquote><p><b>mapping</b></p><p><b>identity</b>: v2</p><p><b>uri</b>: <a href=\"http://hl7.org/v2\">http://hl7.org/v2</a></p><p><b>name</b>: HL7 v2 Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: rim</p><p><b>uri</b>: <a href=\"http://hl7.org/v3\">http://hl7.org/v3</a></p><p><b>name</b>: RIM Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: servd</p><p><b>uri</b>: <a href=\"http://www.omg.org/spec/ServD/1.0/\">http://www.omg.org/spec/ServD/1.0/</a></p><p><b>name</b>: ServD</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: w5</p><p><b>uri</b>: <a href=\"http://hl7.org/fhir/w5\">http://hl7.org/fhir/w5</a></p><p><b>name</b>: W5 Mapping</p></blockquote><p><b>kind</b>: RESOURCE</p><p><b>abstract</b>: false</p><p><b>type</b>: Practitioner</p><p><b>baseDefinition</b>: <a href=\"http://hl7.org/fhir/StructureDefinition/Practitioner\">http://hl7.org/fhir/StructureDefinition/Practitioner</a></p><p><b>derivation</b>: CONSTRAINT</p><h3>Snapshots</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table><h3>Differentials</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table></div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: US  Core Practitioner Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: HL7 US Realm Steering Committee</p><p><b>contact</b>: </p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: US  Core Practitioner Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: HL7 US Realm Steering Committee</p><p><b>contact</b>: </p><p><b>fhirVersion</b>: 3.0.0</p><blockquote><p><b>mapping</b></p><p><b>identity</b>: v2</p><p><b>uri</b>: <a href=\"http://hl7.org/v2\">http://hl7.org/v2</a></p><p><b>name</b>: HL7 v2 Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: rim</p><p><b>uri</b>: <a href=\"http://hl7.org/v3\">http://hl7.org/v3</a></p><p><b>name</b>: RIM Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: servd</p><p><b>uri</b>: <a href=\"http://www.omg.org/spec/ServD/1.0/\">http://www.omg.org/spec/ServD/1.0/</a></p><p><b>name</b>: ServD</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: w5</p><p><b>uri</b>: <a href=\"http://hl7.org/fhir/w5\">http://hl7.org/fhir/w5</a></p><p><b>name</b>: W5 Mapping</p></blockquote><p><b>kind</b>: RESOURCE</p><p><b>abstract</b>: false</p><p><b>type</b>: Practitioner</p><p><b>baseDefinition</b>: <a href=\"http://hl7.org/fhir/StructureDefinition/Practitioner\">http://hl7.org/fhir/StructureDefinition/Practitioner</a></p><p><b>derivation</b>: CONSTRAINT</p><h3>Snapshots</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table><h3>Differentials</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table></div>"
   },
-  "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-pract",
-  "name": "US Core Practitioner",
+  "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner",
+  "version": "1.0.0",
+  "name": "US  Core Practitioner Profile",
   "status": "draft",
-  "publisher": "Health Level Seven International (FHIR-Infrastructure)",
+  "date": "2016-08-01",
+  "publisher": "HL7 US Realm Steering Committee",
   "contact": [
     {
       "telecom": [
@@ -19,7 +21,7 @@
       ]
     }
   ],
-  "date": "2016-08-01",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "v2",
@@ -50,12 +52,12 @@
   "snapshot": {
     "element": [
       {
-        "id": "Practitioner:uscorepract",
+        "id": "Practitioner:uscorepractitioner",
         "path": "Practitioner",
-        "sliceName": "USCorePract",
+        "sliceName": "USCorePractitioner",
         "short": "US Core Practitioner",
         "definition": "This is basic constraint on provider for use in US Core resources.",
-        "comments": "Note that a cab driver no longer fits the bill. You probably would be interested in the organization rather than the individual?",
+        "comment": "Note that a cab driver no longer fits the bill. You probably would be interested in the organization rather than the individual?",
         "alias": [
           "Provider"
         ],
@@ -101,7 +103,6 @@
           }
         ],
         "mustSupport": false,
-        "isSummary": false,
         "mapping": [
           {
             "identity": "rim",
@@ -126,11 +127,11 @@
         ]
       },
       {
-        "id": "Practitioner:uscorepract.id",
+        "id": "Practitioner:uscorepractitioner.id",
         "path": "Practitioner.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -146,7 +147,7 @@
         "isSummary": true
       },
       {
-        "id": "Practitioner:uscorepract.meta",
+        "id": "Practitioner:uscorepractitioner.meta",
         "path": "Practitioner.meta",
         "short": "Metadata about the resource",
         "definition": "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.",
@@ -165,11 +166,11 @@
         "isSummary": true
       },
       {
-        "id": "Practitioner:uscorepract.implicitRules",
+        "id": "Practitioner:uscorepractitioner.implicitRules",
         "path": "Practitioner.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -186,11 +187,11 @@
         "isSummary": true
       },
       {
-        "id": "Practitioner:uscorepract.language",
+        "id": "Practitioner:uscorepractitioner.language",
         "path": "Practitioner.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -210,6 +211,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -220,11 +229,11 @@
         }
       },
       {
-        "id": "Practitioner:uscorepract.text",
+        "id": "Practitioner:uscorepractitioner.text",
         "path": "Practitioner.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -254,11 +263,11 @@
         ]
       },
       {
-        "id": "Practitioner:uscorepract.contained",
+        "id": "Practitioner:uscorepractitioner.contained",
         "path": "Practitioner.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -284,11 +293,11 @@
         ]
       },
       {
-        "id": "Practitioner:uscorepract.extension",
+        "id": "Practitioner:uscorepractitioner.extension",
         "path": "Practitioner.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -313,11 +322,11 @@
         ]
       },
       {
-        "id": "Practitioner:uscorepract.modifierExtension",
+        "id": "Practitioner:uscorepractitioner.modifierExtension",
         "path": "Practitioner.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -343,7 +352,7 @@
         ]
       },
       {
-        "id": "Practitioner:uscorepract.identifier",
+        "id": "Practitioner:uscorepractitioner.identifier",
         "path": "Practitioner.identifier",
         "short": "A identifier for the person as this agent",
         "definition": "An identifier that applies to this person in this role.",
@@ -361,7 +370,7 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -382,7 +391,7 @@
         ]
       },
       {
-        "id": "Practitioner:uscorepract.identifier.id",
+        "id": "Practitioner:uscorepractitioner.identifier.id",
         "path": "Practitioner.identifier.id",
         "representation": [
           "xmlAttr"
@@ -409,11 +418,21 @@
         ]
       },
       {
-        "id": "Practitioner:uscorepract.identifier.extension",
+        "id": "Practitioner:uscorepractitioner.identifier.extension",
         "path": "Practitioner.identifier.extension",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -438,11 +457,11 @@
         ]
       },
       {
-        "id": "Practitioner:uscorepract.identifier.use",
+        "id": "Practitioner:uscorepractitioner.identifier.use",
         "path": "Practitioner.identifier.use",
         "short": "usual | official | temp | secondary (If known)",
         "definition": "The purpose of this identifier.",
-        "comments": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.",
+        "comment": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.",
         "requirements": "Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.",
         "min": 0,
         "max": "1",
@@ -459,6 +478,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "IdentifierUse"
+            }
+          ],
           "strength": "required",
           "description": "Identifies the purpose for this identifier, if known .",
           "valueSetReference": {
@@ -477,11 +502,11 @@
         ]
       },
       {
-        "id": "Practitioner:uscorepract.identifier.type",
+        "id": "Practitioner:uscorepractitioner.identifier.type",
         "path": "Practitioner.identifier.type",
         "short": "Description of identifier",
         "definition": "A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.",
-        "comments": "This element deals only with general categories of identifiers.  It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage.   Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.",
+        "comment": "This element deals only with general categories of identifiers.  It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. \n\nWhere the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.",
         "requirements": "Allows users to make use of identifiers when the identifier system is not known.",
         "min": 0,
         "max": "1",
@@ -497,6 +522,16 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "IdentifierType"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
+            }
+          ],
           "strength": "extensible",
           "description": "A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.",
           "valueSetReference": {
@@ -515,12 +550,12 @@
         ]
       },
       {
-        "id": "Practitioner:uscorepract.identifier.system",
+        "id": "Practitioner:uscorepractitioner.identifier.system",
         "path": "Practitioner.identifier.system",
         "short": "NPI could be used as the identifier system in the US.",
-        "definition": "Establishes the namespace in which set of possible id values is unique.",
-        "comments": "NPI could be used as the identifier system in the US.",
-        "requirements": "There are many sequences of identifiers.  To perform matching, we need to know what sequence we're dealing with. The system identifies a particular sequence or set of unique identifiers.",
+        "definition": "Establishes the namespace for the value - that is, a URL that describes a set values that are unique.",
+        "comment": "NPI could be used as the identifier system in the US.",
+        "requirements": "There are many sets  of identifiers.  To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.",
         "min": 1,
         "max": "1",
         "base": {
@@ -544,7 +579,7 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -561,11 +596,11 @@
         ]
       },
       {
-        "id": "Practitioner:uscorepract.identifier.value",
+        "id": "Practitioner:uscorepractitioner.identifier.value",
         "path": "Practitioner.identifier.value",
         "short": "The value that is unique",
         "definition": "The portion of the identifier typically relevant to the user and which is unique within the context of the system.",
-        "comments": "If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986.  The value's primary purpose is computational mapping.  As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.)  A value formatted for human display can be conveyed using the [Rendered Value extension](extension-rendered-value.html).",
+        "comment": "If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986.  The value's primary purpose is computational mapping.  As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.)  A value formatted for human display can be conveyed using the [Rendered Value extension](extension-rendered-value.html).",
         "min": 1,
         "max": "1",
         "base": {
@@ -585,7 +620,7 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -602,7 +637,7 @@
         ]
       },
       {
-        "id": "Practitioner:uscorepract.identifier.period",
+        "id": "Practitioner:uscorepractitioner.identifier.period",
         "path": "Practitioner.identifier.period",
         "short": "Time period when id is/was valid for use",
         "definition": "Time period during which identifier is/was valid for use.",
@@ -635,11 +670,11 @@
         ]
       },
       {
-        "id": "Practitioner:uscorepract.identifier.assigner",
+        "id": "Practitioner:uscorepractitioner.identifier.assigner",
         "path": "Practitioner.identifier.assigner",
         "short": "Organization that issued id (may be just text)",
         "definition": "Organization that issued/manages the identifier.",
-        "comments": "The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.",
+        "comment": "The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.",
         "min": 0,
         "max": "1",
         "base": {
@@ -670,11 +705,11 @@
         ]
       },
       {
-        "id": "Practitioner:uscorepract.active",
+        "id": "Practitioner:uscorepractitioner.active",
         "path": "Practitioner.active",
         "short": "Whether this practitioner's record is in active use",
         "definition": "Whether this practitioner's record is in active use.",
-        "comments": "Default is true.   If the practitioner is not in use by one organization, then it should mark the period on the PractitonerRole with an end date (even if they are active) as they may be active in another role.",
+        "comment": "Default is true. \r\rIf the practitioner is not in use by one organization, then it should mark the period on the PractitonerRole with an end date (even if they are active) as they may be active in another role.",
         "requirements": "Need to be able to mark a practitioner record as not to be used because it was created in error.",
         "min": 0,
         "max": "1",
@@ -702,11 +737,11 @@
         ]
       },
       {
-        "id": "Practitioner:uscorepract.name",
+        "id": "Practitioner:uscorepractitioner.name",
         "path": "Practitioner.name",
         "short": "The name(s) associated with the practitioner",
         "definition": "The name(s) associated with the practitioner.",
-        "comments": "The selection of the use property should ensure that there is a single usual name specified, and others use the nickname (alias), old, or other values as appropriate.  In general select the value to be used in the ResourceReference.display based on this:  1. There is more than 1 name 2. Use = usual 3. Period is current to the date of the usage 4. Use = official 5. Other order as decided by internal business rules.",
+        "comment": "The selection of the use property should ensure that there is a single usual name specified, and others use the nickname (alias), old, or other values as appropriate.\r\rIn general select the value to be used in the ResourceReference.display based on this:\r\r1. There is more than 1 name\r2. Use = usual\r3. Period is current to the date of the usage\r4. Use = official\r5. Other order as decided by internal business rules.",
         "requirements": "The name(s) that a Practitioner is known by. Where there are multiple, the name that the practitioner is usually known as should be used in the display.",
         "min": 1,
         "max": "1",
@@ -721,7 +756,7 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -738,7 +773,7 @@
         ]
       },
       {
-        "id": "Practitioner:uscorepract.name.id",
+        "id": "Practitioner:uscorepractitioner.name.id",
         "path": "Practitioner.name.id",
         "representation": [
           "xmlAttr"
@@ -765,11 +800,21 @@
         ]
       },
       {
-        "id": "Practitioner:uscorepract.name.extension",
+        "id": "Practitioner:uscorepractitioner.name.extension",
         "path": "Practitioner.name.extension",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -794,11 +839,11 @@
         ]
       },
       {
-        "id": "Practitioner:uscorepract.name.use",
+        "id": "Practitioner:uscorepractitioner.name.use",
         "path": "Practitioner.name.use",
         "short": "usual | official | temp | nickname | anonymous | old | maiden",
         "definition": "Identifies the purpose for this name.",
-        "comments": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary or old name etc.for a current/permanent one. Applications can assume that a name is current unless it explicitly says that it is temporary or old.",
+        "comment": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary or old name etc.for a current/permanent one. Applications can assume that a name is current unless it explicitly says that it is temporary or old.",
         "requirements": "Allows the appropriate name for a particular context of use to be selected from among a set of names.",
         "min": 0,
         "max": "1",
@@ -815,6 +860,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "NameUse"
+            }
+          ],
           "strength": "required",
           "description": "The use of a human name",
           "valueSetReference": {
@@ -837,11 +888,11 @@
         ]
       },
       {
-        "id": "Practitioner:uscorepract.name.text",
+        "id": "Practitioner:uscorepractitioner.name.text",
         "path": "Practitioner.name.text",
         "short": "Text representation of the full name",
         "definition": "A full text representation of the name.",
-        "comments": "Can provide both a text representation and structured parts.",
+        "comment": "Can provide both a text representation and structured parts.",
         "requirements": "A renderable, unencoded form.",
         "min": 0,
         "max": "1",
@@ -868,11 +919,11 @@
         ]
       },
       {
-        "id": "Practitioner:uscorepract.name.family",
+        "id": "Practitioner:uscorepractitioner.name.family",
         "path": "Practitioner.name.family",
         "short": "Family name (often called 'Surname')",
         "definition": "The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.",
-        "comments": "Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).",
+        "comment": "Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).",
         "alias": [
           "surname"
         ],
@@ -889,7 +940,7 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -906,11 +957,11 @@
         ]
       },
       {
-        "id": "Practitioner:uscorepract.name.given",
+        "id": "Practitioner:uscorepractitioner.name.given",
         "path": "Practitioner.name.given",
         "short": "Given names (not always 'first'). Includes middle names",
         "definition": "Given name.",
-        "comments": "If only initials are recorded, they may be used in place of the full name.  Not called \"first name\" since given names do not always come first.",
+        "comment": "If only initials are recorded, they may be used in place of the full name.  Not called \"first name\" since given names do not always come first.",
         "alias": [
           "first name",
           "middle name"
@@ -927,6 +978,7 @@
             "code": "string"
           }
         ],
+        "orderMeaning": "Given Names appear in the correct order for presenting the name",
         "isSummary": true,
         "mapping": [
           {
@@ -944,7 +996,7 @@
         ]
       },
       {
-        "id": "Practitioner:uscorepract.name.prefix",
+        "id": "Practitioner:uscorepractitioner.name.prefix",
         "path": "Practitioner.name.prefix",
         "short": "Parts that come before the name",
         "definition": "Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name.",
@@ -960,6 +1012,7 @@
             "code": "string"
           }
         ],
+        "orderMeaning": "Prefixes appear in the correct order for presenting the name",
         "isSummary": true,
         "mapping": [
           {
@@ -977,7 +1030,7 @@
         ]
       },
       {
-        "id": "Practitioner:uscorepract.name.suffix",
+        "id": "Practitioner:uscorepractitioner.name.suffix",
         "path": "Practitioner.name.suffix",
         "short": "Parts that come after the name",
         "definition": "Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name.",
@@ -993,6 +1046,7 @@
             "code": "string"
           }
         ],
+        "orderMeaning": "Suffixes appear in the correct order for presenting the name",
         "isSummary": true,
         "mapping": [
           {
@@ -1006,7 +1060,7 @@
         ]
       },
       {
-        "id": "Practitioner:uscorepract.name.period",
+        "id": "Practitioner:uscorepractitioner.name.period",
         "path": "Practitioner.name.period",
         "short": "Time period when name was/is in use",
         "definition": "Indicates the period of time when this name was valid for the named person.",
@@ -1040,11 +1094,11 @@
         ]
       },
       {
-        "id": "Practitioner:uscorepract.telecom",
+        "id": "Practitioner:uscorepractitioner.telecom",
         "path": "Practitioner.telecom",
         "short": "A contact detail for the practitioner (that apply to all roles)",
         "definition": "A contact detail for the practitioner, e.g. a telephone number or an email address.",
-        "comments": "Person may have multiple ways to be contacted with different uses or applicable periods.  May need to have options for contacting the person urgently, and also to help with identification  These typically will have home numbers, or mobile numbers that are not role specific.",
+        "comment": "Person may have multiple ways to be contacted with different uses or applicable periods.  May need to have options for contacting the person urgently, and also to help with identification\r\rThese typically will have home numbers, or mobile numbers that are not role specific.",
         "requirements": "Need to know how to reach a practitioner independent to any roles the practitioner may have.",
         "min": 0,
         "max": "*",
@@ -1075,11 +1129,11 @@
         ]
       },
       {
-        "id": "Practitioner:uscorepract.address",
+        "id": "Practitioner:uscorepractitioner.address",
         "path": "Practitioner.address",
         "short": "Address(es) of the practitioner that are not role specific (typically home address)",
-        "definition": "Address(es) of the practitioner that are not role specific (typically home address).  Work addresses are not typically entered in this property as they are usually role dependent.",
-        "comments": "The PractitionerRole does not have an address value on it, as it is expected that the location property be used for this purpose (which has an address).",
+        "definition": "Address(es) of the practitioner that are not role specific (typically home address). \rWork addresses are not typically entered in this property as they are usually role dependent.",
+        "comment": "The PractitionerRole does not have an address value on it, as it is expected that the location property be used for this purpose (which has an address).",
         "requirements": "The home/mailing address of the practitioner is often required for employee administration purposes, and also for some rostering services where the start point (practitioners home) can be used in calculations.",
         "min": 0,
         "max": "*",
@@ -1110,7 +1164,7 @@
         ]
       },
       {
-        "id": "Practitioner:uscorepract.gender",
+        "id": "Practitioner:uscorepractitioner.gender",
         "path": "Practitioner.gender",
         "short": "male | female | other | unknown",
         "definition": "Administrative Gender - the gender that the person is considered to have for administration and record keeping purposes.",
@@ -1129,6 +1183,16 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AdministrativeGender"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
+            }
+          ],
           "strength": "required",
           "description": "The gender of a person used for administrative purposes.",
           "valueSetReference": {
@@ -1151,7 +1215,7 @@
         ]
       },
       {
-        "id": "Practitioner:uscorepract.birthDate",
+        "id": "Practitioner:uscorepractitioner.birthDate",
         "path": "Practitioner.birthDate",
         "short": "The date  on which the practitioner was born",
         "definition": "The date of birth for the practitioner.",
@@ -1185,7 +1249,7 @@
         ]
       },
       {
-        "id": "Practitioner:uscorepract.photo",
+        "id": "Practitioner:uscorepractitioner.photo",
         "path": "Practitioner.photo",
         "short": "Image of the person",
         "definition": "Image of the person.",
@@ -1214,410 +1278,7 @@
         ]
       },
       {
-        "id": "Practitioner:uscorepract.role",
-        "path": "Practitioner.role",
-        "short": "Roles/organizations the practitioner is associated with",
-        "definition": "The list of roles/organizations that the practitioner is associated with.",
-        "comments": "The address to be used for this PractitionerRole is in the referenced location (removing duplication across all the services provided at the location).",
-        "min": 0,
-        "max": "*",
-        "base": {
-          "path": "Practitioner.role",
-          "min": 0,
-          "max": "*"
-        },
-        "type": [
-          {
-            "code": "BackboneElement"
-          }
-        ],
-        "constraint": [
-          {
-            "key": "ele-1",
-            "severity": "error",
-            "human": "All FHIR elements must have a @value or children",
-            "expression": "children().count() > id.count()",
-            "xpath": "@value|f:*|h:div",
-            "source": "Element"
-          }
-        ],
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": ".playingEntity.playingRole"
-          }
-        ]
-      },
-      {
-        "id": "Practitioner:uscorepract.role.id",
-        "path": "Practitioner.role.id",
-        "representation": [
-          "xmlAttr"
-        ],
-        "short": "xml:id (or equivalent in JSON)",
-        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "Element.id",
-          "min": 0,
-          "max": "1"
-        },
-        "type": [
-          {
-            "code": "string"
-          }
-        ],
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "n/a"
-          }
-        ]
-      },
-      {
-        "id": "Practitioner:uscorepract.role.extension",
-        "path": "Practitioner.role.extension",
-        "short": "Additional Content defined by implementations",
-        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
-        "alias": [
-          "extensions",
-          "user content"
-        ],
-        "min": 0,
-        "max": "*",
-        "base": {
-          "path": "Element.extension",
-          "min": 0,
-          "max": "*"
-        },
-        "type": [
-          {
-            "code": "Extension"
-          }
-        ],
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "n/a"
-          }
-        ]
-      },
-      {
-        "id": "Practitioner:uscorepract.role.modifierExtension",
-        "path": "Practitioner.role.modifierExtension",
-        "short": "Extensions that cannot be ignored",
-        "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
-        "alias": [
-          "extensions",
-          "user content",
-          "modifiers"
-        ],
-        "min": 0,
-        "max": "*",
-        "base": {
-          "path": "BackboneElement.modifierExtension",
-          "min": 0,
-          "max": "*"
-        },
-        "type": [
-          {
-            "code": "Extension"
-          }
-        ],
-        "isModifier": true,
-        "isSummary": true,
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "N/A"
-          }
-        ]
-      },
-      {
-        "id": "Practitioner:uscorepract.role.organization",
-        "path": "Practitioner.role.organization",
-        "short": "Organization where the roles are performed",
-        "definition": "The organization where the Practitioner performs the roles associated.",
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "Practitioner.role.organization",
-          "min": 0,
-          "max": "1"
-        },
-        "type": [
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
-          }
-        ],
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": ".playingEntity.playingRole.scopingOrganization"
-          }
-        ]
-      },
-      {
-        "id": "Practitioner:uscorepract.role.code",
-        "path": "Practitioner.role.code",
-        "short": "Roles which this practitioner may perform",
-        "definition": "Roles which this practitioner is authorized to perform for the organization.",
-        "comments": "A person may have more than one role. At least one role is required.",
-        "requirements": "Need to know what authority the practitioner has - what can they do?",
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "Practitioner.role.code",
-          "min": 0,
-          "max": "1"
-        },
-        "type": [
-          {
-            "code": "CodeableConcept"
-          }
-        ],
-        "isSummary": true,
-        "binding": {
-          "strength": "example",
-          "description": "The role a person plays representing an organization",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/practitioner-role"
-          }
-        },
-        "mapping": [
-          {
-            "identity": "v2",
-            "map": "PRD-1 / STF-18  / PRA-3  / PRT-4  / ROL-3 / ORC-12 / OBR-16 / PV1-7 / PV1-8 / PV1-9 / PV1-17"
-          },
-          {
-            "identity": "rim",
-            "map": ".playingEntity.playingRole.code"
-          },
-          {
-            "identity": "servd",
-            "map": "(ServD maps Practitioners and Organizations via another entity, so this concept is not available)"
-          }
-        ]
-      },
-      {
-        "id": "Practitioner:uscorepract.role.specialty",
-        "path": "Practitioner.role.specialty",
-        "short": "Specific specialty of the practitioner",
-        "definition": "Specific specialty of the practitioner.",
-        "min": 0,
-        "max": "*",
-        "base": {
-          "path": "Practitioner.role.specialty",
-          "min": 0,
-          "max": "*"
-        },
-        "type": [
-          {
-            "code": "CodeableConcept"
-          }
-        ],
-        "isSummary": true,
-        "binding": {
-          "strength": "example",
-          "description": "Specific specialty associated with the agency",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/practitioner-specialty"
-          }
-        },
-        "mapping": [
-          {
-            "identity": "v2",
-            "map": "PRA-5"
-          },
-          {
-            "identity": "rim",
-            "map": ".playingEntity.playingRole[classCode=QUAL].code"
-          },
-          {
-            "identity": "servd",
-            "map": "./Specialty"
-          }
-        ]
-      },
-      {
-        "id": "Practitioner:uscorepract.role.identifier",
-        "path": "Practitioner.role.identifier",
-        "short": "Business Identifiers that are specific to a role/location",
-        "definition": "Business Identifiers that are specific to a role/location.",
-        "requirements": "Some business identifiers are specific to a location and should be able to be associated.",
-        "min": 0,
-        "max": "*",
-        "base": {
-          "path": "Practitioner.role.identifier",
-          "min": 0,
-          "max": "*"
-        },
-        "type": [
-          {
-            "code": "Identifier"
-          }
-        ],
-        "isSummary": true,
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": ".playingEntity.playingRole.id"
-          }
-        ]
-      },
-      {
-        "id": "Practitioner:uscorepract.role.telecom",
-        "path": "Practitioner.role.telecom",
-        "short": "Contact details that are specific to the role/location/service",
-        "definition": "Contact details that are specific to the role/location/service.",
-        "requirements": "Often practitioners have a dedicated line for each location (or service) that they work at, and need to be able to define separate contact details for each of these.",
-        "min": 0,
-        "max": "*",
-        "base": {
-          "path": "Practitioner.role.telecom",
-          "min": 0,
-          "max": "*"
-        },
-        "type": [
-          {
-            "code": "ContactPoint"
-          }
-        ],
-        "isSummary": true,
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": ".playingEntity.playingRole.telecom"
-          }
-        ]
-      },
-      {
-        "id": "Practitioner:uscorepract.role.period",
-        "path": "Practitioner.role.period",
-        "short": "The period during which the practitioner is authorized to perform in these role(s)",
-        "definition": "The period during which the person is authorized to act as a practitioner in these role(s) for the organization.",
-        "requirements": "Even after the agencies is revoked, the fact that it existed must still be recorded.",
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "Practitioner.role.period",
-          "min": 0,
-          "max": "1"
-        },
-        "type": [
-          {
-            "code": "Period"
-          }
-        ],
-        "isSummary": true,
-        "mapping": [
-          {
-            "identity": "v2",
-            "map": "PRD-8/9 / PRA-5.4"
-          },
-          {
-            "identity": "rim",
-            "map": ".playingEntity.playingRole.effectiveTime"
-          },
-          {
-            "identity": "servd",
-            "map": "(ServD maps Practitioners and Organizations via another entity, so this concept is not available)"
-          },
-          {
-            "identity": "w5",
-            "map": "when.done"
-          }
-        ]
-      },
-      {
-        "id": "Practitioner:uscorepract.role.location",
-        "path": "Practitioner.role.location",
-        "short": "The location(s) at which this practitioner provides care",
-        "definition": "The location(s) at which this practitioner provides care.",
-        "min": 0,
-        "max": "*",
-        "base": {
-          "path": "Practitioner.role.location",
-          "min": 0,
-          "max": "*"
-        },
-        "type": [
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Location"
-          }
-        ],
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": ".playingEntity.playingRole.location.source[classCode=SDLOC]"
-          },
-          {
-            "identity": "servd",
-            "map": "(ServD maps Practitioners and Organizations via another entity, so this concept is not available)<br/> However these are accessed via the Site.ServiceSite.ServiceSiteProvider record. (The Site has the location)"
-          },
-          {
-            "identity": "w5",
-            "map": "where"
-          }
-        ]
-      },
-      {
-        "id": "Practitioner:uscorepract.role.healthcareService",
-        "path": "Practitioner.role.healthcareService",
-        "short": "The list of healthcare services that this worker provides for this role's Organization/Location(s)",
-        "definition": "The list of healthcare services that this worker provides for this role's Organization/Location(s).",
-        "min": 0,
-        "max": "*",
-        "base": {
-          "path": "Practitioner.role.healthcareService",
-          "min": 0,
-          "max": "*"
-        },
-        "type": [
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/HealthcareService"
-          }
-        ],
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "n/a"
-          }
-        ]
-      },
-      {
-        "id": "Practitioner:uscorepract.role.endpoint",
-        "path": "Practitioner.role.endpoint",
-        "short": "Technical endpoints providing access to services operated for the PractitonerRole",
-        "definition": "Technical endpoints providing access to services operated for the PractitonerRole.",
-        "min": 0,
-        "max": "*",
-        "base": {
-          "path": "Practitioner.role.endpoint",
-          "min": 0,
-          "max": "*"
-        },
-        "type": [
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Endpoint"
-          }
-        ],
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "n/a"
-          }
-        ]
-      },
-      {
-        "id": "Practitioner:uscorepract.qualification",
+        "id": "Practitioner:uscorepractitioner.qualification",
         "path": "Practitioner.qualification",
         "short": "Qualifications obtained by training and certification",
         "definition": "Qualifications obtained by training and certification.",
@@ -1659,7 +1320,7 @@
         ]
       },
       {
-        "id": "Practitioner:uscorepract.qualification.id",
+        "id": "Practitioner:uscorepractitioner.qualification.id",
         "path": "Practitioner.qualification.id",
         "representation": [
           "xmlAttr"
@@ -1686,11 +1347,11 @@
         ]
       },
       {
-        "id": "Practitioner:uscorepract.qualification.extension",
+        "id": "Practitioner:uscorepractitioner.qualification.extension",
         "path": "Practitioner.qualification.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1715,11 +1376,11 @@
         ]
       },
       {
-        "id": "Practitioner:uscorepract.qualification.modifierExtension",
+        "id": "Practitioner:uscorepractitioner.qualification.modifierExtension",
         "path": "Practitioner.qualification.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1747,7 +1408,7 @@
         ]
       },
       {
-        "id": "Practitioner:uscorepract.qualification.identifier",
+        "id": "Practitioner:uscorepractitioner.qualification.identifier",
         "path": "Practitioner.qualification.identifier",
         "short": "An identifier for this qualification for the practitioner",
         "definition": "An identifier that applies to this person's qualification in this role.",
@@ -1772,7 +1433,7 @@
         ]
       },
       {
-        "id": "Practitioner:uscorepract.qualification.code",
+        "id": "Practitioner:uscorepractitioner.qualification.code",
         "path": "Practitioner.qualification.code",
         "short": "Coded representation of the qualification",
         "definition": "Coded representation of the qualification.",
@@ -1789,10 +1450,16 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Qualification"
+            }
+          ],
           "strength": "example",
           "description": "Specific qualification the practitioner has to provide a service",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/anzsco-occupations"
+            "reference": "http://hl7.org/fhir/ValueSet/v2-2.7-0360"
           }
         },
         "mapping": [
@@ -1807,7 +1474,7 @@
         ]
       },
       {
-        "id": "Practitioner:uscorepract.qualification.period",
+        "id": "Practitioner:uscorepractitioner.qualification.period",
         "path": "Practitioner.qualification.period",
         "short": "Period during which the qualification is valid",
         "definition": "Period during which the qualification is valid.",
@@ -1836,7 +1503,7 @@
         ]
       },
       {
-        "id": "Practitioner:uscorepract.qualification.issuer",
+        "id": "Practitioner:uscorepractitioner.qualification.issuer",
         "path": "Practitioner.qualification.issuer",
         "short": "Organization that regulates and issues the qualification",
         "definition": "Organization that regulates and issues the qualification.",
@@ -1861,11 +1528,11 @@
         ]
       },
       {
-        "id": "Practitioner:uscorepract.communication",
+        "id": "Practitioner:uscorepractitioner.communication",
         "path": "Practitioner.communication",
         "short": "A language the practitioner is able to use in patient communication",
         "definition": "A language the practitioner is able to use in patient communication.",
-        "comments": "The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.",
+        "comment": "The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.",
         "requirements": "Knowing which language a practitioner speaks can help in facilitating communication with patients.",
         "min": 0,
         "max": "*",
@@ -1886,6 +1553,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -1914,20 +1589,19 @@
   "differential": {
     "element": [
       {
-        "id": "Practitioner:uscorepract",
+        "id": "Practitioner:uscorepractitioner",
         "path": "Practitioner",
-        "sliceName": "USCorePract",
+        "sliceName": "USCorePractitioner",
         "short": "US Core Practitioner",
         "definition": "This is basic constraint on provider for use in US Core resources.",
         "alias": [
           "Provider"
         ],
         "mustSupport": false,
-        "isModifier": false,
-        "isSummary": false
+        "isModifier": false
       },
       {
-        "id": "Practitioner:uscorepract.identifier",
+        "id": "Practitioner:uscorepractitioner.identifier",
         "path": "Practitioner.identifier",
         "requirements": "Either id or name is needed.",
         "min": 1,
@@ -1938,14 +1612,13 @@
           }
         ],
         "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false
+        "isModifier": false
       },
       {
-        "id": "Practitioner:uscorepract.identifier.system",
+        "id": "Practitioner:uscorepractitioner.identifier.system",
         "path": "Practitioner.identifier.system",
         "short": "NPI could be used as the identifier system in the US.",
-        "comments": "NPI could be used as the identifier system in the US.",
+        "comment": "NPI could be used as the identifier system in the US.",
         "min": 1,
         "max": "1",
         "type": [
@@ -1960,11 +1633,10 @@
           }
         ],
         "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false
+        "isModifier": false
       },
       {
-        "id": "Practitioner:uscorepract.identifier.value",
+        "id": "Practitioner:uscorepractitioner.identifier.value",
         "path": "Practitioner.identifier.value",
         "min": 1,
         "max": "1",
@@ -1974,11 +1646,10 @@
           }
         ],
         "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false
+        "isModifier": false
       },
       {
-        "id": "Practitioner:uscorepract.name",
+        "id": "Practitioner:uscorepractitioner.name",
         "path": "Practitioner.name",
         "min": 1,
         "max": "1",
@@ -1988,11 +1659,10 @@
           }
         ],
         "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false
+        "isModifier": false
       },
       {
-        "id": "Practitioner:uscorepract.name.family",
+        "id": "Practitioner:uscorepractitioner.name.family",
         "path": "Practitioner.name.family",
         "min": 1,
         "max": "1",
@@ -2002,9 +1672,8 @@
           }
         ],
         "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false
+        "isModifier": false
       }
     ]
   }
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/StructureDefinition-us-core-procedure.json b/lib/resources/us_core/StructureDefinition-us-core-procedure.json
index 1a6d5a4..1a62622 100755
--- a/lib/resources/us_core/StructureDefinition-us-core-procedure.json
+++ b/lib/resources/us_core/StructureDefinition-us-core-procedure.json
@@ -3,12 +3,14 @@
   "id": "us-core-procedure",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure</a></p><p><b>name</b>: US Core Procedure Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: Health Level Seven International (FHIR-Infrastructure)</p><p><b>contact</b>: </p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure</a></p><p><b>name</b>: US Core Procedure Profile</p><p><b>status</b>: DRAFT</p><p><b>publisher</b>: Health Level Seven International (FHIR-Infrastructure)</p><p><b>contact</b>: </p><p><b>date</b>: 01/08/2016</p><blockquote><p><b>mapping</b></p><p><b>identity</b>: rim</p><p><b>uri</b>: <a href=\"http://hl7.org/v3\">http://hl7.org/v3</a></p><p><b>name</b>: RIM Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: w5</p><p><b>uri</b>: <a href=\"http://hl7.org/fhir/w5\">http://hl7.org/fhir/w5</a></p><p><b>name</b>: W5 Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: v2</p><p><b>uri</b>: <a href=\"http://hl7.org/v2\">http://hl7.org/v2</a></p><p><b>name</b>: HL7 v2 Mapping</p></blockquote><p><b>kind</b>: RESOURCE</p><p><b>abstract</b>: false</p><p><b>type</b>: Procedure</p><p><b>baseDefinition</b>: <a href=\"http://hl7.org/fhir/StructureDefinition/Procedure\">http://hl7.org/fhir/StructureDefinition/Procedure</a></p><p><b>derivation</b>: CONSTRAINT</p><h3>Snapshots</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table><h3>Differentials</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table></div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: US  Core Procedure Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: HL7 US Realm Steering Committee</p><p><b>contact</b>: </p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: US  Core Procedure Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: HL7 US Realm Steering Committee</p><p><b>contact</b>: </p><p><b>fhirVersion</b>: 3.0.0</p><blockquote><p><b>mapping</b></p><p><b>identity</b>: argonaut-dq-dstu2</p><p><b>uri</b>: <a href=\"http://unknown.org/Argonaut DQ DSTU2\">http://unknown.org/Argonaut DQ DSTU2</a></p><p><b>name</b>: Argonaut DQ DSTU2</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: rim</p><p><b>uri</b>: <a href=\"http://hl7.org/v3\">http://hl7.org/v3</a></p><p><b>name</b>: RIM Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: w5</p><p><b>uri</b>: <a href=\"http://hl7.org/fhir/w5\">http://hl7.org/fhir/w5</a></p><p><b>name</b>: W5 Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: v2</p><p><b>uri</b>: <a href=\"http://hl7.org/v2\">http://hl7.org/v2</a></p><p><b>name</b>: HL7 v2 Mapping</p></blockquote><p><b>kind</b>: RESOURCE</p><p><b>abstract</b>: false</p><p><b>type</b>: Procedure</p><p><b>baseDefinition</b>: <a href=\"http://hl7.org/fhir/StructureDefinition/Procedure\">http://hl7.org/fhir/StructureDefinition/Procedure</a></p><p><b>derivation</b>: CONSTRAINT</p><h3>Snapshots</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table><h3>Differentials</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table></div>"
   },
   "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure",
-  "name": "US Core Procedure Profile",
+  "version": "1.0.0",
+  "name": "US  Core Procedure Profile",
   "status": "draft",
-  "publisher": "Health Level Seven International (FHIR-Infrastructure)",
+  "date": "2016-08-01",
+  "publisher": "HL7 US Realm Steering Committee",
   "contact": [
     {
       "telecom": [
@@ -19,8 +21,13 @@
       ]
     }
   ],
-  "date": "2016-08-01",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "argonaut-dq-dstu2",
+      "uri": "http://unknown.org/Argonaut DQ DSTU2",
+      "name": "Argonaut DQ DSTU2"
+    },
     {
       "identity": "rim",
       "uri": "http://hl7.org/v3",
@@ -93,14 +100,13 @@
           {
             "key": "pro-1",
             "severity": "error",
-            "human": "Reason not performed is only permitted if notPerformed indicator is true",
-            "expression": "reasonNotPerformed.empty() or notPerformed = true",
-            "xpath": "not(exists(f:reasonNotPerformed)) or f:notPerformed/@value=true()",
+            "human": "Reason not done is only permitted if notDone indicator is true",
+            "expression": "notDoneReason.empty() or notDone = true",
+            "xpath": "not(exists(f:notDoneReason)) or f:notDone/@value=true()",
             "source": "Procedure"
           }
         ],
         "mustSupport": false,
-        "isSummary": false,
         "mapping": [
           {
             "identity": "rim",
@@ -113,6 +119,10 @@
           {
             "identity": "w5",
             "map": "clinical.general"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Procedure"
           }
         ]
       },
@@ -121,7 +131,7 @@
         "path": "Procedure.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -160,7 +170,7 @@
         "path": "Procedure.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -181,7 +191,7 @@
         "path": "Procedure.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -201,6 +211,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -215,7 +233,7 @@
         "path": "Procedure.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -249,7 +267,7 @@
         "path": "Procedure.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -279,7 +297,7 @@
         "path": "Procedure.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -308,7 +326,7 @@
         "path": "Procedure.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -368,332 +386,321 @@
         ]
       },
       {
-        "id": "Procedure:uscoreprocedure.status",
-        "path": "Procedure.status",
-        "short": "in-progress | aborted | completed | entered-in-error | unknown",
-        "definition": "A code specifying the state of the procedure. Generally this will be in-progress or completed state.",
-        "comments": "The unknown code is not to be used to convey other statuses.  The unknown code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the procedure.",
-        "min": 1,
-        "max": "1",
+        "id": "Procedure:uscoreprocedure.definition",
+        "path": "Procedure.definition",
+        "short": "Instantiates protocol or definition",
+        "definition": "A protocol, guideline, orderset or other definition that was adhered to in whole or in part by this procedure.",
+        "min": 0,
+        "max": "*",
         "base": {
-          "path": "Procedure.status",
-          "min": 1,
-          "max": "1"
+          "path": "Procedure.definition",
+          "min": 0,
+          "max": "*"
         },
         "type": [
           {
-            "code": "code"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/PlanDefinition"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ActivityDefinition"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/HealthcareService"
           }
         ],
-        "mustSupport": true,
-        "isModifier": true,
-        "isSummary": false,
-        "binding": {
-          "strength": "required",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/procedure-status"
-          }
-        },
+        "isSummary": true,
         "mapping": [
           {
-            "identity": "w5",
-            "map": "status"
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=DEFN].target"
           }
         ]
       },
       {
-        "id": "Procedure:uscoreprocedure.category",
-        "path": "Procedure.category",
-        "short": "Classification of the procedure",
-        "definition": "A code that classifies the procedure for searching, sorting and display purposes (e.g. \"Surgical Procedure\").",
+        "id": "Procedure:uscoreprocedure.basedOn",
+        "path": "Procedure.basedOn",
+        "short": "A request for this procedure",
+        "definition": "A reference to a resource that contains details of the request for this procedure.",
+        "alias": [
+          "fulfills"
+        ],
         "min": 0,
-        "max": "1",
+        "max": "*",
         "base": {
-          "path": "Procedure.category",
+          "path": "Procedure.basedOn",
           "min": 0,
-          "max": "1"
+          "max": "*"
         },
         "type": [
           {
-            "code": "CodeableConcept"
-          }
-        ],
-        "isSummary": true,
-        "binding": {
-          "strength": "example",
-          "description": "A code that classifies a procedure for searching, sorting and display purposes.",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/procedure-category"
-          }
-        },
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": ".outboundRelationship[typeCode=\"COMP].target[classCode=\"LIST\", moodCode=\"EVN\"].code"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
           },
           {
-            "identity": "w5",
-            "map": "class"
-          }
-        ]
-      },
-      {
-        "id": "Procedure:uscoreprocedure.code",
-        "path": "Procedure.code",
-        "short": "SNOMED-CT | ICD-10 | CPT-4",
-        "definition": "The specific procedure that is performed. Use text if the exact nature of the procedure cannot be coded (e.g. \"Laparoscopic Appendectomy\").",
-        "min": 1,
-        "max": "1",
-        "base": {
-          "path": "Procedure.code",
-          "min": 1,
-          "max": "1"
-        },
-        "type": [
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
           {
-            "code": "CodeableConcept"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
           }
         ],
-        "mustSupport": true,
-        "isSummary": false,
-        "binding": {
-          "strength": "example",
-          "description": "A code to identify a specific procedure .",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/procedure-code"
-          }
-        },
+        "isSummary": true,
         "mapping": [
-          {
-            "identity": "v2",
-            "map": "OBR-44/OBR-45"
-          },
           {
             "identity": "rim",
-            "map": ".code"
-          },
-          {
-            "identity": "w5",
-            "map": "what"
+            "map": ".outboundRelationship[typeCode=FLFS].target[classCode=(various e.g. PROC, OBS, PCPR, ACT,  moodCode=RQO].code"
           }
         ]
       },
       {
-        "id": "Procedure:uscoreprocedure.code.id",
-        "path": "Procedure.code.id",
-        "representation": [
-          "xmlAttr"
+        "id": "Procedure:uscoreprocedure.partOf",
+        "path": "Procedure.partOf",
+        "short": "Part of referenced event",
+        "definition": "A larger event of which this particular procedure is a component or step.",
+        "comment": "The MedicationAdministration has a partOf reference to Procedure, but this is not a circular reference.  For a surgical procedure, the anesthesia related medicationAdministration is part of the procedure.  For an IV medication administration,  the procedure to insert the IV port is part of the medication administration.",
+        "alias": [
+          "container"
         ],
-        "short": "xml:id (or equivalent in JSON)",
-        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
         "min": 0,
-        "max": "1",
+        "max": "*",
         "base": {
-          "path": "Element.id",
+          "path": "Procedure.partOf",
           "min": 0,
-          "max": "1"
+          "max": "*"
         },
         "type": [
           {
-            "code": "string"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Procedure"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Observation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationAdministration"
           }
         ],
+        "isSummary": true,
         "mapping": [
           {
             "identity": "rim",
-            "map": "n/a"
+            "map": ".inboundRelationship[typeCode=COMP].source[classCode=SBADM or PROC or OBS, moodCode=EVN]"
           }
         ]
       },
       {
-        "id": "Procedure:uscoreprocedure.code.extension",
-        "path": "Procedure.code.extension",
-        "short": "Additional Content defined by implementations",
-        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
-        "alias": [
-          "extensions",
-          "user content"
-        ],
-        "min": 0,
-        "max": "*",
+        "id": "Procedure:uscoreprocedure.status",
+        "path": "Procedure.status",
+        "short": "preparation | in-progress | suspended | aborted | completed | entered-in-error | unknown",
+        "definition": "A code specifying the state of the procedure. Generally this will be in-progress or completed state.",
+        "comment": "The unknown code is not to be used to convey other statuses.  The unknown code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the procedure.\n\nThis element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
+        "min": 1,
+        "max": "1",
         "base": {
-          "path": "Element.extension",
-          "min": 0,
-          "max": "*"
+          "path": "Procedure.status",
+          "min": 1,
+          "max": "1"
         },
         "type": [
           {
-            "code": "Extension"
+            "code": "code"
           }
         ],
+        "mustSupport": true,
+        "isModifier": true,
+        "isSummary": true,
+        "binding": {
+          "strength": "required",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/event-status"
+          }
+        },
         "mapping": [
           {
             "identity": "rim",
-            "map": "n/a"
+            "map": "statusCode"
+          },
+          {
+            "identity": "w5",
+            "map": "status"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Procedure.status"
           }
         ]
       },
       {
-        "id": "Procedure:uscoreprocedure.code.coding",
-        "path": "Procedure.code.coding",
-        "slicing": {
-          "discriminator": [
-            "code"
-          ],
-          "rules": "open"
-        },
-        "short": "Code defined by a terminology system",
-        "definition": "A reference to a code defined by a terminology system.",
-        "comments": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true.",
-        "requirements": "Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings.",
+        "id": "Procedure:uscoreprocedure.notDone",
+        "path": "Procedure.notDone",
+        "short": "True if procedure was not performed as scheduled",
+        "definition": "Set this to true if the record is saying that the procedure was NOT performed.",
+        "comment": "If true, it means the procedure did not occur as described.  Typically it would be accompanied by attributes describing the type of activity.  It might also be accompanied by body site information or time information (i.e. no procedure was done to the left arm or no procedure was done in this 2-year period).  Specifying additional information such as performer, outcome, etc. is generally inappropriate.  For example, it's not that useful to say \"There was no appendectomy done at 12:03pm June 6th by Dr. Smith with a successful outcome\" as it implies that there *could* have been an appendectomy done at any other time, by any other clinician or with any other outcome.\n\nThis element is labeled as a modifier because it indicates that a procedure didn't happen.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "base": {
-          "path": "CodeableConcept.coding",
+          "path": "Procedure.notDone",
           "min": 0,
-          "max": "*"
+          "max": "1"
         },
         "type": [
           {
-            "code": "Coding"
+            "code": "boolean"
           }
         ],
+        "defaultValueBoolean": false,
+        "isModifier": true,
         "isSummary": true,
         "mapping": [
-          {
-            "identity": "v2",
-            "map": "C*E.1-8, C*E.10-22"
-          },
           {
             "identity": "rim",
-            "map": "union(., ./translation)"
-          },
-          {
-            "identity": "orim",
-            "map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"
+            "map": ".actionNegationInd"
           }
         ]
       },
       {
-        "id": "Procedure:uscoreprocedure.code.coding:uscoreprocedurecode",
-        "path": "Procedure.code.coding",
-        "sliceName": "USCoreProcedureCode",
-        "short": "Code defined by a terminology system",
-        "definition": "A reference to a code defined by a terminology system.",
-        "comments": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true.",
-        "requirements": "Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings.",
-        "min": 1,
+        "id": "Procedure:uscoreprocedure.notDoneReason",
+        "path": "Procedure.notDoneReason",
+        "short": "Reason procedure was not performed",
+        "definition": "A code indicating why the procedure was not performed.",
+        "min": 0,
         "max": "1",
         "base": {
-          "path": "CodeableConcept.coding",
+          "path": "Procedure.notDoneReason",
           "min": 0,
-          "max": "*"
+          "max": "1"
         },
         "type": [
           {
-            "code": "Coding"
+            "code": "CodeableConcept"
           }
         ],
-        "mustSupport": true,
-        "isSummary": false,
+        "condition": [
+          "pro-1"
+        ],
+        "isSummary": true,
         "binding": {
-          "strength": "required",
-          "description": "Codes describing the Procedure Type",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ProcedureNegationReason"
+            }
+          ],
+          "strength": "example",
+          "description": "A code that identifies the reason a procedure was not performed.",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-type"
+            "reference": "http://hl7.org/fhir/ValueSet/procedure-not-performed-reason"
           }
         },
         "mapping": [
-          {
-            "identity": "v2",
-            "map": "C*E.1-8, C*E.10-22"
-          },
           {
             "identity": "rim",
-            "map": "union(., ./translation)"
-          },
-          {
-            "identity": "orim",
-            "map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"
+            "map": ".reason.Observation.value"
           }
         ]
       },
       {
-        "id": "Procedure:uscoreprocedure.code.coding",
-        "path": "Procedure.code.coding",
-        "short": "Code defined by a terminology system",
-        "definition": "A reference to a code defined by a terminology system.",
-        "comments": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true.",
-        "requirements": "Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings.",
+        "id": "Procedure:uscoreprocedure.category",
+        "path": "Procedure.category",
+        "short": "Classification of the procedure",
+        "definition": "A code that classifies the procedure for searching, sorting and display purposes (e.g. \"Surgical Procedure\").",
         "min": 0,
         "max": "1",
         "base": {
-          "path": "CodeableConcept.coding",
+          "path": "Procedure.category",
           "min": 0,
-          "max": "*"
+          "max": "1"
         },
         "type": [
           {
-            "code": "Coding"
+            "code": "CodeableConcept"
           }
         ],
-        "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "binding": {
-          "strength": "required",
-          "description": "Optional ICD-10PCS Code translations describing the Procedure Type",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ProcedureCategory"
+            }
+          ],
+          "strength": "example",
+          "description": "A code that classifies a procedure for searching, sorting and display purposes.",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-icd10pcs"
+            "reference": "http://hl7.org/fhir/ValueSet/procedure-category"
           }
         },
         "mapping": [
-          {
-            "identity": "v2",
-            "map": "C*E.1-8, C*E.10-22"
-          },
           {
             "identity": "rim",
-            "map": "union(., ./translation)"
+            "map": ".outboundRelationship[typeCode=\"COMP].target[classCode=\"LIST\", moodCode=\"EVN\"].code"
           },
           {
-            "identity": "orim",
-            "map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"
+            "identity": "w5",
+            "map": "class"
           }
         ]
       },
       {
-        "id": "Procedure:uscoreprocedure.code.text",
-        "path": "Procedure.code.text",
-        "short": "Plain text representation of the concept",
-        "definition": "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.",
-        "comments": "Very often the text is the same as a displayName of one of the codings.",
-        "requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.",
-        "min": 0,
+        "id": "Procedure:uscoreprocedure.code",
+        "path": "Procedure.code",
+        "short": "SNOMED-CT | ICD-10 | CPT-4",
+        "definition": "The specific procedure that is performed. Use text if the exact nature of the procedure cannot be coded (e.g. \"Laparoscopic Appendectomy\").",
+        "requirements": "0..1 to account for primarily narrative only resources.",
+        "alias": [
+          "type"
+        ],
+        "min": 1,
         "max": "1",
         "base": {
-          "path": "CodeableConcept.text",
+          "path": "Procedure.code",
           "min": 0,
           "max": "1"
         },
         "type": [
           {
-            "code": "string"
+            "code": "CodeableConcept"
           }
         ],
+        "mustSupport": true,
         "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
+              "valueReference": {
+                "reference": "http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code"
+              }
+            }
+          ],
+          "strength": "extensible",
+          "description": "Codes describing the type of  Procedure",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code"
+          }
+        },
         "mapping": [
           {
             "identity": "v2",
-            "map": "C*E.9. But note many systems use C*E.2 for this"
+            "map": "OBR-44/OBR-45"
           },
           {
             "identity": "rim",
-            "map": "./originalText[mediaType/code=\"text/plain\"]/data"
+            "map": ".code"
+          },
+          {
+            "identity": "w5",
+            "map": "what"
           },
           {
-            "identity": "orim",
-            "map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"
+            "identity": "argonaut-dq-dstu2",
+            "map": "Procedure.code"
           }
         ]
       },
@@ -702,6 +709,9 @@
         "path": "Procedure.subject",
         "short": "Who the procedure was performed on",
         "definition": "The person, animal or group on which the procedure was performed.",
+        "alias": [
+          "patient"
+        ],
         "min": 1,
         "max": "1",
         "base": {
@@ -716,7 +726,7 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -729,18 +739,25 @@
           {
             "identity": "w5",
             "map": "who.focus"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Procedure.subject"
           }
         ]
       },
       {
-        "id": "Procedure:uscoreprocedure.encounter",
-        "path": "Procedure.encounter",
-        "short": "The encounter associated with the procedure",
+        "id": "Procedure:uscoreprocedure.context",
+        "path": "Procedure.context",
+        "short": "Encounter or episode associated with the procedure",
         "definition": "The encounter during which the procedure was performed.",
+        "alias": [
+          "encounter"
+        ],
         "min": 0,
         "max": "1",
         "base": {
-          "path": "Procedure.encounter",
+          "path": "Procedure.context",
           "min": 0,
           "max": "1"
         },
@@ -748,6 +765,10 @@
           {
             "code": "Reference",
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "isSummary": true,
@@ -787,7 +808,7 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -800,6 +821,10 @@
           {
             "identity": "w5",
             "map": "when.done"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Procedure.performed[x]"
           }
         ]
       },
@@ -834,7 +859,7 @@
         "mapping": [
           {
             "identity": "rim",
-            "map": ".participation[typeCode=PFM]"
+            "map": ".participation[typeCode=PRF]"
           }
         ]
       },
@@ -870,7 +895,7 @@
         "path": "Procedure.performer.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -899,7 +924,7 @@
         "path": "Procedure.performer.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -926,16 +951,59 @@
           }
         ]
       },
+      {
+        "id": "Procedure:uscoreprocedure.performer.role",
+        "path": "Procedure.performer.role",
+        "short": "The role the actor was in",
+        "definition": "For example: surgeon, anaethetist, endoscopist.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Procedure.performer.role",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ProcedurePerformerRole"
+            }
+          ],
+          "strength": "example",
+          "description": "A code that identifies the role of a performer of the procedure.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/performer-role"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "v2",
+            "map": "Some combination of STF-18 / PRA-3 / PRT-4 / ROL-3 / ORC-12 / OBR-16 / PV1-7 / PV1-8 / PV1-9 / PV1-17 / OBX-25"
+          },
+          {
+            "identity": "rim",
+            "map": ".functionCode"
+          }
+        ]
+      },
       {
         "id": "Procedure:uscoreprocedure.performer.actor",
         "path": "Procedure.performer.actor",
         "short": "The reference to the practitioner",
         "definition": "The practitioner who was involved in the procedure.",
-        "min": 0,
+        "requirements": "A reference to Device supports use cases, such as pacemakers.",
+        "min": 1,
         "max": "1",
         "base": {
           "path": "Procedure.performer.actor",
-          "min": 0,
+          "min": 1,
           "max": "1"
         },
         "type": [
@@ -954,6 +1022,10 @@
           {
             "code": "Reference",
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Device"
           }
         ],
         "isSummary": true,
@@ -973,96 +1045,59 @@
         ]
       },
       {
-        "id": "Procedure:uscoreprocedure.performer.role",
-        "path": "Procedure.performer.role",
-        "short": "The role the actor was in",
-        "definition": "For example: surgeon, anaethetist, endoscopist.",
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "Procedure.performer.role",
-          "min": 0,
-          "max": "1"
-        },
-        "type": [
-          {
-            "code": "CodeableConcept"
-          }
-        ],
-        "isSummary": true,
-        "binding": {
-          "strength": "example",
-          "description": "A code that identifies the role of a performer of the procedure.",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/performer-role"
-          }
-        },
-        "mapping": [
-          {
-            "identity": "v2",
-            "map": "Some combination of STF-18 / PRA-3 / PRT-4 / ROL-3 / ORC-12 / OBR-16 / PV1-7 / PV1-8 / PV1-9 / PV1-17 / OBX-25"
-          },
-          {
-            "identity": "rim",
-            "map": ".functionCode"
-          }
-        ]
-      },
-      {
-        "id": "Procedure:uscoreprocedure.location",
-        "path": "Procedure.location",
-        "short": "Where the procedure happened",
-        "definition": "The location where the procedure actually happened.  E.g. a newborn at home, a tracheostomy at a restaurant.",
-        "requirements": "Ties a procedure to where the records are likely kept.",
+        "id": "Procedure:uscoreprocedure.performer.onBehalfOf",
+        "path": "Procedure.performer.onBehalfOf",
+        "short": "Organization the device or practitioner was acting for",
+        "definition": "The organization the device or practitioner was acting on behalf of.",
+        "requirements": "Practitioners and Devices can be associated with multiple organizations.  This element indicates which organization they were acting on behalf of when performing the action.",
         "min": 0,
         "max": "1",
         "base": {
-          "path": "Procedure.location",
+          "path": "Procedure.performer.onBehalfOf",
           "min": 0,
           "max": "1"
         },
         "type": [
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Location"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
           }
         ],
-        "isSummary": true,
         "mapping": [
           {
-            "identity": "w5",
-            "map": "where"
+            "identity": "rim",
+            "map": ".scoper"
           }
         ]
       },
       {
-        "id": "Procedure:uscoreprocedure.reasonReference",
-        "path": "Procedure.reasonReference",
-        "short": "Condition that is the reason the procedure performed",
-        "definition": "The condition that is the reason why the procedure was performed.",
-        "comments": "e.g. endoscopy for dilatation and biopsy, combination diagnosis and therapeutic.",
+        "id": "Procedure:uscoreprocedure.location",
+        "path": "Procedure.location",
+        "short": "Where the procedure happened",
+        "definition": "The location where the procedure actually happened.  E.g. a newborn at home, a tracheostomy at a restaurant.",
+        "requirements": "Ties a procedure to where the records are likely kept.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "base": {
-          "path": "Procedure.reasonReference",
+          "path": "Procedure.location",
           "min": 0,
-          "max": "*"
+          "max": "1"
         },
         "type": [
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Condition"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Location"
           }
         ],
         "isSummary": true,
         "mapping": [
           {
             "identity": "rim",
-            "map": ".reasonCode"
+            "map": ".participation[typeCode=LOC].role[classCode=SDLOC]"
           },
           {
             "identity": "w5",
-            "map": "why"
+            "map": "where"
           }
         ]
       },
@@ -1085,6 +1120,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ProcedureReason"
+            }
+          ],
           "strength": "example",
           "description": "A code that identifies the reason a procedure is  required.",
           "valueSetReference": {
@@ -1103,64 +1144,37 @@
         ]
       },
       {
-        "id": "Procedure:uscoreprocedure.notPerformed",
-        "path": "Procedure.notPerformed",
-        "short": "True if procedure was not performed as scheduled",
-        "definition": "Set this to true if the record is saying that the procedure was NOT performed.",
-        "comments": "If true, it means the procedure did not occur as described.  Typically it would be accompanied by attributes describing the type of activity.  It might also be accompanied by body site information or time information (i.e. no procedure was done to the left arm or no procedure was done in this 2-year period).  Specifying additional information such as performer, outcome, etc. is generally inappropriate.  For example, it's not that useful to say \"There was no appendectomy done at 12:03pm June 6th by Dr. Smith with a successful outcome\" as it implies that there *could* have been an appendectomy done at any other time, by any other clinician or with any other outcome.",
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "Procedure.notPerformed",
-          "min": 0,
-          "max": "1"
-        },
-        "type": [
-          {
-            "code": "boolean"
-          }
-        ],
-        "defaultValueBoolean": false,
-        "isModifier": true,
-        "isSummary": true,
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": ".actionNegationInd"
-          }
-        ]
-      },
-      {
-        "id": "Procedure:uscoreprocedure.reasonNotPerformed",
-        "path": "Procedure.reasonNotPerformed",
-        "short": "Reason procedure was not performed",
-        "definition": "A code indicating why the procedure was not performed.",
+        "id": "Procedure:uscoreprocedure.reasonReference",
+        "path": "Procedure.reasonReference",
+        "short": "Condition that is the reason the procedure performed",
+        "definition": "The condition that is the reason why the procedure was performed.",
+        "comment": "e.g. endoscopy for dilatation and biopsy, combination diagnosis and therapeutic.",
         "min": 0,
         "max": "*",
         "base": {
-          "path": "Procedure.reasonNotPerformed",
+          "path": "Procedure.reasonReference",
           "min": 0,
           "max": "*"
         },
         "type": [
           {
-            "code": "CodeableConcept"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Condition"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Observation"
           }
         ],
-        "condition": [
-          "pro-1"
-        ],
-        "binding": {
-          "strength": "example",
-          "description": "A code that identifies the reason a procedure was not performed.",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/procedure-not-performed-reason"
-          }
-        },
+        "isSummary": true,
         "mapping": [
           {
             "identity": "rim",
-            "map": ".reason.Observation.value"
+            "map": ".reasonCode"
+          },
+          {
+            "identity": "w5",
+            "map": "why"
           }
         ]
       },
@@ -1183,6 +1197,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -1205,7 +1225,7 @@
         "path": "Procedure.outcome",
         "short": "The result of procedure",
         "definition": "The outcome of the procedure - did it resolve reasons for the procedure being performed?",
-        "comments": "If outcome contains narrative text only, it can be captured using the CodeableConcept.text.",
+        "comment": "If outcome contains narrative text only, it can be captured using the CodeableConcept.text.",
         "min": 0,
         "max": "1",
         "base": {
@@ -1220,6 +1240,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ProcedureOutcome"
+            }
+          ],
           "strength": "example",
           "description": "An outcome of a procedure - whether it was resolved or otherwise.",
           "valueSetReference": {
@@ -1238,7 +1264,7 @@
         "path": "Procedure.report",
         "short": "Any report resulting from the procedure",
         "definition": "This could be a histology result, pathology report, surgical report, etc..",
-        "comments": "There could potentially be multiple reports - e.g. if this was a procedure which took multiple biopsies resulting in a number of anatomical pathology reports.",
+        "comment": "There could potentially be multiple reports - e.g. if this was a procedure which took multiple biopsies resulting in a number of anatomical pathology reports.",
         "min": 0,
         "max": "*",
         "base": {
@@ -1264,7 +1290,7 @@
         "path": "Procedure.complication",
         "short": "Complication following the procedure",
         "definition": "Any complications that occurred during the procedure, or in the immediate post-performance period. These are generally tracked separately from the notes, which will typically describe the procedure itself rather than any 'post procedure' issues.",
-        "comments": "If complications are only expressed by the narrative text, they can be captured using the CodeableConcept.text.",
+        "comment": "If complications are only expressed by the narrative text, they can be captured using the CodeableConcept.text.",
         "min": 0,
         "max": "*",
         "base": {
@@ -1278,6 +1304,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ProcedureComplication"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing complications that resulted from a procedure.",
           "valueSetReference": {
@@ -1287,7 +1319,33 @@
         "mapping": [
           {
             "identity": "rim",
-            "map": "Need specialization of OUT for this."
+            "map": ".outboundRelationship[typeCode=OUTC].target[classCode=OBS, code=\"complication\", moodCode=EVN].value"
+          }
+        ]
+      },
+      {
+        "id": "Procedure:uscoreprocedure.complicationDetail",
+        "path": "Procedure.complicationDetail",
+        "short": "A condition that is a result of the procedure",
+        "definition": "Any complications that occurred during the procedure, or in the immediate post-performance period.",
+        "requirements": "This is used to document a condition that is a result of the procedure, not the condition that was the reason for the procedure.",
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "Procedure.complicationDetail",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Condition"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=OUTC].target[classCode=OBS, code=\"complication\", moodCode=EVN].value"
           }
         ]
       },
@@ -1309,6 +1367,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ProcedureFollowUp"
+            }
+          ],
           "strength": "example",
           "description": "Specific follow up required for a procedure e.g. removal of sutures.",
           "valueSetReference": {
@@ -1323,45 +1387,14 @@
         ]
       },
       {
-        "id": "Procedure:uscoreprocedure.request",
-        "path": "Procedure.request",
-        "short": "A request for this procedure",
-        "definition": "A reference to a resource that contains details of the request for this procedure.",
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "Procedure.request",
-          "min": 0,
-          "max": "1"
-        },
-        "type": [
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
-          },
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DiagnosticRequest"
-          },
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
-          },
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
-          }
-        ]
-      },
-      {
-        "id": "Procedure:uscoreprocedure.notes",
-        "path": "Procedure.notes",
+        "id": "Procedure:uscoreprocedure.note",
+        "path": "Procedure.note",
         "short": "Additional information about the procedure",
         "definition": "Any other notes about the procedure.  E.g. the operative notes.",
         "min": 0,
         "max": "*",
         "base": {
-          "path": "Procedure.notes",
+          "path": "Procedure.note",
           "min": 0,
           "max": "*"
         },
@@ -1407,6 +1440,12 @@
             "xpath": "@value|f:*|h:div",
             "source": "Element"
           }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".participation[typeCode=DEV].role[classCode=MANU]"
+          }
         ]
       },
       {
@@ -1441,7 +1480,7 @@
         "path": "Procedure.focalDevice.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1470,7 +1509,7 @@
         "path": "Procedure.focalDevice.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1515,12 +1554,24 @@
           }
         ],
         "binding": {
-          "strength": "required",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "DeviceActionKind"
+            }
+          ],
+          "strength": "preferred",
           "description": "A kind of change that happened to the device during the procedure.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/device-action"
           }
-        }
+        },
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=\"procedure device action\"].value=:procedure device action codes"
+          }
+        ]
       },
       {
         "id": "Procedure:uscoreprocedure.focalDevice.manipulated",
@@ -1539,6 +1590,12 @@
             "code": "Reference",
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/Device"
           }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".participation[typeCode=DEV].role[classCode=SDLOC]"
+          }
         ]
       },
       {
@@ -1546,7 +1603,7 @@
         "path": "Procedure.usedReference",
         "short": "Items used during procedure",
         "definition": "Identifies medications, devices and any other substance used as part of the procedure.",
-        "comments": "For devices actually implanted or removed, use Procedure.device.",
+        "comment": "For devices actually implanted or removed, use Procedure.device.",
         "requirements": "Used for tracking contamination, etc.",
         "min": 0,
         "max": "*",
@@ -1568,6 +1625,12 @@
             "code": "Reference",
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/Substance"
           }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".participation[typeCode=DEV].role[classCode=MANU] or\n.participation[typeCode=CSM].role[classCode=ADMM] (for Medication or Substance)"
+          }
         ]
       },
       {
@@ -1575,7 +1638,7 @@
         "path": "Procedure.usedCode",
         "short": "Coded items used during the procedure",
         "definition": "Identifies coded items that were used as part of the procedure.",
-        "comments": "For devices actually implanted or removed, use Procedure.device.",
+        "comment": "For devices actually implanted or removed, use Procedure.device.",
         "min": 0,
         "max": "*",
         "base": {
@@ -1589,34 +1652,22 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ProcedureUsed"
+            }
+          ],
           "strength": "example",
-          "description": "Codes describing items used during a procedure"
-        }
-      },
-      {
-        "id": "Procedure:uscoreprocedure.component",
-        "path": "Procedure.component",
-        "short": "Events related to the procedure",
-        "definition": "Identifies medication administrations, other procedures or observations that are related to this procedure.",
-        "min": 0,
-        "max": "*",
-        "base": {
-          "path": "Procedure.component",
-          "min": 0,
-          "max": "*"
+          "description": "Codes describing items used during a procedure",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/device-kind"
+          }
         },
-        "type": [
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationAdministration"
-          },
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Procedure"
-          },
+        "mapping": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Observation"
+            "identity": "rim",
+            "map": "participation[typeCode=Dev].role[classCode=MANU]"
           }
         ]
       }
@@ -1632,7 +1683,12 @@
         "definition": "The US Core Condition Profile is based upon the core FHIR Procedure Resource and created to meet the 2015 Edition Common Clinical Data Set 'Procedures' requirements.",
         "mustSupport": false,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Procedure"
+          }
+        ]
       },
       {
         "id": "Procedure:uscoreprocedure.status",
@@ -1646,13 +1702,18 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false,
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/procedure-status"
+            "reference": "http://hl7.org/fhir/ValueSet/event-status"
           }
-        }
+        },
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Procedure.status"
+          }
+        ]
       },
       {
         "id": "Procedure:uscoreprocedure.code",
@@ -1667,56 +1728,27 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false
-      },
-      {
-        "id": "Procedure:uscoreprocedure.code.coding:uscoreprocedurecode",
-        "path": "Procedure.code.coding",
-        "sliceName": "USCoreProcedureCode",
-        "slicing": {
-          "discriminator": [
-            "code"
-          ],
-          "rules": "open"
-        },
-        "min": 1,
-        "max": "1",
-        "type": [
-          {
-            "code": "Coding"
-          }
-        ],
-        "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false,
         "binding": {
-          "strength": "required",
-          "description": "Codes describing the Procedure Type",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
+              "valueReference": {
+                "reference": "http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code"
+              }
+            }
+          ],
+          "strength": "extensible",
+          "description": "Codes describing the type of  Procedure",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-type"
+            "reference": "http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code"
           }
-        }
-      },
-      {
-        "id": "Procedure:uscoreprocedure.code.coding",
-        "path": "Procedure.code.coding",
-        "min": 0,
-        "max": "1",
-        "type": [
+        },
+        "mapping": [
           {
-            "code": "Coding"
-          }
-        ],
-        "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false,
-        "binding": {
-          "strength": "required",
-          "description": "Optional ICD-10PCS Code translations describing the Procedure Type",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-icd10pcs"
+            "identity": "argonaut-dq-dstu2",
+            "map": "Procedure.code"
           }
-        }
+        ]
       },
       {
         "id": "Procedure:uscoreprocedure.subject",
@@ -1731,7 +1763,12 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Procedure.subject"
+          }
+        ]
       },
       {
         "id": "Procedure:uscoreprocedure.performed[x]",
@@ -1748,8 +1785,13 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Procedure.performed[x]"
+          }
+        ]
       }
     ]
   }
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/StructureDefinition-us-core-profile-link.json b/lib/resources/us_core/StructureDefinition-us-core-profile-link.json
new file mode 100755
index 0000000..9c8d57d
--- /dev/null
+++ b/lib/resources/us_core/StructureDefinition-us-core-profile-link.json
@@ -0,0 +1,259 @@
+{
+  "resourceType": "StructureDefinition",
+  "id": "us-core-profile-link",
+  "text": {
+    "status": "generated",
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-profile-link\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-profile-link</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: Profile-resource association extension</p><p><b>title</b>: Profile-resource association extension</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 21/03/2017 11:28:08 AM</p><p><b>publisher</b>: HL7 US Realm Steering Committee</p><p><b>contact</b>: </p><p><b>description</b>: Used in the CapabilityStatment resource to link profiles to the resources they are based upon for the purpose of describing profile specific capababilties such as specific search criteria or operations which are supported on a profile by profile bases. It is a code that references a resource listed in Capability.rest.resource. For more information on how the Capability resource describes profiles on resources, see [Two uses of Profiles](http://hl7.org/fhir/STU3/profiling.html#profile-uses).</p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-profile-link\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-profile-link</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: Profile-resource association extension</p><p><b>title</b>: Profile-resource association extension</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 21/03/2017 11:28:08 AM</p><p><b>publisher</b>: HL7 US Realm Steering Committee</p><p><b>contact</b>: </p><p><b>description</b>: Used in the CapabilityStatment resource to link profiles to the resources they are based upon for the purpose of describing profile specific capababilties such as specific search criteria or operations which are supported on a profile by profile bases. It is a code that references a resource listed in Capability.rest.resource. For more information on how the Capability resource describes profiles on resources, see [Two uses of Profiles](http://hl7.org/fhir/STU3/profiling.html#profile-uses).</p><p><b>purpose</b>: To allow profiles to be associated with resources in CapabilityStatements.</p><p><b>fhirVersion</b>: 3.0.0</p><h3>Mappings</h3><table class=\"grid\"><tr><td>-</td><td><b>Identity</b></td><td><b>Uri</b></td><td><b>Name</b></td></tr><tr><td>*</td><td>rim</td><td><a href=\"http://hl7.org/v3\">http://hl7.org/v3</a></td><td>RIM Mapping</td></tr></table><p><b>kind</b>: COMPLEXTYPE</p><p><b>abstract</b>: false</p><p><b>contextType</b>: RESOURCE</p><p><b>context</b>: CapabilityStatement.profile</p><p><b>type</b>: Extension</p><p><b>baseDefinition</b>: <a href=\"http://hl7.org/fhir/StructureDefinition/Extension\">http://hl7.org/fhir/StructureDefinition/Extension</a></p><p><b>derivation</b>: CONSTRAINT</p><h3>Snapshots</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table><h3>Differentials</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table></div>"
+  },
+  "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-profile-link",
+  "version": "1.0.0",
+  "name": "Profile-resource association extension",
+  "title": "Profile-resource association extension",
+  "status": "draft",
+  "date": "2017-03-21T11:28:08+11:00",
+  "publisher": "HL7 US Realm Steering Committee",
+  "contact": [
+    {
+      "telecom": [
+        {
+          "system": "url",
+          "value": "http://www.healthit.gov"
+        }
+      ]
+    }
+  ],
+  "description": "Used in the CapabilityStatment resource to link profiles to the resources they are based upon for the purpose of describing profile specific capababilties such as specific search criteria or operations which are supported on a profile by profile bases. It is a code that references a resource listed in Capability.rest.resource. For more information on how the Capability resource describes profiles on resources, see [Two uses of Profiles](http://hl7.org/fhir/STU3/profiling.html#profile-uses).",
+  "purpose": "To allow profiles to be associated with resources in CapabilityStatements.",
+  "fhirVersion": "3.0.0",
+  "mapping": [
+    {
+      "identity": "rim",
+      "uri": "http://hl7.org/v3",
+      "name": "RIM Mapping"
+    }
+  ],
+  "kind": "complex-type",
+  "abstract": false,
+  "contextType": "resource",
+  "context": [
+    "CapabilityStatement.profile"
+  ],
+  "type": "Extension",
+  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Extension",
+  "derivation": "constraint",
+  "snapshot": {
+    "element": [
+      {
+        "id": "Extension:profile-link",
+        "path": "Extension",
+        "sliceName": "profile-link",
+        "short": "Resource that this profile is based on",
+        "definition": "This is a code that references a  resource listed in CapabilityStatement.rest.resource.  This is used to link the profile to the resources for the purpose of describing profile specific capababilties such as specific search criteria or operations which are supported on a profile by profile bases.",
+        "comment": "This is helpful for publishing the CapabilityResource narrative.",
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "Extension",
+          "min": 0,
+          "max": "*"
+        },
+        "condition": [
+          "ele-1"
+        ],
+        "constraint": [
+          {
+            "key": "ele-1",
+            "severity": "error",
+            "human": "All FHIR elements must have a @value or children",
+            "expression": "children().count() > id.count()",
+            "xpath": "@value|f:*|h:div",
+            "source": "Element"
+          },
+          {
+            "key": "ext-1",
+            "severity": "error",
+            "human": "Must have either extensions or value[x], not both",
+            "expression": "extension.exists() != value.exists()",
+            "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
+            "source": "Extension"
+          }
+        ],
+        "isModifier": false,
+        "mapping": [
+          {
+            "identity": "v2",
+            "map": "No v2 equivalent"
+          },
+          {
+            "identity": "rim",
+            "map": "No RIM equivalent"
+          }
+        ]
+      },
+      {
+        "id": "Extension:profile-link.id",
+        "path": "Extension.id",
+        "representation": [
+          "xmlAttr"
+        ],
+        "short": "xml:id (or equivalent in JSON)",
+        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Element.id",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "Extension:profile-link.extension",
+        "path": "Extension.extension",
+        "short": "Additional Content defined by implementations",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "Element.extension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "Extension:profile-link.url",
+        "path": "Extension.url",
+        "representation": [
+          "xmlAttr"
+        ],
+        "short": "identifies the meaning of the extension",
+        "definition": "Source of the definition for the extension code - a logical name or a URL.",
+        "comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
+        "min": 1,
+        "max": "1",
+        "base": {
+          "path": "Extension.url",
+          "min": 1,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "uri"
+          }
+        ],
+        "fixedUri": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-profile-link",
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "N/A"
+          }
+        ]
+      },
+      {
+        "id": "Extension:profile-link.valueCode",
+        "path": "Extension.valueCode",
+        "short": "Value of extension",
+        "definition": "Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Extension.value[x]",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "code"
+          }
+        ],
+        "binding": {
+          "strength": "required",
+          "description": "One of the resource types defined as part of FHIR.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/resource-types"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "N/A"
+          }
+        ]
+      }
+    ]
+  },
+  "differential": {
+    "element": [
+      {
+        "id": "Extension:profile-link",
+        "path": "Extension",
+        "sliceName": "profile-link",
+        "short": "Resource that this profile is based on",
+        "definition": "This is a code that references a  resource listed in CapabilityStatement.rest.resource.  This is used to link the profile to the resources for the purpose of describing profile specific capababilties such as specific search criteria or operations which are supported on a profile by profile bases.",
+        "comment": "This is helpful for publishing the CapabilityResource narrative.",
+        "min": 0,
+        "max": "*",
+        "isModifier": false,
+        "mapping": [
+          {
+            "identity": "v2",
+            "map": "No v2 equivalent"
+          },
+          {
+            "identity": "rim",
+            "map": "No RIM equivalent"
+          }
+        ]
+      },
+      {
+        "id": "Extension:profile-link.url",
+        "path": "Extension.url",
+        "fixedUri": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-profile-link"
+      },
+      {
+        "id": "Extension:profile-link.valueCode",
+        "path": "Extension.valueCode",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "code"
+          }
+        ],
+        "binding": {
+          "strength": "required",
+          "description": "One of the resource types defined as part of FHIR.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/resource-types"
+          }
+        }
+      }
+    ]
+  }
+}
diff --git a/lib/resources/us_core/StructureDefinition-us-core-race.json b/lib/resources/us_core/StructureDefinition-us-core-race.json
index f48d0bb..c930090 100755
--- a/lib/resources/us_core/StructureDefinition-us-core-race.json
+++ b/lib/resources/us_core/StructureDefinition-us-core-race.json
@@ -3,13 +3,15 @@
   "id": "us-core-race",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-race\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-race</a></p><p><b>name</b>: US Core Race Extension</p><p><b>title</b>: US Core Race Extension</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: Health Level Seven International (FHIR-Infrastructure)</p><p><b>contact</b>: </p><p><b>description</b>: Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The race codes used to represent these concepts are based upon the [CDC Race and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 921 reference race.  The race concepts are grouped by and pre-mapped to the 5 OMB race categories:\r- American Indian or Alaska Native\r- Asian\r- Black or African American\r- Native Hawaiian or Other Pacific Islander\r- White.</p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-race\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-race</a></p><p><b>name</b>: US Core Race Extension</p><p><b>title</b>: US Core Race Extension</p><p><b>status</b>: DRAFT</p><p><b>publisher</b>: Health Level Seven International (FHIR-Infrastructure)</p><p><b>contact</b>: </p><p><b>date</b>: 01/08/2016</p><p><b>description</b>: Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The race codes used to represent these concepts are based upon the [CDC Race and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 921 reference race.  The race concepts are grouped by and pre-mapped to the 5 OMB race categories:\r- American Indian or Alaska Native\r- Asian\r- Black or African American\r- Native Hawaiian or Other Pacific Islander\r- White.</p><p><b>purpose</b>: Complies with 2015 Edition Common Clinical Data Set for patient race.</p><p><b>fhirVersion</b>: 1.8.0</p><h3>Mappings</h3><table class=\"grid\"><tr><td>-</td><td><b>Identity</b></td><td><b>Uri</b></td><td><b>Name</b></td></tr><tr><td>*</td><td>rim</td><td><a href=\"http://hl7.org/v3\">http://hl7.org/v3</a></td><td>RIM Mapping</td></tr></table><p><b>kind</b>: COMPLEXTYPE</p><p><b>abstract</b>: false</p><p><b>contextType</b>: RESOURCE</p><p><b>context</b>: Patient</p><p><b>type</b>: Extension</p><p><b>baseDefinition</b>: <a href=\"http://hl7.org/fhir/StructureDefinition/Extension\">http://hl7.org/fhir/StructureDefinition/Extension</a></p><p><b>derivation</b>: CONSTRAINT</p><h3>Snapshots</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table><h3>Differentials</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table></div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-race\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-race</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: US Core Race Extension</p><p><b>title</b>: US Core Race Extension</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: HL7 US Realm Steering Committee</p><p><b>contact</b>: </p><p><b>description</b>: Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The race codes used to represent these concepts are based upon the [CDC Race and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 921 reference race.  The race concepts are grouped by and pre-mapped to the 5 OMB race categories: - American Indian or Alaska Native - Asian - Black or African American - Native Hawaiian or Other Pacific Islander - White.</p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-race\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-race</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: US Core Race Extension</p><p><b>title</b>: US Core Race Extension</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: HL7 US Realm Steering Committee</p><p><b>contact</b>: </p><p><b>description</b>: Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The race codes used to represent these concepts are based upon the [CDC Race and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 921 reference race.  The race concepts are grouped by and pre-mapped to the 5 OMB race categories: - American Indian or Alaska Native - Asian - Black or African American - Native Hawaiian or Other Pacific Islander - White.</p><p><b>purpose</b>: Complies with 2015 Edition Common Clinical Data Set for patient race.</p><p><b>fhirVersion</b>: 3.0.0</p><h3>Mappings</h3><table class=\"grid\"><tr><td>-</td><td><b>Identity</b></td><td><b>Uri</b></td><td><b>Name</b></td></tr><tr><td>*</td><td>rim</td><td><a href=\"http://hl7.org/v3\">http://hl7.org/v3</a></td><td>RIM Mapping</td></tr></table><p><b>kind</b>: COMPLEXTYPE</p><p><b>abstract</b>: false</p><p><b>contextType</b>: RESOURCE</p><p><b>context</b>: Patient</p><p><b>type</b>: Extension</p><p><b>baseDefinition</b>: <a href=\"http://hl7.org/fhir/StructureDefinition/Extension\">http://hl7.org/fhir/StructureDefinition/Extension</a></p><p><b>derivation</b>: CONSTRAINT</p><h3>Snapshots</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table><h3>Differentials</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table></div>"
   },
   "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race",
+  "version": "1.0.0",
   "name": "US Core Race Extension",
   "title": "US Core Race Extension",
   "status": "draft",
-  "publisher": "Health Level Seven International (FHIR-Infrastructure)",
+  "date": "2016-08-01",
+  "publisher": "HL7 US Realm Steering Committee",
   "contact": [
     {
       "telecom": [
@@ -20,10 +22,9 @@
       ]
     }
   ],
-  "date": "2016-08-01",
-  "description": "Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The race codes used to represent these concepts are based upon the [CDC Race and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 921 reference race.  The race concepts are grouped by and pre-mapped to the 5 OMB race categories:\r- American Indian or Alaska Native\r- Asian\r- Black or African American\r- Native Hawaiian or Other Pacific Islander\r- White.",
+  "description": "Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The race codes used to represent these concepts are based upon the [CDC Race and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 921 reference race.  The race concepts are grouped by and pre-mapped to the 5 OMB race categories: - American Indian or Alaska Native - Asian - Black or African American - Native Hawaiian or Other Pacific Islander - White.",
   "purpose": "Complies with 2015 Edition Common Clinical Data Set for patient race.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "rim",
@@ -47,7 +48,7 @@
         "path": "Extension",
         "sliceName": "race",
         "short": "US Core Race Extension",
-        "definition": "Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The race codes used to represent these concepts are based upon the [CDC Race and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 921 reference race.  The race concepts are grouped by and pre-mapped to the 5 OMB race categories:\r- American Indian or Alaska Native\r- Asian\r- Black or African American\r- Native Hawaiian or Other Pacific Islander\r- White.",
+        "definition": "Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The race codes used to represent these concepts are based upon the [CDC Race and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 921 reference race.  The race concepts are grouped by and pre-mapped to the 5 OMB race categories: - American Indian or Alaska Native - Asian - Black or African American - Native Hawaiian or Other Pacific Islander - White.",
         "min": 0,
         "max": "1",
         "base": {
@@ -111,7 +112,10 @@
         "slicing": {
           "id": "1",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -137,7 +141,7 @@
         "sliceName": "ombCategory",
         "short": "American Indian or Alaska Native|Asian|Black or African American|Native Hawaiian or Other Pacific Islander|White",
         "definition": "The 5 race category codes according to the [OMB Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity, Statistical Policy Directive No. 15, as revised, October 30, 1997](https://www.whitehouse.gov/omb/fedreg_1997standards).",
-        "min": 1,
+        "min": 0,
         "max": "5",
         "base": {
           "path": "Element.extension",
@@ -149,6 +153,7 @@
             "code": "Extension"
           }
         ],
+        "mustSupport": true,
         "isModifier": false,
         "mapping": [
           {
@@ -189,13 +194,13 @@
         "path": "Extension.extension.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
         ],
         "min": 0,
-        "max": "*",
+        "max": "0",
         "base": {
           "path": "Element.extension",
           "min": 0,
@@ -221,7 +226,7 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
+        "comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -234,6 +239,7 @@
             "code": "uri"
           }
         ],
+        "fixedUri": "ombCategory",
         "mapping": [
           {
             "identity": "rim",
@@ -246,7 +252,7 @@
         "path": "Extension.extension.valueCoding",
         "short": "Value of extension",
         "definition": "Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).",
-        "min": 0,
+        "min": 1,
         "max": "1",
         "base": {
           "path": "Extension.value[x]",
@@ -262,7 +268,7 @@
           "strength": "required",
           "description": "The 5 race category codes according to the [OMB Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity, Statistical Policy Directive No. 15, as revised, October 30, 1997](https://www.whitehouse.gov/omb/fedreg_1997standards).",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/us/core/ValueSet/omb-race"
+            "reference": "http://hl7.org/fhir/us/core/ValueSet/omb-race-category"
           }
         },
         "mapping": [
@@ -330,13 +336,13 @@
         "path": "Extension.extension.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
         ],
         "min": 0,
-        "max": "*",
+        "max": "0",
         "base": {
           "path": "Element.extension",
           "min": 0,
@@ -362,7 +368,7 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
+        "comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -375,6 +381,7 @@
             "code": "uri"
           }
         ],
+        "fixedUri": "detailed",
         "mapping": [
           {
             "identity": "rim",
@@ -387,7 +394,7 @@
         "path": "Extension.extension.valueCoding",
         "short": "Value of extension",
         "definition": "Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).",
-        "min": 0,
+        "min": 1,
         "max": "1",
         "base": {
           "path": "Extension.value[x]",
@@ -419,7 +426,7 @@
         "sliceName": "text",
         "short": "Race Text",
         "definition": "Plain text representation of the race concept(s).",
-        "min": 0,
+        "min": 1,
         "max": "1",
         "base": {
           "path": "Element.extension",
@@ -431,6 +438,7 @@
             "code": "Extension"
           }
         ],
+        "mustSupport": true,
         "isModifier": false
       },
       {
@@ -465,13 +473,13 @@
         "path": "Extension.extension.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
         ],
         "min": 0,
-        "max": "*",
+        "max": "0",
         "base": {
           "path": "Element.extension",
           "min": 0,
@@ -497,7 +505,7 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
+        "comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -510,6 +518,7 @@
             "code": "uri"
           }
         ],
+        "fixedUri": "text",
         "mapping": [
           {
             "identity": "rim",
@@ -522,7 +531,7 @@
         "path": "Extension.extension.valueString",
         "short": "Value of extension",
         "definition": "Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).",
-        "min": 0,
+        "min": 1,
         "max": "1",
         "base": {
           "path": "Extension.value[x]",
@@ -549,7 +558,7 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
+        "comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -714,7 +723,7 @@
         "path": "Extension",
         "sliceName": "race",
         "short": "US Core Race Extension",
-        "definition": "Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The race codes used to represent these concepts are based upon the [CDC Race and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 921 reference race.  The race concepts are grouped by and pre-mapped to the 5 OMB race categories:\r- American Indian or Alaska Native\r- Asian\r- Black or African American\r- Native Hawaiian or Other Pacific Islander\r- White.",
+        "definition": "Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The race codes used to represent these concepts are based upon the [CDC Race and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 921 reference race.  The race concepts are grouped by and pre-mapped to the 5 OMB race categories: - American Indian or Alaska Native - Asian - Black or African American - Native Hawaiian or Other Pacific Islander - White.",
         "min": 0,
         "max": "1",
         "isModifier": false
@@ -725,13 +734,14 @@
         "sliceName": "ombCategory",
         "short": "American Indian or Alaska Native|Asian|Black or African American|Native Hawaiian or Other Pacific Islander|White",
         "definition": "The 5 race category codes according to the [OMB Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity, Statistical Policy Directive No. 15, as revised, October 30, 1997](https://www.whitehouse.gov/omb/fedreg_1997standards).",
-        "min": 1,
+        "min": 0,
         "max": "5",
         "type": [
           {
             "code": "Extension"
           }
         ],
+        "mustSupport": true,
         "isModifier": false,
         "mapping": [
           {
@@ -741,8 +751,22 @@
         ]
       },
       {
-        "id": "Extension:race.extension:ombcategory.value[x]",
-        "path": "Extension.extension.value[x]",
+        "id": "Extension:race.extension:ombcategory.url",
+        "path": "Extension.extension.url",
+        "min": 1,
+        "max": "1",
+        "type": [
+          {
+            "code": "uri"
+          }
+        ],
+        "fixedUri": "ombCategory"
+      },
+      {
+        "id": "Extension:race.extension:ombcategory.valueCoding",
+        "path": "Extension.extension.valueCoding",
+        "min": 1,
+        "max": "1",
         "type": [
           {
             "code": "Coding"
@@ -752,7 +776,7 @@
           "strength": "required",
           "description": "The 5 race category codes according to the [OMB Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity, Statistical Policy Directive No. 15, as revised, October 30, 1997](https://www.whitehouse.gov/omb/fedreg_1997standards).",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/us/core/ValueSet/omb-race"
+            "reference": "http://hl7.org/fhir/us/core/ValueSet/omb-race-category"
           }
         }
       },
@@ -778,8 +802,22 @@
         ]
       },
       {
-        "id": "Extension:race.extension:detailed.value[x]",
-        "path": "Extension.extension.value[x]",
+        "id": "Extension:race.extension:detailed.url",
+        "path": "Extension.extension.url",
+        "min": 1,
+        "max": "1",
+        "type": [
+          {
+            "code": "uri"
+          }
+        ],
+        "fixedUri": "detailed"
+      },
+      {
+        "id": "Extension:race.extension:detailed.valueCoding",
+        "path": "Extension.extension.valueCoding",
+        "min": 1,
+        "max": "1",
         "type": [
           {
             "code": "Coding"
@@ -799,18 +837,33 @@
         "sliceName": "text",
         "short": "Race Text",
         "definition": "Plain text representation of the race concept(s).",
-        "min": 0,
+        "min": 1,
         "max": "1",
         "type": [
           {
             "code": "Extension"
           }
         ],
+        "mustSupport": true,
         "isModifier": false
       },
       {
-        "id": "Extension:race.extension:text.value[x]",
-        "path": "Extension.extension.value[x]",
+        "id": "Extension:race.extension:text.url",
+        "path": "Extension.extension.url",
+        "min": 1,
+        "max": "1",
+        "type": [
+          {
+            "code": "uri"
+          }
+        ],
+        "fixedUri": "text"
+      },
+      {
+        "id": "Extension:race.extension:text.valueString",
+        "path": "Extension.extension.valueString",
+        "min": 1,
+        "max": "1",
         "type": [
           {
             "code": "string"
@@ -820,13 +873,10 @@
       {
         "id": "Extension:race.url",
         "path": "Extension.url",
+        "min": 1,
+        "max": "1",
         "fixedUri": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race"
-      },
-      {
-        "id": "Extension:race.value[x]",
-        "path": "Extension.value[x]",
-        "max": "0"
       }
     ]
   }
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/StructureDefinition-us-core-smokingstatus.json b/lib/resources/us_core/StructureDefinition-us-core-smokingstatus.json
index 52645c1..4a0c078 100755
--- a/lib/resources/us_core/StructureDefinition-us-core-smokingstatus.json
+++ b/lib/resources/us_core/StructureDefinition-us-core-smokingstatus.json
@@ -3,12 +3,14 @@
   "id": "us-core-smokingstatus",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-smokingstatus\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-smokingstatus</a></p><p><b>name</b>: US Core Smoking Status Observation Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: Health Level Seven International (FHIR-Infrastructure)</p><p><b>contact</b>: </p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-smokingstatus\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-smokingstatus</a></p><p><b>name</b>: US Core Smoking Status Observation Profile</p><p><b>status</b>: DRAFT</p><p><b>publisher</b>: Health Level Seven International (FHIR-Infrastructure)</p><p><b>contact</b>: </p><p><b>date</b>: 01/08/2016</p><blockquote><p><b>mapping</b></p><p><b>identity</b>: v2</p><p><b>uri</b>: <a href=\"http://hl7.org/v2\">http://hl7.org/v2</a></p><p><b>name</b>: HL7 v2 Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: rim</p><p><b>uri</b>: <a href=\"http://hl7.org/v3\">http://hl7.org/v3</a></p><p><b>name</b>: RIM Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: w5</p><p><b>uri</b>: <a href=\"http://hl7.org/fhir/w5\">http://hl7.org/fhir/w5</a></p><p><b>name</b>: W5 Mapping</p></blockquote><p><b>kind</b>: RESOURCE</p><p><b>abstract</b>: false</p><p><b>type</b>: Observation</p><p><b>baseDefinition</b>: <a href=\"http://hl7.org/fhir/StructureDefinition/Observation\">http://hl7.org/fhir/StructureDefinition/Observation</a></p><p><b>derivation</b>: CONSTRAINT</p><h3>Snapshots</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table><h3>Differentials</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table></div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-smokingstatus\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-smokingstatus</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: US  Core Smoking Status Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: HL7 US Realm Steering Committee</p><p><b>contact</b>: </p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-smokingstatus\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-smokingstatus</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: US  Core Smoking Status Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: HL7 US Realm Steering Committee</p><p><b>contact</b>: </p><p><b>fhirVersion</b>: 3.0.0</p><blockquote><p><b>mapping</b></p><p><b>identity</b>: argonaut-dq-dstu2</p><p><b>uri</b>: <a href=\"http://unknown.org/Argonaut DQ DSTU2\">http://unknown.org/Argonaut DQ DSTU2</a></p><p><b>name</b>: Argonaut DQ DSTU2</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: workflow</p><p><b>uri</b>: <a href=\"http://hl7.org/fhir/workflow\">http://hl7.org/fhir/workflow</a></p><p><b>name</b>: Workflow Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: sct-concept</p><p><b>uri</b>: <a href=\"http://snomed.info/conceptdomain\">http://snomed.info/conceptdomain</a></p><p><b>name</b>: SNOMED CT Concept Domain Binding</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: v2</p><p><b>uri</b>: <a href=\"http://hl7.org/v2\">http://hl7.org/v2</a></p><p><b>name</b>: HL7 v2 Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: rim</p><p><b>uri</b>: <a href=\"http://hl7.org/v3\">http://hl7.org/v3</a></p><p><b>name</b>: RIM Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: w5</p><p><b>uri</b>: <a href=\"http://hl7.org/fhir/w5\">http://hl7.org/fhir/w5</a></p><p><b>name</b>: W5 Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: sct-attr</p><p><b>uri</b>: <a href=\"http://snomed.info/sct\">http://snomed.info/sct</a></p><p><b>name</b>: SNOMED CT Attribute Binding</p></blockquote><p><b>kind</b>: RESOURCE</p><p><b>abstract</b>: false</p><p><b>type</b>: Observation</p><p><b>baseDefinition</b>: <a href=\"http://hl7.org/fhir/StructureDefinition/Observation\">http://hl7.org/fhir/StructureDefinition/Observation</a></p><p><b>derivation</b>: CONSTRAINT</p><h3>Snapshots</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table><h3>Differentials</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table></div>"
   },
   "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-smokingstatus",
-  "name": "US Core Smoking Status Observation Profile",
+  "version": "1.0.0",
+  "name": "US  Core Smoking Status Profile",
   "status": "draft",
-  "publisher": "Health Level Seven International (FHIR-Infrastructure)",
+  "date": "2016-08-01",
+  "publisher": "HL7 US Realm Steering Committee",
   "contact": [
     {
       "telecom": [
@@ -19,8 +21,23 @@
       ]
     }
   ],
-  "date": "2016-08-01",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "argonaut-dq-dstu2",
+      "uri": "http://unknown.org/Argonaut DQ DSTU2",
+      "name": "Argonaut DQ DSTU2"
+    },
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -35,6 +52,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -50,7 +72,7 @@
         "sliceName": "USCoreSmookingStatus",
         "short": "US Core Smoking Status Observation Profile",
         "definition": "The US Core Smoking Status Observation Profile is based upon the core FHIR Observation Resource and created to meet the 2015 Edition Common Clinical Data Set 'Smoking status' requirements.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -116,12 +138,19 @@
           }
         ],
         "mustSupport": false,
-        "isSummary": false,
         "mapping": [
           {
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -133,6 +162,10 @@
           {
             "identity": "w5",
             "map": "clinical.diagnostics"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Observation"
           }
         ]
       },
@@ -141,7 +174,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -180,7 +213,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -201,7 +234,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -221,6 +254,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -235,7 +276,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -269,7 +310,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -299,7 +340,7 @@
         "path": "Observation.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -328,7 +369,7 @@
         "path": "Observation.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -356,8 +397,8 @@
       {
         "id": "Observation:uscoresmookingstatus.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -371,7 +412,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -386,6 +432,68 @@
           }
         ]
       },
+      {
+        "id": "Observation:uscoresmookingstatus.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "Observation.basedOn",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:uscoresmookingstatus.status",
         "extension": [
@@ -397,6 +505,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -412,7 +521,7 @@
         ],
         "mustSupport": true,
         "isModifier": true,
-        "isSummary": false,
+        "isSummary": true,
         "binding": {
           "strength": "required",
           "valueSetReference": {
@@ -420,6 +529,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -431,6 +548,10 @@
           {
             "identity": "w5",
             "map": "status"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Observation.status"
           }
         ]
       },
@@ -439,8 +560,8 @@
         "path": "Observation.category",
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 0,
         "max": "*",
         "base": {
@@ -454,8 +575,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -477,6 +604,9 @@
         "short": "Smoking Status: LOINC 72166-2  = Tobacco smoking status NHIS",
         "definition": "Smoking Status: Limited to fixed LOINC  value 72166-2  = Tobacco smoking status NHIS.",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "base": {
@@ -498,8 +628,14 @@
           ]
         },
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -507,6 +643,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -515,9 +659,17 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Observation.code"
           }
         ]
       },
@@ -526,7 +678,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.  If the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -542,8 +694,12 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -555,19 +711,27 @@
           {
             "identity": "w5",
             "map": "who.focus"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Observation.subject"
           }
         ]
       },
       {
-        "id": "Observation:uscoresmookingstatus.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:uscoresmookingstatus.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "base": {
-          "path": "Observation.encounter",
+          "path": "Observation.context",
           "min": 0,
           "max": "1"
         },
@@ -575,9 +739,17 @@
           {
             "code": "Reference",
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -597,8 +769,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "base": {
@@ -616,6 +791,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -635,7 +814,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "base": {
@@ -649,7 +828,7 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -662,6 +841,10 @@
           {
             "identity": "w5",
             "map": "when.recorded"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Observation.issued"
           }
         ]
       },
@@ -698,6 +881,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -717,8 +904,8 @@
         "path": "Observation.valueCodeableConcept",
         "short": "Coded Responses from Smoking Status Value Set",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).   If the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 1,
         "max": "1",
         "base": {
@@ -735,15 +922,31 @@
           "obs-7"
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "binding": {
-          "strength": "required",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
+              "valueReference": {
+                "reference": "http://hl7.org/fhir/us/core/ValueSet/us-core-observation-ccdasmokingstatus"
+              }
+            }
+          ],
+          "strength": "extensible",
           "description": "This value set indicates the current smoking status of a patient",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/us/core/ValueSet/us-core-observation-ccdasmokingstatus"
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -751,6 +954,14 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
+          },
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Observation.valueCodeableConcept"
           }
         ]
       },
@@ -759,7 +970,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -777,6 +988,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -784,6 +1001,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -816,6 +1037,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -823,6 +1050,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -830,6 +1061,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -852,6 +1087,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -867,8 +1106,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "base": {
@@ -882,6 +1120,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -889,6 +1133,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -896,6 +1144,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -904,7 +1156,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -919,6 +1171,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -941,7 +1199,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "base": {
@@ -956,6 +1214,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -963,6 +1225,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -971,7 +1237,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "base": {
@@ -990,6 +1256,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -997,6 +1267,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1005,7 +1279,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1079,7 +1353,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1108,7 +1382,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1200,16 +1474,63 @@
         ]
       },
       {
-        "id": "Observation:uscoresmookingstatus.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:uscoresmookingstatus.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Observation.referenceRange.type",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
+          "description": "Code for the meaning of a reference range.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:uscoresmookingstatus.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
         "min": 0,
         "max": "*",
         "base": {
-          "path": "Observation.referenceRange.meaning",
+          "path": "Observation.referenceRange.appliesTo",
           "min": 0,
           "max": "*"
         },
@@ -1219,16 +1540,26 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
           "strength": "example",
-          "description": "Code for the meaning of a reference range.",
+          "description": "Codes identifying the population the reference range applies to.",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1294,8 +1625,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "base": {
@@ -1362,7 +1693,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1391,7 +1722,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1423,7 +1754,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1438,6 +1769,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1493,7 +1830,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1561,7 +1898,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1590,7 +1927,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1637,6 +1974,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1644,6 +1987,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1663,8 +2010,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "base": {
@@ -1706,6 +2053,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1713,6 +2064,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1721,7 +2076,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1739,6 +2094,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1761,7 +2122,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1779,6 +2140,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1786,6 +2153,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1793,6 +2164,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1801,7 +2176,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1837,7 +2212,12 @@
         ],
         "mustSupport": false,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Observation"
+          }
+        ]
       },
       {
         "id": "Observation:uscoresmookingstatus.status",
@@ -1846,13 +2226,18 @@
         "max": "1",
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false,
         "binding": {
           "strength": "required",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-status"
           }
-        }
+        },
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Observation.status"
+          }
+        ]
       },
       {
         "id": "Observation:uscoresmookingstatus.code",
@@ -1876,7 +2261,12 @@
         },
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Observation.code"
+          }
+        ]
       },
       {
         "id": "Observation:uscoresmookingstatus.subject",
@@ -1891,7 +2281,12 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Observation.subject"
+          }
+        ]
       },
       {
         "id": "Observation:uscoresmookingstatus.issued",
@@ -1900,7 +2295,12 @@
         "max": "1",
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Observation.issued"
+          }
+        ]
       },
       {
         "id": "Observation:uscoresmookingstatus.valueCodeableConcept",
@@ -1915,15 +2315,28 @@
         ],
         "mustSupport": true,
         "isModifier": false,
-        "isSummary": false,
         "binding": {
-          "strength": "required",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
+              "valueReference": {
+                "reference": "http://hl7.org/fhir/us/core/ValueSet/us-core-observation-ccdasmokingstatus"
+              }
+            }
+          ],
+          "strength": "extensible",
           "description": "This value set indicates the current smoking status of a patient",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/us/core/ValueSet/us-core-observation-ccdasmokingstatus"
           }
-        }
+        },
+        "mapping": [
+          {
+            "identity": "argonaut-dq-dstu2",
+            "map": "Observation.valueCodeableConcept"
+          }
+        ]
       }
     ]
   }
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/StructureDefinition-us-core-vitalsigns.json b/lib/resources/us_core/StructureDefinition-us-core-vitalsigns.json
old mode 100755
new mode 100644
index c41d895..b2c8ee6
--- a/lib/resources/us_core/StructureDefinition-us-core-vitalsigns.json
+++ b/lib/resources/us_core/StructureDefinition-us-core-vitalsigns.json
@@ -1,26 +1,46 @@
 {
   "resourceType": "StructureDefinition",
-  "id": "us-core-vitalsigns",
+  "id": "vitalsigns",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-vitalsigns\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-vitalsigns</a></p><p><b>name</b>: US Core Vital Signs Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: Health Level Seven International (FHIR-Infrastructure)</p><p><b>contact</b>: </p><p><b>url</b>: <a href=\"http://hl7.org/fhir/us/core/StructureDefinition/us-core-vitalsigns\">http://hl7.org/fhir/us/core/StructureDefinition/us-core-vitalsigns</a></p><p><b>name</b>: US Core Vital Signs Profile</p><p><b>status</b>: DRAFT</p><p><b>publisher</b>: Health Level Seven International (FHIR-Infrastructure)</p><p><b>contact</b>: </p><p><b>date</b>: 01/08/2016</p><blockquote><p><b>mapping</b></p><p><b>identity</b>: v2</p><p><b>uri</b>: <a href=\"http://hl7.org/v2\">http://hl7.org/v2</a></p><p><b>name</b>: HL7 v2 Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: rim</p><p><b>uri</b>: <a href=\"http://hl7.org/v3\">http://hl7.org/v3</a></p><p><b>name</b>: RIM Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: w5</p><p><b>uri</b>: <a href=\"http://hl7.org/fhir/w5\">http://hl7.org/fhir/w5</a></p><p><b>name</b>: W5 Mapping</p></blockquote><p><b>kind</b>: RESOURCE</p><p><b>abstract</b>: false</p><p><b>type</b>: Observation</p><p><b>baseDefinition</b>: <a href=\"http://hl7.org/fhir/StructureDefinition/Observation\">http://hl7.org/fhir/StructureDefinition/Observation</a></p><p><b>derivation</b>: CONSTRAINT</p><h3>Snapshots</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table><h3>Differentials</h3><table class=\"grid\"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table></div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">to do</div>"
   },
-  "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-vitalsigns",
-  "name": "US Core Vital Signs Profile",
+  "extension": [
+    {
+      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-summary",
+      "valueMarkdown": "### Complete Summary of the Mandatory Requirements\n\n1.  One status in `Observation.status`which has a [required](http://hl7.org/fhir/terminologies.html#extensible) binding to:\n    -    [ObservationStatus] value set.\n1.  A category in `Observation.category` which must have:\n    -   a fixed `Observation.category.coding.system`=\"http://hl7.org/fhir/observation-category\"\n    -   a fixed `Observation.category.coding.code`= \"vital-signs\"\n\n1.  A code in `Observation.code`\n    -   a fixed `Observation.code.coding.system`= \"http://loinc.org\"\n    -   a LOINC code in `Observation.code.coding.code` which has an [extensible](http://hl7.org/fhir/terminologies.html#extensible) binding to:\n         -   [Vital Signs] value set.\n                \n1.  One patient in `Observation.subject`\n1.  A date and time in `effectiveDateTime` or `effectivePeriod`\n1.  Either one `Observation.valueQuantity` or, if there is no value, one code in `Observation.DataAbsentReason`\n    -   Each Observation.valueQuantity must have:\n        -   One numeric value in `Observation.valueQuantity.value`\n        -   a fixed `Observation.valueQuantity.system`=\"http://unitsofmeasure\"\n        -   a UCUM unit code in `Observation.valueQuantity.code` which has an [required] binding to:\n             -   [Vital Signs Units] value set.\n    -   Observation.DataAbsentReason is bound to [Observation Value\n        Absent Reason] value set.\n\n1.  When using a panel code to group component observations (Note: See\n    the comments regarding blood pressure in the table above), one or\n    more `Observation.component.code` each of which must have:\n    -   a fixed\n        `Observation.component.code.coding.system` =\"<http://loinc.org>\"\n         -   a LOINC code in `Observation.code.coding.code` which has an [extensible] binding to:\n             -   [Vital Signs Units] value set.\n\n1.  Either one `Observation.component.valueQuantity` or, if there is\n    no value, one code in `Observation.component.DataAbsentReason`\n    -   Each Observation.component.valueQuantity must have:\n        -   One numeric value in\n            `Observation.component.valueQuantity.value`\n        -   a fixed `Observation.component.valueQuantity.system`= \"<http://unitsofmeasure.org>\"\n        -   a UCUM unit code in\n            `Observation.component.valueQuantity.code` which has an [required] binding to:\n             -   [Vital Signs Units] value set.\n    -   Observation.component.DataAbsentReason is bound to [Observation\n        Value Absent Reason] value set.\n\n1.  When using a panel code to group observations, one or more reference\n    to Vitals Signs Observations in `Observation.related.target`\n    -   a fixed `Observation.related.type`= \"has-member\"\n\n [Vital Signs]: valueset-observation-vitalsignresult.html\n  [Vital Signs Units]: valueset-ucum-vitals-common.html\n  [extensible]: terminologies.html#extensible\n  [ObservationStatus]: valueset-observation-status.html\n [Observation Value Absent Reason]: valueset-observation-valueabsentreason.html\n[required]: terminologies.html#required"
+    }
+  ],
+  "url": "http://hl7.org/fhir/StructureDefinition/vitalsigns",
+  "name": "Vital Signs Profile",
+  "title": "VitalSigns",
   "status": "draft",
-  "publisher": "Health Level Seven International (FHIR-Infrastructure)",
+  "experimental": false,
+  "date": "2016-03-25",
+  "publisher": "Health Level Seven International (Orders and Observations Workgroup)",
   "contact": [
     {
       "telecom": [
         {
           "system": "url",
-          "value": "http://www.healthit.gov"
+          "value": "http://www.hl7.org/Special/committees/orders/index.cfm Orders and Observations"
         }
       ]
     }
   ],
-  "date": "2016-08-01",
+  "description": "FHIR Vital Signs Profile",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -35,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -45,12 +70,11 @@
   "snapshot": {
     "element": [
       {
-        "id": "Observation:uscorevitalsigns",
+        "id": "Observation:vitalsignsprofile",
         "path": "Observation",
-        "sliceName": "USCoreVitalSigns",
-        "short": "US Core Vital Signs Profile",
-        "definition": "The US Core Vital Signs Profile is based upon the core FHIR Observation Resource and created to meet the 2015 Edition Common Clinical Data Set 'Vital Signs' requirements.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "short": "FHIR Vital Signs Profile",
+        "definition": "The FHIR Vitals Signs profile sets a minimum expectations for the Observation Resource to record, search and fetch the vital signs associated with a patient.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -114,20 +138,26 @@
             "source": "Observation"
           },
           {
-            "key": "us-core-2",
+            "key": "vs-2",
             "severity": "error",
             "human": "If there is no component or related element then either a value[x] or a data absent reason must be present",
-            "expression": "component.value.exists() or dataAbsentReason.exists()",
-            "xpath": "exists(f:component) or exists(f:related) or exists(f:*[starts-with(local-name(.), 'value)]) or exists(f:dataAbsentReason)"
+            "expression": "(component.empty() and related.empty()) implies (dataAbsentReason or value)",
+            "xpath": "exists(f:component) or exists(f:related) or exists(f:*[starts-with(local-name(.), 'value')]) or exists(f:dataAbsentReason)"
           }
         ],
-        "mustSupport": false,
-        "isSummary": false,
         "mapping": [
           {
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -143,11 +173,11 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.id",
+        "id": "Observation:vitalsignsprofile.id",
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -163,7 +193,7 @@
         "isSummary": true
       },
       {
-        "id": "Observation:uscorevitalsigns.meta",
+        "id": "Observation:vitalsignsprofile.meta",
         "path": "Observation.meta",
         "short": "Metadata about the resource",
         "definition": "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.",
@@ -182,11 +212,11 @@
         "isSummary": true
       },
       {
-        "id": "Observation:uscorevitalsigns.implicitRules",
+        "id": "Observation:vitalsignsprofile.implicitRules",
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -203,11 +233,11 @@
         "isSummary": true
       },
       {
-        "id": "Observation:uscorevitalsigns.language",
+        "id": "Observation:vitalsignsprofile.language",
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -227,6 +257,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -237,11 +275,11 @@
         }
       },
       {
-        "id": "Observation:uscorevitalsigns.text",
+        "id": "Observation:vitalsignsprofile.text",
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -271,11 +309,11 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.contained",
+        "id": "Observation:vitalsignsprofile.contained",
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -301,11 +339,11 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.extension",
+        "id": "Observation:vitalsignsprofile.extension",
         "path": "Observation.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -330,11 +368,11 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.modifierExtension",
+        "id": "Observation:vitalsignsprofile.modifierExtension",
         "path": "Observation.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -360,10 +398,10 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.identifier",
+        "id": "Observation:vitalsignsprofile.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -377,7 +415,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -393,7 +436,69 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.status",
+        "id": "Observation:vitalsignsprofile.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "Observation.basedOn",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
+      {
+        "id": "Observation:vitalsignsprofile.status",
         "extension": [
           {
             "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint",
@@ -403,6 +508,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -418,14 +524,28 @@
         ],
         "mustSupport": true,
         "isModifier": true,
-        "isSummary": false,
+        "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Status"
+            }
+          ],
           "strength": "required",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-status"
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -441,14 +561,14 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.category",
+        "id": "Observation:vitalsignsprofile.category",
         "path": "Observation.category",
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 1,
-        "max": "1",
+        "max": "*",
         "base": {
           "path": "Observation.category",
           "min": 0,
@@ -459,19 +579,25 @@
             "code": "CodeableConcept"
           }
         ],
-        "patternCodeableConcept": {
-          "coding": [
-            {
-              "system": "http://hl7.org/fhir/observation-category",
-              "code": "vital-signs"
-            }
-          ]
-        },
+        "constraint": [
+          {
+            "key": "vs-4",
+            "severity": "error",
+            "human": "Must have a category of 'vital-signs' and a code system 'http://hl7.org/fhir/observation-category'",
+            "expression": "where(coding.system='http://hl7.org/fhir/observation-category' and coding.code='vital-signs').exists()",
+            "xpath": "exists(f:coding/code[@value='vital-signs']) and exists(f:coding/system[@value='http://hl7.org/fhir/observation-category'])"
+          }
+        ],
         "mustSupport": true,
-        "isSummary": false,
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -488,11 +614,14 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.code",
+        "id": "Observation:vitalsignsprofile.code",
         "path": "Observation.code",
         "short": "Coded Responses from C-CDA Vital Sign Results",
-        "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
+        "definition": "Coded Responses from C-CDA Vital Sign Results.",
         "requirements": "5. SHALL contain exactly one [1..1] code, where the @code SHOULD be selected from ValueSet HITSP Vital Sign Result Type 2.16.840.1.113883.3.88.12.80.62 DYNAMIC (CONF:7301).",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "base": {
@@ -506,15 +635,29 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "VitalSigns"
+            }
+          ],
           "strength": "extensible",
           "description": "This identifies the vital sign result type.",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/us/core/ValueSet/us-core-observation-ccdavitalsignresult"
+            "reference": "http://hl7.org/fhir/ValueSet/observation-vitalsignresult"
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -523,6 +666,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -530,11 +677,11 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.subject",
+        "id": "Observation:vitalsignsprofile.subject",
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.  If the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -546,12 +693,16 @@
         "type": [
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient"
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -567,15 +718,19 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:vitalsignsprofile.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "base": {
-          "path": "Observation.encounter",
+          "path": "Observation.context",
           "min": 0,
           "max": "1"
         },
@@ -583,9 +738,17 @@
           {
             "code": "Reference",
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -601,12 +764,15 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.effective[x]",
+        "id": "Observation:vitalsignsprofile.effective[x]",
         "path": "Observation.effective[x]",
         "short": "Often just a dateTime for Vital Signs",
-        "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "definition": "Often just a dateTime for Vital Signs.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 1,
         "max": "1",
         "base": {
@@ -624,16 +790,20 @@
         ],
         "constraint": [
           {
-            "key": "us-core-1",
+            "key": "vs-1",
             "severity": "error",
             "human": "Datetime must be at least to day.",
-            "expression": "length() >= 8",
+            "expression": "($this as dateTime).toString().length() >= 8",
             "xpath": "f:matches(effectiveDateTime,/\\d{4}-[01]\\d-[0-3]\\dT[0-2]\\d:[0-5]\\d([+-][0-2]\\d:[0-5]\\d|Z)/)"
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -649,11 +819,11 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.issued",
+        "id": "Observation:vitalsignsprofile.issued",
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 0,
         "max": "1",
         "base": {
@@ -683,7 +853,7 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.performer",
+        "id": "Observation:vitalsignsprofile.performer",
         "path": "Observation.performer",
         "short": "Who is responsible for the observation",
         "definition": "Who was responsible for asserting the observed value as \"true\".",
@@ -715,6 +885,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -730,11 +904,11 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.valueQuantity",
+        "id": "Observation:vitalsignsprofile.valueQuantity",
         "path": "Observation.valueQuantity",
         "short": "Vital Sign Value recorded with UCUM",
-        "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).   If the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
+        "definition": "Vital Sign Value recorded with UCUM.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
         "requirements": "9. SHALL contain exactly one [1..1] value with @xsi:type=\"PQ\" (CONF:7305).",
         "min": 0,
         "max": "1",
@@ -752,15 +926,29 @@
           "obs-7"
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "binding": {
-          "strength": "extensible",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "VitalSignsUnits"
+            }
+          ],
+          "strength": "required",
           "description": "Common UCUM units for recording Vital Signs",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/ucum-vitals-common"
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -768,11 +956,15 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.valueQuantity.id",
+        "id": "Observation:vitalsignsprofile.valueQuantity.id",
         "path": "Observation.valueQuantity.id",
         "representation": [
           "xmlAttr"
@@ -799,11 +991,21 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.valueQuantity.extension",
+        "id": "Observation:vitalsignsprofile.valueQuantity.extension",
         "path": "Observation.valueQuantity.extension",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -828,11 +1030,11 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.valueQuantity.value",
+        "id": "Observation:vitalsignsprofile.valueQuantity.value",
         "path": "Observation.valueQuantity.value",
         "short": "Numerical value (with implicit precision)",
         "definition": "The value of the measured amount. The value includes an implicit precision in the presentation of the value.",
-        "comments": "The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).",
+        "comment": "The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).",
         "requirements": "Precision is handled implicitly in almost all cases of measurement.",
         "min": 1,
         "max": "1",
@@ -847,7 +1049,7 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -860,11 +1062,11 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.valueQuantity.comparator",
+        "id": "Observation:vitalsignsprofile.valueQuantity.comparator",
         "path": "Observation.valueQuantity.comparator",
         "short": "< | <= | >= | > - how to understand the value",
         "definition": "How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is \"<\" , then the real value is < stated value.",
-        "comments": "This is labeled as \"Is Modifier\" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value.",
+        "comment": "This is labeled as \"Is Modifier\" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value.",
         "requirements": "Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.",
         "min": 0,
         "max": "1",
@@ -882,6 +1084,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "QuantityComparator"
+            }
+          ],
           "strength": "required",
           "description": "How the Quantity should be understood and represented.",
           "valueSetReference": {
@@ -900,7 +1108,13 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.valueQuantity.unit",
+        "id": "Observation:vitalsignsprofile.valueQuantity.unit",
+        "extension": [
+          {
+            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
+            "valueBoolean": true
+          }
+        ],
         "path": "Observation.valueQuantity.unit",
         "short": "Unit representation",
         "definition": "A human-readable form of the unit.",
@@ -918,7 +1132,7 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -931,7 +1145,7 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.valueQuantity.system",
+        "id": "Observation:vitalsignsprofile.valueQuantity.system",
         "path": "Observation.valueQuantity.system",
         "short": "System that defines coded unit form",
         "definition": "The identification of the system that provides the coded form of the unit.",
@@ -953,7 +1167,7 @@
           "qty-3"
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -966,11 +1180,11 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.valueQuantity.code",
+        "id": "Observation:vitalsignsprofile.valueQuantity.code",
         "path": "Observation.valueQuantity.code",
         "short": "Coded responses from the common UCUM units for vital signs value set.",
-        "definition": "A computer processable form of the unit in some unit representation system.",
-        "comments": "The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency.  The context of use may additionally require a code from a particular system.",
+        "definition": "Coded responses from the common UCUM units for vital signs value set.",
+        "comment": "The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency.  The context of use may additionally require a code from a particular system.",
         "requirements": "Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.",
         "min": 1,
         "max": "1",
@@ -985,7 +1199,7 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -998,11 +1212,11 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.dataAbsentReason",
+        "id": "Observation:vitalsignsprofile.dataAbsentReason",
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1020,14 +1234,23 @@
           "obs-6"
         ],
         "mustSupport": true,
-        "isSummary": false,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "DAR"
+            }
+          ],
           "strength": "extensible",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-valueabsentreason"
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -1039,7 +1262,7 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.interpretation",
+        "id": "Observation:vitalsignsprofile.interpretation",
         "path": "Observation.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
@@ -1060,6 +1283,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1067,6 +1296,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1074,11 +1307,15 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.comment",
+        "id": "Observation:vitalsignsprofile.comment",
         "path": "Observation.comment",
         "short": "Comments about result",
         "definition": "May include statements about significant, unexpected or unreliable values, or information about the source of the value where this may be relevant to the interpretation of the result.",
@@ -1096,6 +1333,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -1107,12 +1348,11 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.bodySite",
+        "id": "Observation:vitalsignsprofile.bodySite",
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "base": {
@@ -1126,6 +1366,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -1133,6 +1379,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -1140,15 +1390,19 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.method",
+        "id": "Observation:vitalsignsprofile.method",
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1163,6 +1417,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1181,11 +1441,11 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.specimen",
+        "id": "Observation:vitalsignsprofile.specimen",
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "base": {
@@ -1200,6 +1460,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1207,15 +1471,19 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.device",
+        "id": "Observation:vitalsignsprofile.device",
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "base": {
@@ -1234,6 +1502,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1241,15 +1513,19 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.referenceRange",
+        "id": "Observation:vitalsignsprofile.referenceRange",
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1292,7 +1568,7 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.referenceRange.id",
+        "id": "Observation:vitalsignsprofile.referenceRange.id",
         "path": "Observation.referenceRange.id",
         "representation": [
           "xmlAttr"
@@ -1319,11 +1595,11 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.referenceRange.extension",
+        "id": "Observation:vitalsignsprofile.referenceRange.extension",
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1348,11 +1624,11 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.referenceRange.modifierExtension",
+        "id": "Observation:vitalsignsprofile.referenceRange.modifierExtension",
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1380,7 +1656,7 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.referenceRange.low",
+        "id": "Observation:vitalsignsprofile.referenceRange.low",
         "path": "Observation.referenceRange.low",
         "short": "Low Range, if relevant",
         "definition": "The value of the low bound of the reference range.  The low bound of the reference range endpoint is inclusive of the value (e.g.  reference range is >=5 - <=9).   If the low bound is omitted,  it is assumed to be meaningless (e.g. reference range is <=2.3).",
@@ -1412,7 +1688,7 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.referenceRange.high",
+        "id": "Observation:vitalsignsprofile.referenceRange.high",
         "path": "Observation.referenceRange.high",
         "short": "High Range, if relevant",
         "definition": "The value of the high bound of the reference range.  The high bound of the reference range endpoint is inclusive of the value (e.g.  reference range is >=5 - <=9).   If the high bound is omitted,  it is assumed to be meaningless (e.g. reference range is >= 2.3).",
@@ -1444,16 +1720,63 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:vitalsignsprofile.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Observation.referenceRange.type",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
+          "description": "Code for the meaning of a reference range.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:vitalsignsprofile.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
         "min": 0,
         "max": "*",
         "base": {
-          "path": "Observation.referenceRange.meaning",
+          "path": "Observation.referenceRange.appliesTo",
           "min": 0,
           "max": "*"
         },
@@ -1463,16 +1786,26 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
           "strength": "example",
-          "description": "Code for the meaning of a reference range.",
+          "description": "Codes identifying the population the reference range applies to.",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1481,7 +1814,7 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.referenceRange.age",
+        "id": "Observation:vitalsignsprofile.referenceRange.age",
         "path": "Observation.referenceRange.age",
         "short": "Applicable age range, if relevant",
         "definition": "The age at which this reference range is applicable. This is a neonatal age (e.g. number of weeks at term) if the meaning says so.",
@@ -1506,7 +1839,7 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.referenceRange.text",
+        "id": "Observation:vitalsignsprofile.referenceRange.text",
         "path": "Observation.referenceRange.text",
         "short": "Text based reference range in an observation",
         "definition": "Text based reference range in an observation which may be used when a quantitative range is not appropriate for an observation.  An example would be a reference value of \"Negative\" or a list or table of 'normals'.",
@@ -1534,14 +1867,14 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.related",
+        "id": "Observation:vitalsignsprofile.related",
         "path": "Observation.related",
-        "short": "Used when reporting systolic and diastolic blood pressure.",
-        "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "short": "Used when reporting vital signs panel components",
+        "definition": "Used when reporting vital signs panel components.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
-        "max": "1",
+        "max": "*",
         "base": {
           "path": "Observation.related",
           "min": 0,
@@ -1563,7 +1896,7 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -1576,7 +1909,7 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.related.id",
+        "id": "Observation:vitalsignsprofile.related.id",
         "path": "Observation.related.id",
         "representation": [
           "xmlAttr"
@@ -1603,11 +1936,11 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.related.extension",
+        "id": "Observation:vitalsignsprofile.related.extension",
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1632,11 +1965,11 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.related.modifierExtension",
+        "id": "Observation:vitalsignsprofile.related.modifierExtension",
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1664,11 +1997,11 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.related.type",
+        "id": "Observation:vitalsignsprofile.related.type",
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 1,
         "max": "1",
@@ -1684,8 +2017,13 @@
         ],
         "fixedCode": "has-member",
         "mustSupport": true,
-        "isSummary": false,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1704,7 +2042,7 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.related.target",
+        "id": "Observation:vitalsignsprofile.related.target",
         "path": "Observation.related.target",
         "short": "Resource that is related to this one",
         "definition": "A reference to the observation or [QuestionnaireResponse](questionnaireresponse.html#) resource that is related to this observation.",
@@ -1718,11 +2056,10 @@
         "type": [
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-vitalsigns"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/vitalsigns"
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
         "mapping": [
           {
             "identity": "rim",
@@ -1731,14 +2068,14 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.component",
+        "id": "Observation:vitalsignsprofile.component",
         "path": "Observation.component",
         "short": "Used when reporting systolic and diastolic blood pressure.",
-        "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "definition": "Used when reporting systolic and diastolic blood pressure.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
-        "max": "1",
+        "max": "*",
         "base": {
           "path": "Observation.component",
           "min": 0,
@@ -1759,15 +2096,15 @@
             "source": "Element"
           },
           {
-            "key": "us-core-3",
+            "key": "vs-3",
             "severity": "error",
             "human": "If there is no a value a data absent reason must be present",
             "expression": "value.exists() or dataAbsentReason.exists()",
-            "xpath": "exists(f:*[starts-with(local-name(.), 'value)]) or exists(f:dataAbsentReason)"
+            "xpath": "exists(f:*[starts-with(local-name(.), 'value')]) or exists(f:dataAbsentReason)"
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -1780,7 +2117,7 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.component.id",
+        "id": "Observation:vitalsignsprofile.component.id",
         "path": "Observation.component.id",
         "representation": [
           "xmlAttr"
@@ -1807,11 +2144,11 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.component.extension",
+        "id": "Observation:vitalsignsprofile.component.extension",
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1836,11 +2173,11 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.component.modifierExtension",
+        "id": "Observation:vitalsignsprofile.component.modifierExtension",
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1868,7 +2205,7 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.component.code",
+        "id": "Observation:vitalsignsprofile.component.code",
         "path": "Observation.component.code",
         "short": "Type of component observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"code\".",
@@ -1886,15 +2223,25 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "VitalSigns"
+            }
+          ],
           "strength": "extensible",
           "description": "This identifies the vital sign result type.",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/us/core/ValueSet/us-core-observation-ccdavitalsignresult"
+            "reference": "http://hl7.org/fhir/ValueSet/observation-vitalsignresult"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1910,11 +2257,11 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.component.valueQuantity",
+        "id": "Observation:vitalsignsprofile.component.valueQuantity",
         "path": "Observation.component.valueQuantity",
         "short": "Vital Sign Value recorded with UCUM",
-        "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "definition": "Vital Sign Value recorded with UCUM.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
         "requirements": "9. SHALL contain exactly one [1..1] value with @xsi:type=\"PQ\" (CONF:7305).",
         "min": 0,
         "max": "1",
@@ -1929,15 +2276,25 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "binding": {
-          "strength": "extensible",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "VitalSignsUnits"
+            }
+          ],
+          "strength": "required",
           "description": "Common UCUM units for recording Vital Signs",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/ucum-vitals-common"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1945,11 +2302,15 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.component.valueQuantity.id",
+        "id": "Observation:vitalsignsprofile.component.valueQuantity.id",
         "path": "Observation.component.valueQuantity.id",
         "representation": [
           "xmlAttr"
@@ -1976,11 +2337,21 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.component.valueQuantity.extension",
+        "id": "Observation:vitalsignsprofile.component.valueQuantity.extension",
         "path": "Observation.component.valueQuantity.extension",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -2005,11 +2376,11 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.component.valueQuantity.value",
+        "id": "Observation:vitalsignsprofile.component.valueQuantity.value",
         "path": "Observation.component.valueQuantity.value",
         "short": "Numerical value (with implicit precision)",
         "definition": "The value of the measured amount. The value includes an implicit precision in the presentation of the value.",
-        "comments": "The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).",
+        "comment": "The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).",
         "requirements": "Precision is handled implicitly in almost all cases of measurement.",
         "min": 1,
         "max": "1",
@@ -2024,7 +2395,7 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -2037,11 +2408,11 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.component.valueQuantity.comparator",
+        "id": "Observation:vitalsignsprofile.component.valueQuantity.comparator",
         "path": "Observation.component.valueQuantity.comparator",
         "short": "< | <= | >= | > - how to understand the value",
         "definition": "How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is \"<\" , then the real value is < stated value.",
-        "comments": "This is labeled as \"Is Modifier\" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value.",
+        "comment": "This is labeled as \"Is Modifier\" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value.",
         "requirements": "Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.",
         "min": 0,
         "max": "1",
@@ -2059,6 +2430,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "QuantityComparator"
+            }
+          ],
           "strength": "required",
           "description": "How the Quantity should be understood and represented.",
           "valueSetReference": {
@@ -2077,7 +2454,13 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.component.valueQuantity.unit",
+        "id": "Observation:vitalsignsprofile.component.valueQuantity.unit",
+        "extension": [
+          {
+            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
+            "valueBoolean": true
+          }
+        ],
         "path": "Observation.component.valueQuantity.unit",
         "short": "Unit representation",
         "definition": "A human-readable form of the unit.",
@@ -2095,7 +2478,7 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -2108,7 +2491,7 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.component.valueQuantity.system",
+        "id": "Observation:vitalsignsprofile.component.valueQuantity.system",
         "path": "Observation.component.valueQuantity.system",
         "short": "System that defines coded unit form",
         "definition": "The identification of the system that provides the coded form of the unit.",
@@ -2130,7 +2513,7 @@
           "qty-3"
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -2143,11 +2526,11 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.component.valueQuantity.code",
+        "id": "Observation:vitalsignsprofile.component.valueQuantity.code",
         "path": "Observation.component.valueQuantity.code",
         "short": "Coded responses from the common UCUM units for vital signs value set.",
-        "definition": "A computer processable form of the unit in some unit representation system.",
-        "comments": "The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency.  The context of use may additionally require a code from a particular system.",
+        "definition": "Coded responses from the common UCUM units for vital signs value set.",
+        "comment": "The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency.  The context of use may additionally require a code from a particular system.",
         "requirements": "Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.",
         "min": 1,
         "max": "1",
@@ -2162,7 +2545,7 @@
           }
         ],
         "mustSupport": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -2175,11 +2558,11 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.component.dataAbsentReason",
+        "id": "Observation:vitalsignsprofile.component.dataAbsentReason",
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -2197,8 +2580,13 @@
           "obs-6"
         ],
         "mustSupport": true,
-        "isSummary": false,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "DAR"
+            }
+          ],
           "strength": "extensible",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-valueabsentreason"
@@ -2216,11 +2604,11 @@
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.component.interpretation",
+        "id": "Observation:vitalsignsprofile.component.interpretation",
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -2238,6 +2626,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -2245,6 +2639,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -2252,15 +2650,19 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
       {
-        "id": "Observation:uscorevitalsigns.component.referenceRange",
+        "id": "Observation:vitalsignsprofile.component.referenceRange",
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -2269,7 +2671,7 @@
           "min": 0,
           "max": "*"
         },
-        "contentReference": "#Observation:uscorevitalsigns.referenceRange",
+        "contentReference": "#Observation:vitalsignsprofile.referenceRange",
         "mapping": [
           {
             "identity": "v2",
@@ -2286,32 +2688,30 @@
   "differential": {
     "element": [
       {
-        "id": "Observation:uscorevitalsigns",
+        "id": "Observation:vitalsignsprofile",
         "path": "Observation",
-        "sliceName": "USCoreVitalSigns",
-        "short": "US Core Vital Signs Profile",
-        "definition": "The US Core Vital Signs Profile is based upon the core FHIR Observation Resource and created to meet the 2015 Edition Common Clinical Data Set 'Vital Signs' requirements.",
+        "short": "FHIR Vital Signs Profile",
+        "definition": "The FHIR Vitals Signs profile sets a minimum expectations for the Observation Resource to record, search and fetch the vital signs associated with a patient.",
         "alias": [
           "Vital Signs",
           "Measurement",
           "Results",
           "Tests"
         ],
+        "min": 0,
+        "max": "*",
         "constraint": [
           {
-            "key": "us-core-2",
+            "key": "vs-2",
             "severity": "error",
             "human": "If there is no component or related element then either a value[x] or a data absent reason must be present",
-            "expression": "component.value.exists() or dataAbsentReason.exists()",
-            "xpath": "exists(f:component) or exists(f:related) or exists(f:*[starts-with(local-name(.), 'value)]) or exists(f:dataAbsentReason)"
+            "expression": "(component.empty() and related.empty()) implies (dataAbsentReason or value)",
+            "xpath": "exists(f:component) or exists(f:related) or exists(f:*[starts-with(local-name(.), 'value')]) or exists(f:dataAbsentReason)"
           }
-        ],
-        "mustSupport": false,
-        "isModifier": false,
-        "isSummary": false
+        ]
       },
       {
-        "id": "Observation:uscorevitalsigns.status",
+        "id": "Observation:vitalsignsprofile.status",
         "path": "Observation.status",
         "min": 1,
         "max": "1",
@@ -2321,9 +2721,13 @@
           }
         ],
         "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Status"
+            }
+          ],
           "strength": "required",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-status"
@@ -2331,31 +2735,34 @@
         }
       },
       {
-        "id": "Observation:uscorevitalsigns.category",
+        "id": "Observation:vitalsignsprofile.category",
         "path": "Observation.category",
         "min": 1,
-        "max": "1",
+        "max": "*",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
-        "patternCodeableConcept": {
-          "coding": [
-            {
-              "system": "http://hl7.org/fhir/observation-category",
-              "code": "vital-signs"
-            }
-          ]
-        },
-        "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false
+        "condition": [
+          "vs-4"
+        ],
+        "constraint": [
+          {
+            "key": "vs-4",
+            "severity": "error",
+            "human": "Must have a category of 'vital-signs' and a code system 'http://hl7.org/fhir/observation-category'",
+            "expression": "where(coding.system='http://hl7.org/fhir/observation-category' and coding.code='vital-signs').exists()",
+            "xpath": "exists(f:coding/code[@value='vital-signs']) and exists(f:coding/system[@value='http://hl7.org/fhir/observation-category'])"
+          }
+        ],
+        "mustSupport": true
       },
       {
-        "id": "Observation:uscorevitalsigns.code",
+        "id": "Observation:vitalsignsprofile.code",
         "path": "Observation.code",
         "short": "Coded Responses from C-CDA Vital Sign Results",
+        "definition": "Coded Responses from C-CDA Vital Sign Results.",
         "requirements": "5. SHALL contain exactly one [1..1] code, where the @code SHOULD be selected from ValueSet HITSP Vital Sign Result Type 2.16.840.1.113883.3.88.12.80.62 DYNAMIC (CONF:7301).",
         "min": 1,
         "max": "1",
@@ -2365,35 +2772,38 @@
           }
         ],
         "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "VitalSigns"
+            }
+          ],
           "strength": "extensible",
           "description": "This identifies the vital sign result type.",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/us/core/ValueSet/us-core-observation-ccdavitalsignresult"
+            "reference": "http://hl7.org/fhir/ValueSet/observation-vitalsignresult"
           }
         }
       },
       {
-        "id": "Observation:uscorevitalsigns.subject",
+        "id": "Observation:vitalsignsprofile.subject",
         "path": "Observation.subject",
         "min": 1,
         "max": "1",
         "type": [
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient"
           }
         ],
-        "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false
+        "mustSupport": true
       },
       {
-        "id": "Observation:uscorevitalsigns.effective[x]",
+        "id": "Observation:vitalsignsprofile.effective[x]",
         "path": "Observation.effective[x]",
         "short": "Often just a dateTime for Vital Signs",
+        "definition": "Often just a dateTime for Vital Signs.",
         "min": 1,
         "max": "1",
         "type": [
@@ -2404,23 +2814,25 @@
             "code": "Period"
           }
         ],
+        "condition": [
+          "vs-1"
+        ],
         "constraint": [
           {
-            "key": "us-core-1",
+            "key": "vs-1",
             "severity": "error",
             "human": "Datetime must be at least to day.",
-            "expression": "length() >= 8",
+            "expression": "($this as dateTime).toString().length() >= 8",
             "xpath": "f:matches(effectiveDateTime,/\\d{4}-[01]\\d-[0-3]\\dT[0-2]\\d:[0-5]\\d([+-][0-2]\\d:[0-5]\\d|Z)/)"
           }
         ],
-        "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false
+        "mustSupport": true
       },
       {
-        "id": "Observation:uscorevitalsigns.valueQuantity",
+        "id": "Observation:vitalsignsprofile.valueQuantity",
         "path": "Observation.valueQuantity",
         "short": "Vital Sign Value recorded with UCUM",
+        "definition": "Vital Sign Value recorded with UCUM.",
         "requirements": "9. SHALL contain exactly one [1..1] value with @xsi:type=\"PQ\" (CONF:7305).",
         "min": 0,
         "max": "1",
@@ -2429,11 +2841,18 @@
             "code": "Quantity"
           }
         ],
+        "condition": [
+          "vs-2"
+        ],
         "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false,
         "binding": {
-          "strength": "extensible",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "VitalSignsUnits"
+            }
+          ],
+          "strength": "required",
           "description": "Common UCUM units for recording Vital Signs",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/ucum-vitals-common"
@@ -2441,7 +2860,7 @@
         }
       },
       {
-        "id": "Observation:uscorevitalsigns.valueQuantity.value",
+        "id": "Observation:vitalsignsprofile.valueQuantity.value",
         "path": "Observation.valueQuantity.value",
         "min": 1,
         "max": "1",
@@ -2450,12 +2869,10 @@
             "code": "decimal"
           }
         ],
-        "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false
+        "mustSupport": true
       },
       {
-        "id": "Observation:uscorevitalsigns.valueQuantity.unit",
+        "id": "Observation:vitalsignsprofile.valueQuantity.unit",
         "path": "Observation.valueQuantity.unit",
         "min": 1,
         "max": "1",
@@ -2464,12 +2881,10 @@
             "code": "string"
           }
         ],
-        "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false
+        "mustSupport": true
       },
       {
-        "id": "Observation:uscorevitalsigns.valueQuantity.system",
+        "id": "Observation:vitalsignsprofile.valueQuantity.system",
         "path": "Observation.valueQuantity.system",
         "min": 1,
         "max": "1",
@@ -2479,14 +2894,13 @@
           }
         ],
         "fixedUri": "http://unitsofmeasure.org",
-        "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false
+        "mustSupport": true
       },
       {
-        "id": "Observation:uscorevitalsigns.valueQuantity.code",
+        "id": "Observation:vitalsignsprofile.valueQuantity.code",
         "path": "Observation.valueQuantity.code",
         "short": "Coded responses from the common UCUM units for vital signs value set.",
+        "definition": "Coded responses from the common UCUM units for vital signs value set.",
         "min": 1,
         "max": "1",
         "type": [
@@ -2494,12 +2908,10 @@
             "code": "code"
           }
         ],
-        "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false
+        "mustSupport": true
       },
       {
-        "id": "Observation:uscorevitalsigns.dataAbsentReason",
+        "id": "Observation:vitalsignsprofile.dataAbsentReason",
         "path": "Observation.dataAbsentReason",
         "min": 0,
         "max": "1",
@@ -2508,10 +2920,17 @@
             "code": "CodeableConcept"
           }
         ],
+        "condition": [
+          "vs-2"
+        ],
         "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "DAR"
+            }
+          ],
           "strength": "extensible",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-valueabsentreason"
@@ -2519,17 +2938,14 @@
         }
       },
       {
-        "id": "Observation:uscorevitalsigns.related",
+        "id": "Observation:vitalsignsprofile.related",
         "path": "Observation.related",
-        "short": "Used when reporting systolic and diastolic blood pressure.",
-        "min": 0,
-        "max": "1",
-        "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false
+        "short": "Used when reporting vital signs panel components",
+        "definition": "Used when reporting vital signs panel components.",
+        "mustSupport": true
       },
       {
-        "id": "Observation:uscorevitalsigns.related.type",
+        "id": "Observation:vitalsignsprofile.related.type",
         "path": "Observation.related.type",
         "min": 1,
         "max": "1",
@@ -2539,46 +2955,39 @@
           }
         ],
         "fixedCode": "has-member",
-        "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false
+        "mustSupport": true
       },
       {
-        "id": "Observation:uscorevitalsigns.related.target",
+        "id": "Observation:vitalsignsprofile.related.target",
         "path": "Observation.related.target",
         "min": 1,
         "max": "1",
         "type": [
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-vitalsigns"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/vitalsigns"
           }
         ],
-        "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false
+        "mustSupport": true
       },
       {
-        "id": "Observation:uscorevitalsigns.component",
+        "id": "Observation:vitalsignsprofile.component",
         "path": "Observation.component",
         "short": "Used when reporting systolic and diastolic blood pressure.",
-        "min": 0,
-        "max": "1",
+        "definition": "Used when reporting systolic and diastolic blood pressure.",
         "constraint": [
           {
-            "key": "us-core-3",
+            "key": "vs-3",
             "severity": "error",
             "human": "If there is no a value a data absent reason must be present",
             "expression": "value.exists() or dataAbsentReason.exists()",
-            "xpath": "exists(f:*[starts-with(local-name(.), 'value)]) or exists(f:dataAbsentReason)"
+            "xpath": "exists(f:*[starts-with(local-name(.), 'value')]) or exists(f:dataAbsentReason)"
           }
         ],
-        "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false
+        "mustSupport": true
       },
       {
-        "id": "Observation:uscorevitalsigns.component.code",
+        "id": "Observation:vitalsignsprofile.component.code",
         "path": "Observation.component.code",
         "min": 1,
         "max": "1",
@@ -2588,20 +2997,25 @@
           }
         ],
         "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "VitalSigns"
+            }
+          ],
           "strength": "extensible",
           "description": "This identifies the vital sign result type.",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/us/core/ValueSet/us-core-observation-ccdavitalsignresult"
+            "reference": "http://hl7.org/fhir/ValueSet/observation-vitalsignresult"
           }
         }
       },
       {
-        "id": "Observation:uscorevitalsigns.component.valueQuantity",
+        "id": "Observation:vitalsignsprofile.component.valueQuantity",
         "path": "Observation.component.valueQuantity",
         "short": "Vital Sign Value recorded with UCUM",
+        "definition": "Vital Sign Value recorded with UCUM.",
         "requirements": "9. SHALL contain exactly one [1..1] value with @xsi:type=\"PQ\" (CONF:7305).",
         "min": 0,
         "max": "1",
@@ -2610,11 +3024,18 @@
             "code": "Quantity"
           }
         ],
+        "condition": [
+          "vs-3"
+        ],
         "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false,
         "binding": {
-          "strength": "extensible",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "VitalSignsUnits"
+            }
+          ],
+          "strength": "required",
           "description": "Common UCUM units for recording Vital Signs",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/ucum-vitals-common"
@@ -2622,7 +3043,7 @@
         }
       },
       {
-        "id": "Observation:uscorevitalsigns.component.valueQuantity.value",
+        "id": "Observation:vitalsignsprofile.component.valueQuantity.value",
         "path": "Observation.component.valueQuantity.value",
         "min": 1,
         "max": "1",
@@ -2631,12 +3052,10 @@
             "code": "decimal"
           }
         ],
-        "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false
+        "mustSupport": true
       },
       {
-        "id": "Observation:uscorevitalsigns.component.valueQuantity.unit",
+        "id": "Observation:vitalsignsprofile.component.valueQuantity.unit",
         "path": "Observation.component.valueQuantity.unit",
         "min": 1,
         "max": "1",
@@ -2645,12 +3064,10 @@
             "code": "string"
           }
         ],
-        "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false
+        "mustSupport": true
       },
       {
-        "id": "Observation:uscorevitalsigns.component.valueQuantity.system",
+        "id": "Observation:vitalsignsprofile.component.valueQuantity.system",
         "path": "Observation.component.valueQuantity.system",
         "min": 1,
         "max": "1",
@@ -2660,14 +3077,13 @@
           }
         ],
         "fixedUri": "http://unitsofmeasure.org",
-        "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false
+        "mustSupport": true
       },
       {
-        "id": "Observation:uscorevitalsigns.component.valueQuantity.code",
+        "id": "Observation:vitalsignsprofile.component.valueQuantity.code",
         "path": "Observation.component.valueQuantity.code",
         "short": "Coded responses from the common UCUM units for vital signs value set.",
+        "definition": "Coded responses from the common UCUM units for vital signs value set.",
         "min": 1,
         "max": "1",
         "type": [
@@ -2675,12 +3091,10 @@
             "code": "code"
           }
         ],
-        "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false
+        "mustSupport": true
       },
       {
-        "id": "Observation:uscorevitalsigns.component.dataAbsentReason",
+        "id": "Observation:vitalsignsprofile.component.dataAbsentReason",
         "path": "Observation.component.dataAbsentReason",
         "min": 0,
         "max": "1",
@@ -2689,10 +3103,17 @@
             "code": "CodeableConcept"
           }
         ],
+        "condition": [
+          "vs-3"
+        ],
         "mustSupport": true,
-        "isModifier": false,
-        "isSummary": false,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "DAR"
+            }
+          ],
           "strength": "extensible",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-valueabsentreason"
diff --git a/lib/resources/us_core/ValueSet-detailed-ethnicity.json b/lib/resources/us_core/ValueSet-detailed-ethnicity.json
index f1090d2..81e0588 100755
--- a/lib/resources/us_core/ValueSet-detailed-ethnicity.json
+++ b/lib/resources/us_core/ValueSet-detailed-ethnicity.json
@@ -3,25 +3,31 @@
   "id": "detailed-ethnicity",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>US-Core Detailed ethnicity</h2><div><p>The 41 <a href=\"http://www.cdc.gov/phin/resources/vocabulary/index.html\">CDC ethnicity codes</a> that are grouped under one of the 2 OMB ethnicity category codes.</p>\n</div><p>This value set includes codes from the following code systems:</p><ul><li/><li>Import all the codes that are contained in <a href=\"http://hl7.org/fhir/2017Jan/v3/Ethnicity/vs.html\">http://hl7.org/fhir/ValueSet/v3-Ethnicity</a></li><li>Exclude these codes as defined in <a href=\"http://hl7.org/fhir/2017Jan/v3/Ethnicity/cs.html\">http://hl7.org/fhir/v3/Ethnicity</a><table class=\"none\"><tr><td><b>Code</b></td><td><b>Display</b></td></tr><tr><td>2135-2</td><td>Hispanic or Latino</td><td>Hispanic or Latino</td></tr><tr><td>2186-5</td><td>Not Hispanic or Latino</td><td>Note that this term remains in the table for completeness, even though within HL7, the notion of &quot;not otherwise coded&quot; term is deprecated.</td></tr></table></li></ul></div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>US-Core Detailed ethnicity</h2><div><p>The 41 <a href=\"http://www.cdc.gov/phin/resources/vocabulary/index.html\">CDC ethnicity codes</a> that are grouped under one of the 2 OMB ethnicity category codes.</p>\n</div><p>This value set includes codes from the following code systems:</p><ul><li>Include codes from <a href=\"CodeSystem-cdcrec.html\"><code>urn:oid:2.16.840.1.113883.6.238</code></a> where concept  is-a  <a href=\"CodeSystem-cdcrec.html#cdcrec-2133-7\">2133-7</a></li><li>Exclude these codes as defined in <a href=\"CodeSystem-cdcrec.html\"><code>urn:oid:2.16.840.1.113883.6.238</code></a><table class=\"none\"><tr><td><b>Code</b></td><td><b>Display</b></td></tr><tr><td><a href=\"CodeSystem-cdcrec.html#cdcrec-2135-2\">2135-2</a></td><td>Hispanic or Latino</td><td>Hispanic or Latino</td></tr><tr><td><a href=\"CodeSystem-cdcrec.html#cdcrec-2186-5\">2186-5</a></td><td>Not Hispanic or Latino</td><td>Note that this term remains in the table for completeness, even though within HL7, the notion of &quot;not otherwise coded&quot; term is deprecated.</td></tr></table></li></ul></div>"
   },
   "url": "http://hl7.org/fhir/us/core/ValueSet/detailed-ethnicity",
+  "version": "1.0.0",
   "name": "US-Core Detailed ethnicity",
   "status": "draft",
-  "publisher": "USRealm Task Force",
   "date": "2016-08-30",
+  "publisher": "HL7 US Realm Steering Committee",
   "description": "The 41 [CDC ethnicity codes](http://www.cdc.gov/phin/resources/vocabulary/index.html) that are grouped under one of the 2 OMB ethnicity category codes.",
   "compose": {
     "include": [
       {
-        "valueSet": [
-          "http://hl7.org/fhir/ValueSet/v3-Ethnicity"
+        "system": "urn:oid:2.16.840.1.113883.6.238",
+        "filter": [
+          {
+            "property": "concept",
+            "op": "is-a",
+            "value": "2133-7"
+          }
         ]
       }
     ],
     "exclude": [
       {
-        "system": "http://hl7.org/fhir/v3/Ethnicity",
+        "system": "urn:oid:2.16.840.1.113883.6.238",
         "concept": [
           {
             "code": "2135-2"
@@ -33,4 +39,4 @@
       }
     ]
   }
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/ValueSet-detailed-race.json b/lib/resources/us_core/ValueSet-detailed-race.json
index 2f2fc6b..90ffa98 100755
--- a/lib/resources/us_core/ValueSet-detailed-race.json
+++ b/lib/resources/us_core/ValueSet-detailed-race.json
@@ -3,25 +3,31 @@
   "id": "detailed-race",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>US-Core Detailed Race</h2><div><p>The 900+ <a href=\"http://www.cdc.gov/phin/resources/vocabulary/index.html\">CDC Race codes</a> that are grouped under one of the 5 OMB race category codes.</p>\n</div><p>This value set includes codes from the following code systems:</p><ul><li/><li>Import all the codes that are contained in <a href=\"http://hl7.org/fhir/2017Jan/v3/Race/vs.html\">http://hl7.org/fhir/ValueSet/v3-Race</a></li><li>Exclude these codes as defined in <a href=\"http://hl7.org/fhir/2017Jan/v3/Race/cs.html\">http://hl7.org/fhir/v3/Race</a><table class=\"none\"><tr><td><b>Code</b></td><td><b>Display</b></td></tr><tr><td>1002-5</td><td>American Indian or Alaska Native</td><td>American Indian or Alaska Native</td></tr><tr><td>2028-9</td><td>Asian</td><td>Asian</td></tr><tr><td>2054-5</td><td>Black or African American</td><td>Black or African American</td></tr><tr><td>2076-8</td><td>Native Hawaiian or Other Pacific Islander</td><td>Native Hawaiian or Other Pacific Islander</td></tr><tr><td>2106-3</td><td>White</td><td>White</td></tr></table></li></ul></div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>US-Core Detailed Race</h2><div><p>The 900+ <a href=\"http://www.cdc.gov/phin/resources/vocabulary/index.html\">CDC Race codes</a> that are grouped under one of the 5 OMB race category codes.</p>\n</div><p>This value set includes codes from the following code systems:</p><ul><li>Include codes from <a href=\"CodeSystem-cdcrec.html\"><code>urn:oid:2.16.840.1.113883.6.238</code></a> where concept  is-a  <a href=\"CodeSystem-cdcrec.html#cdcrec-1000-9\">1000-9</a></li><li>Exclude these codes as defined in <a href=\"CodeSystem-cdcrec.html\"><code>urn:oid:2.16.840.1.113883.6.238</code></a><table class=\"none\"><tr><td><b>Code</b></td><td><b>Display</b></td></tr><tr><td><a href=\"CodeSystem-cdcrec.html#cdcrec-1002-5\">1002-5</a></td><td>American Indian or Alaska Native</td><td>American Indian or Alaska Native</td></tr><tr><td><a href=\"CodeSystem-cdcrec.html#cdcrec-2028-9\">2028-9</a></td><td>Asian</td><td>Asian</td></tr><tr><td><a href=\"CodeSystem-cdcrec.html#cdcrec-2054-5\">2054-5</a></td><td>Black or African American</td><td>Black or African American</td></tr><tr><td><a href=\"CodeSystem-cdcrec.html#cdcrec-2076-8\">2076-8</a></td><td>Native Hawaiian or Other Pacific Islander</td><td>Native Hawaiian or Other Pacific Islander</td></tr><tr><td><a href=\"CodeSystem-cdcrec.html#cdcrec-2106-3\">2106-3</a></td><td>White</td><td>White</td></tr></table></li></ul></div>"
   },
   "url": "http://hl7.org/fhir/us/core/ValueSet/detailed-race",
+  "version": "1.0.0",
   "name": "US-Core Detailed Race",
   "status": "draft",
-  "publisher": "USRealm Task Force",
   "date": "2016-08-30",
+  "publisher": "HL7 US Realm Steering Committee",
   "description": "The 900+ [CDC Race codes](http://www.cdc.gov/phin/resources/vocabulary/index.html) that are grouped under one of the 5 OMB race category codes.",
   "compose": {
     "include": [
       {
-        "valueSet": [
-          "http://hl7.org/fhir/ValueSet/v3-Race"
+        "system": "urn:oid:2.16.840.1.113883.6.238",
+        "filter": [
+          {
+            "property": "concept",
+            "op": "is-a",
+            "value": "1000-9"
+          }
         ]
       }
     ],
     "exclude": [
       {
-        "system": "http://hl7.org/fhir/v3/Race",
+        "system": "urn:oid:2.16.840.1.113883.6.238",
         "concept": [
           {
             "code": "1002-5"
@@ -42,4 +48,4 @@
       }
     ]
   }
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/ValueSet-omb-ethnicity.json b/lib/resources/us_core/ValueSet-omb-ethnicity-category.json
similarity index 60%
rename from lib/resources/us_core/ValueSet-omb-ethnicity.json
rename to lib/resources/us_core/ValueSet-omb-ethnicity-category.json
index 957a0fc..9c099cf 100755
--- a/lib/resources/us_core/ValueSet-omb-ethnicity.json
+++ b/lib/resources/us_core/ValueSet-omb-ethnicity-category.json
@@ -1,20 +1,21 @@
 {
   "resourceType": "ValueSet",
-  "id": "omb-ethnicity",
+  "id": "omb-ethnicity-category",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>OMB Ethnicity Categories</h2><div><p>The codes for the ethnicity categories - 'Hispanic or Latino' and 'Non Hispanic or Latino' - as defined by the <a href=\"https://www.whitehouse.gov/omb/fedreg_1997standards\">OMB Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity, Statistical Policy Directive No. 15, as revised, October 30, 1997</a>.</p>\n</div><p>This value set includes codes from the following code systems:</p><ul><li>Include these codes as defined in http://hl7.org/fhir/ValueSet/v3-Ethnicity<table class=\"none\"><tr><td><b>Code</b></td><td><b>Display</b></td></tr><tr><td>2135-2</td><td>Hispanic or Latino</td><td/></tr><tr><td>2186-5</td><td>Non Hispanic or Latino</td><td/></tr></table></li></ul></div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>OMB Ethnicity Categories</h2><div><p>The codes for the ethnicity categories - 'Hispanic or Latino' and 'Non Hispanic or Latino' - as defined by the <a href=\"https://www.whitehouse.gov/omb/fedreg_1997standards\">OMB Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity, Statistical Policy Directive No. 15, as revised, October 30, 1997</a>.</p>\n</div><p>This value set includes codes from the following code systems:</p><ul><li>Include these codes as defined in <a href=\"CodeSystem-cdcrec.html\"><code>urn:oid:2.16.840.1.113883.6.238</code></a><table class=\"none\"><tr><td><b>Code</b></td><td><b>Display</b></td></tr><tr><td><a href=\"CodeSystem-cdcrec.html#cdcrec-2135-2\">2135-2</a></td><td>Hispanic or Latino</td><td>Hispanic or Latino</td></tr><tr><td><a href=\"CodeSystem-cdcrec.html#cdcrec-2186-5\">2186-5</a></td><td>Non Hispanic or Latino</td><td>Note that this term remains in the table for completeness, even though within HL7, the notion of &quot;not otherwise coded&quot; term is deprecated.</td></tr></table></li></ul></div>"
   },
-  "url": "http://hl7.org/fhir/us/core/ValueSet/omb-ethnicity",
+  "url": "http://hl7.org/fhir/us/core/ValueSet/omb-ethnicity-category",
+  "version": "1.0.0",
   "name": "OMB Ethnicity Categories",
   "status": "draft",
-  "publisher": "USRealm Task Force",
   "date": "2016-08-30",
+  "publisher": "HL7 US Realm Steering Committee",
   "description": "The codes for the ethnicity categories - 'Hispanic or Latino' and 'Non Hispanic or Latino' - as defined by the [OMB Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity, Statistical Policy Directive No. 15, as revised, October 30, 1997](https://www.whitehouse.gov/omb/fedreg_1997standards).",
   "compose": {
     "include": [
       {
-        "system": "http://hl7.org/fhir/ValueSet/v3-Ethnicity",
+        "system": "urn:oid:2.16.840.1.113883.6.238",
         "concept": [
           {
             "code": "2135-2",
@@ -28,4 +29,4 @@
       }
     ]
   }
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/ValueSet-omb-race.json b/lib/resources/us_core/ValueSet-omb-race-category.json
similarity index 51%
rename from lib/resources/us_core/ValueSet-omb-race.json
rename to lib/resources/us_core/ValueSet-omb-race-category.json
index db01923..0d0be36 100755
--- a/lib/resources/us_core/ValueSet-omb-race.json
+++ b/lib/resources/us_core/ValueSet-omb-race-category.json
@@ -1,22 +1,22 @@
 {
   "resourceType": "ValueSet",
-  "id": "omb-race",
+  "id": "omb-race-category",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>OMB Race Categories</h2><div><p>The codes for the concepts 'Unknown' and  'Asked but no answer' and the the codes for the five race categories - 'American Indian' or 'Alaska Native', 'Asian', 'Black or African American', 'Native Hawaiian or Other Pacific Islander', and 'White' - as defined by the <a href=\"https://www.whitehouse.gov/omb/fedreg_1997standards\">OMB Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity, Statistical Policy Directive No. 15, as revised, October 30, 1997</a> .</p>\n</div><p>This value set includes codes from the following code systems:</p><ul><li>Include these codes as defined in <a href=\"http://hl7.org/fhir/2017Jan/v3/Race/cs.html\">http://hl7.org/fhir/v3/Race</a><table class=\"none\"><tr><td><b>Code</b></td><td><b>Display</b></td></tr><tr><td>1002-5</td><td>American Indian or Alaska Native</td><td>American Indian or Alaska Native</td></tr><tr><td>2028-9</td><td>Asian</td><td>Asian</td></tr><tr><td>2054-5</td><td>Black or African American</td><td>Black or African American</td></tr><tr><td>2076-8</td><td>Native Hawaiian or Other Pacific Islander</td><td>Native Hawaiian or Other Pacific Islander</td></tr><tr><td>2106-3</td><td>White</td><td>White</td></tr></table></li><li>Include these codes as defined in <a href=\"http://hl7.org/fhir/2017Jan/v3/NullFlavor/cs.html\">http://hl7.org/fhir/v3/NullFlavor</a><table class=\"none\"><tr><td><b>Code</b></td><td><b>Display</b></td></tr><tr><td>UNK</td><td>Unknown</td><td>Description:A proper value is applicable, but not known.                                                      Usage Notes: This means the actual value is not known.  If the only thing that is unknown is how to properly express the value in the necessary constraints (value set, datatype, etc.), then the OTH or UNC flavor should be used.  No properties should be included for a datatype with this property unless:                                                      Those properties themselves directly translate to a semantic of &quot;unknown&quot;.  (E.g. a local code sent as a translation that conveys 'unknown')                            Those properties further qualify the nature of what is unknown.  (E.g. specifying a use code of &quot;H&quot; and a URL prefix of &quot;tel:&quot; to convey that it is the home phone number that is unknown.)</td></tr><tr><td>ASKU</td><td>Asked but no answer</td><td>Information was sought but not found (e.g., patient was asked but didn't know)</td></tr></table></li></ul></div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>OMB Race Categories</h2><div><p>The codes for the concepts 'Unknown' and  'Asked but no answer' and the the codes for the five race categories - 'American Indian' or 'Alaska Native', 'Asian', 'Black or African American', 'Native Hawaiian or Other Pacific Islander', and 'White' - as defined by the <a href=\"https://www.whitehouse.gov/omb/fedreg_1997standards\">OMB Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity, Statistical Policy Directive No. 15, as revised, October 30, 1997</a> .</p>\n</div><p>This value set includes codes from the following code systems:</p><ul><li>Include these codes as defined in <a href=\"CodeSystem-cdcrec.html\"><code>urn:oid:2.16.840.1.113883.6.238</code></a><table class=\"none\"><tr><td><b>Code</b></td><td><b>Display</b></td></tr><tr><td><a href=\"CodeSystem-cdcrec.html#cdcrec-1002-5\">1002-5</a></td><td>American Indian or Alaska Native</td><td>American Indian or Alaska Native</td></tr><tr><td><a href=\"CodeSystem-cdcrec.html#cdcrec-2028-9\">2028-9</a></td><td>Asian</td><td>Asian</td></tr><tr><td><a href=\"CodeSystem-cdcrec.html#cdcrec-2054-5\">2054-5</a></td><td>Black or African American</td><td>Black or African American</td></tr><tr><td><a href=\"CodeSystem-cdcrec.html#cdcrec-2076-8\">2076-8</a></td><td>Native Hawaiian or Other Pacific Islander</td><td>Native Hawaiian or Other Pacific Islander</td></tr><tr><td><a href=\"CodeSystem-cdcrec.html#cdcrec-2106-3\">2106-3</a></td><td>White</td><td>White</td></tr></table></li><li>Include these codes as defined in <a href=\"http://build.fhir.org/v3/NullFlavor/cs.html\"><code>http://hl7.org/fhir/v3/NullFlavor</code></a><table class=\"none\"><tr><td><b>Code</b></td><td><b>Display</b></td></tr><tr><td><a href=\"http://build.fhir.org/v3/NullFlavor/cs.html#v3-NullFlavor-UNK\">UNK</a></td><td>Unknown</td><td>Description:A proper value is applicable, but not known.<br/>\n                        \n                           Usage Notes: This means the actual value is not known.  If the only thing that is unknown is how to properly express the value in the necessary constraints (value set, datatype, etc.), then the OTH or UNC flavor should be used.  No properties should be included for a datatype with this property unless:<br/>\n                        \n                           Those properties themselves directly translate to a semantic of &quot;unknown&quot;.  (E.g. a local code sent as a translation that conveys 'unknown')\n                           Those properties further qualify the nature of what is unknown.  (E.g. specifying a use code of &quot;H&quot; and a URL prefix of &quot;tel:&quot; to convey that it is the home phone number that is unknown.)</td></tr><tr><td><a href=\"http://build.fhir.org/v3/NullFlavor/cs.html#v3-NullFlavor-ASKU\">ASKU</a></td><td>Asked but no answer</td><td>Information was sought but not found (e.g., patient was asked but didn't know)</td></tr></table></li></ul></div>"
   },
-  "url": "http://hl7.org/fhir/us/core/ValueSet/omb-race",
+  "url": "http://hl7.org/fhir/us/core/ValueSet/omb-race-category",
   "identifier": [
     {
       "system": "urn:ietf:rfc:3986",
       "value": "urn:oid:2.16.840.1.113883.4.642.2.575"
     }
   ],
-  "version": "1.5.0",
+  "version": "1.0.0",
   "name": "OMB Race Categories",
   "status": "active",
-  "experimental": true,
-  "publisher": "DAF Project",
+  "date": "2016-05-25T16:59:08+10:00",
+  "publisher": "HL7 US Realm Steering Committee",
   "contact": [
     {
       "telecom": [
@@ -35,12 +35,11 @@
       ]
     }
   ],
-  "date": "2016-05-25T16:59:08+10:00",
   "description": "The codes for the concepts 'Unknown' and  'Asked but no answer' and the the codes for the five race categories - 'American Indian' or 'Alaska Native', 'Asian', 'Black or African American', 'Native Hawaiian or Other Pacific Islander', and 'White' - as defined by the [OMB Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity, Statistical Policy Directive No. 15, as revised, October 30, 1997](https://www.whitehouse.gov/omb/fedreg_1997standards) .",
   "compose": {
     "include": [
       {
-        "system": "http://hl7.org/fhir/v3/Race",
+        "system": "urn:oid:2.16.840.1.113883.6.238",
         "concept": [
           {
             "code": "1002-5",
@@ -79,4 +78,4 @@
       }
     ]
   }
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/ValueSet-simple-language.json b/lib/resources/us_core/ValueSet-simple-language.json
new file mode 100755
index 0000000..603f1ac
--- /dev/null
+++ b/lib/resources/us_core/ValueSet-simple-language.json
@@ -0,0 +1,59 @@
+{
+  "resourceType": "ValueSet",
+  "id": "simple-language",
+  "text": {
+    "status": "generated",
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>Language codes with language and optionally a region modifier</h2><div><p>This value set includes codes from <a href=\"http://tools.ietf.org/html/bcp47\">BCP-47</a>. This value set matches the ONC 2015 Edition LanguageCommunication data element value set within C-CDA to use a 2 character language code if one exists,   and a 3 character code if a 2 character code does not exist. It points back to <a href=\"https://tools.ietf.org/html/rfc5646\">RFC 5646</a>, however only the language codes are required, all other elements are optional.</p>\n</div><p>This value set includes codes from the following code systems:</p><ul><li>Include codes from <code>urn:ietf:bcp:47</code> where ext-lang  exists  false and <code>urn:ietf:bcp:47</code> where script  exists  false and <code>urn:ietf:bcp:47</code> where variant  exists  false and <code>urn:ietf:bcp:47</code> where extension  exists  false and <code>urn:ietf:bcp:47</code> where private-use  exists  false</li></ul></div>"
+  },
+  "url": "http://hl7.org/fhir/us/core/ValueSet/simple-language",
+  "version": "1.0.0",
+  "name": "Language codes with language and optionally a region modifier",
+  "status": "draft",
+  "date": "2017-02-28",
+  "publisher": "HL7 US Realm Steering Committee",
+  "contact": [
+    {
+      "telecom": [
+        {
+          "system": "url",
+          "value": "http://hl7.org/fhir"
+        }
+      ]
+    }
+  ],
+  "description": "This value set includes codes from [BCP-47](http://tools.ietf.org/html/bcp47). This value set matches the ONC 2015 Edition LanguageCommunication data element value set within C-CDA to use a 2 character language code if one exists,   and a 3 character code if a 2 character code does not exist. It points back to [RFC 5646](https://tools.ietf.org/html/rfc5646), however only the language codes are required, all other elements are optional.",
+  "compose": {
+    "include": [
+      {
+        "system": "urn:ietf:bcp:47",
+        "filter": [
+          {
+            "property": "ext-lang",
+            "op": "exists",
+            "value": "false"
+          },
+          {
+            "property": "script",
+            "op": "exists",
+            "value": "false"
+          },
+          {
+            "property": "variant",
+            "op": "exists",
+            "value": "false"
+          },
+          {
+            "property": "extension",
+            "op": "exists",
+            "value": "false"
+          },
+          {
+            "property": "private-use",
+            "op": "exists",
+            "value": "false"
+          }
+        ]
+      }
+    ]
+  }
+}
diff --git a/lib/resources/us_core/ValueSet-us-core-birthsex.json b/lib/resources/us_core/ValueSet-us-core-birthsex.json
index 3215dea..4ffd9c4 100755
--- a/lib/resources/us_core/ValueSet-us-core-birthsex.json
+++ b/lib/resources/us_core/ValueSet-us-core-birthsex.json
@@ -3,13 +3,14 @@
   "id": "us-core-birthsex",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>US Core Birth Sex Value Set</h2><div><p>Codes for assigning sex at birth as specified by the <a href=\"https://www.healthit.gov/newsroom/about-onc\">Office of the National Coordinator for Health IT (ONC)</a></p>\n</div><p>This value set includes codes from the following code systems:</p><ul><li>Include these codes as defined in <a href=\"http://hl7.org/fhir/2017Jan/v3/AdministrativeGender/cs.html\">http://hl7.org/fhir/v3/AdministrativeGender</a><table class=\"none\"><tr><td><b>Code</b></td><td><b>Display</b></td></tr><tr><td>F</td><td>Female</td><td>Female</td></tr><tr><td>M</td><td>Male</td><td>Male</td></tr></table></li><li>Include these codes as defined in <a href=\"http://hl7.org/fhir/2017Jan/v3/NullFlavor/cs.html\">http://hl7.org/fhir/v3/NullFlavor</a><table class=\"none\"><tr><td><b>Code</b></td><td><b>Display</b></td></tr><tr><td>UNK</td><td>Unknown</td><td>Description:A proper value is applicable, but not known.                                                      Usage Notes: This means the actual value is not known.  If the only thing that is unknown is how to properly express the value in the necessary constraints (value set, datatype, etc.), then the OTH or UNC flavor should be used.  No properties should be included for a datatype with this property unless:                                                      Those properties themselves directly translate to a semantic of &quot;unknown&quot;.  (E.g. a local code sent as a translation that conveys 'unknown')                            Those properties further qualify the nature of what is unknown.  (E.g. specifying a use code of &quot;H&quot; and a URL prefix of &quot;tel:&quot; to convey that it is the home phone number that is unknown.)</td></tr></table></li></ul></div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>US Core Birth Sex Value Set</h2><div><p>Codes for assigning sex at birth as specified by the <a href=\"https://www.healthit.gov/newsroom/about-onc\">Office of the National Coordinator for Health IT (ONC)</a></p>\n</div><p>This value set includes codes from the following code systems:</p><ul><li>Include these codes as defined in <a href=\"http://build.fhir.org/v3/AdministrativeGender/cs.html\"><code>http://hl7.org/fhir/v3/AdministrativeGender</code></a><table class=\"none\"><tr><td><b>Code</b></td><td><b>Display</b></td></tr><tr><td><a href=\"http://build.fhir.org/v3/AdministrativeGender/cs.html#v3-AdministrativeGender-F\">F</a></td><td>Female</td><td>Female</td></tr><tr><td><a href=\"http://build.fhir.org/v3/AdministrativeGender/cs.html#v3-AdministrativeGender-M\">M</a></td><td>Male</td><td>Male</td></tr></table></li><li>Include these codes as defined in <a href=\"http://build.fhir.org/v3/NullFlavor/cs.html\"><code>http://hl7.org/fhir/v3/NullFlavor</code></a><table class=\"none\"><tr><td><b>Code</b></td><td><b>Display</b></td></tr><tr><td><a href=\"http://build.fhir.org/v3/NullFlavor/cs.html#v3-NullFlavor-UNK\">UNK</a></td><td>Unknown</td><td>Description:A proper value is applicable, but not known.<br/>\n                        \n                           Usage Notes: This means the actual value is not known.  If the only thing that is unknown is how to properly express the value in the necessary constraints (value set, datatype, etc.), then the OTH or UNC flavor should be used.  No properties should be included for a datatype with this property unless:<br/>\n                        \n                           Those properties themselves directly translate to a semantic of &quot;unknown&quot;.  (E.g. a local code sent as a translation that conveys 'unknown')\n                           Those properties further qualify the nature of what is unknown.  (E.g. specifying a use code of &quot;H&quot; and a URL prefix of &quot;tel:&quot; to convey that it is the home phone number that is unknown.)</td></tr></table></li></ul></div>"
   },
   "url": "http://hl7.org/fhir/us/core/ValueSet/us-core-birthsex",
-  "version": "1.6.0",
+  "version": "1.0.0",
   "name": "US Core Birth Sex Value Set",
   "status": "active",
-  "publisher": "US Realm Steering Committee",
+  "date": "2016-08-10",
+  "publisher": "HL7 US Realm Steering Committee",
   "contact": [
     {
       "telecom": [
@@ -20,7 +21,6 @@
       ]
     }
   ],
-  "date": "2016-08-10",
   "description": "Codes for assigning sex at birth as specified by the [Office of the National Coordinator for Health IT (ONC)](https://www.healthit.gov/newsroom/about-onc)",
   "compose": {
     "include": [
@@ -48,4 +48,4 @@
       }
     ]
   }
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/ValueSet-us-core-careteam-provider-roles.json b/lib/resources/us_core/ValueSet-us-core-careteam-provider-roles.json
index 3f89bfa..fc7c25f 100755
--- a/lib/resources/us_core/ValueSet-us-core-careteam-provider-roles.json
+++ b/lib/resources/us_core/ValueSet-us-core-careteam-provider-roles.json
@@ -3,12 +3,14 @@
   "id": "us-core-careteam-provider-roles",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>CareTeam Provider Roles</h2><div><p>Provider roles codes consist of NUCC Health Care Provider Taxonomy Code Set for providers and SNOMED-CT for - non clinical and organization roles including codes from the SCTID 125676002 Person (person) heirarchy and the SCTID 394730007 Healthcare related organization (qualifier value) heirarchy.</p>\n</div><p><b>Copyright Statement:</b> This value set includes content from SNOMED CT, which is copyright © 2002+ International Health Terminology Standards Development Organisation (IHTSDO), and distributed by agreement between IHTSDO and HL7. Implementer use of SNOMED CT is not covered by this agreement. TODO: Permission to Use and Distribute the Health Care Provider Taxonomy Code Set</p><p>This value set includes codes from the following code systems:</p><ul><li>Include all codes defined in http://nucc.org/provider-taxonomy</li><li>Include codes from <a href=\"http://hl7.org/fhir/2017Jan/codesystem-snomedct.html\">http://snomed.info/sct</a> where concept  is-a  125676002</li><li>Include codes from <a href=\"http://hl7.org/fhir/2017Jan/codesystem-snomedct.html\">http://snomed.info/sct</a> where concept  is-a  394730007</li></ul></div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>CareTeam Provider Roles</h2><div><p>Provider roles codes consist of NUCC Health Care Provider Taxonomy Code Set for providers and SNOMED-CT for - non clinical and organization roles including codes from the SCTID 125676002 Person (person) heirarchy and the SCTID 394730007 Healthcare related organization (qualifier value) heirarchy.</p>\n</div><p><b>Copyright Statement:</b> This value set includes content from SNOMED CT, which is copyright © 2002+ International Health Terminology Standards Development Organisation (IHTSDO), and distributed by agreement between IHTSDO and HL7. Implementer use of SNOMED CT is not covered by this agreement. This value set includes content from NUCC Health Care Provider Taxonomy Code Set for providers which is copyright © 2016+ American Medical Association.  For commercial use, including sales or licensing, a license must be obtained.</p><p>This value set includes codes from the following code systems:</p><ul><li>Include all codes defined in <code>http://nucc.org/provider-taxonomy</code></li><li>Include codes from <a href=\"http://www.snomed.org/\"><code>http://snomed.info/sct</code></a> where concept  is-a  125676002 (Person)</li><li>Include codes from <a href=\"http://www.snomed.org/\"><code>http://snomed.info/sct</code></a> where concept  is-a  394730007 (Healthcare related organisation)</li></ul></div>"
   },
   "url": "http://hl7.org/fhir/us/core/ValueSet/us-core-careteam-provider-roles",
+  "version": "1.0.0",
   "name": "CareTeam Provider Roles",
   "status": "draft",
-  "publisher": "FHIR Project Team",
+  "date": "2016-08-08T08:27:28-07:00",
+  "publisher": "HL7 US Realm Steering Committee",
   "contact": [
     {
       "telecom": [
@@ -19,10 +21,9 @@
       ]
     }
   ],
-  "date": "2016-08-08T08:27:28-07:00",
   "description": "Provider roles codes consist of NUCC Health Care Provider Taxonomy Code Set for providers and SNOMED-CT for - non clinical and organization roles including codes from the SCTID 125676002 Person (person) heirarchy and the SCTID 394730007 Healthcare related organization (qualifier value) heirarchy.",
   "purpose": "Codes that may be used for implementation of the Argonaut Procedures IG and MU2015 certification.",
-  "copyright": "This value set includes content from SNOMED CT, which is copyright © 2002+ International Health Terminology Standards Development Organisation (IHTSDO), and distributed by agreement between IHTSDO and HL7. Implementer use of SNOMED CT is not covered by this agreement. TODO: Permission to Use and Distribute the Health Care Provider Taxonomy Code Set",
+  "copyright": "This value set includes content from SNOMED CT, which is copyright © 2002+ International Health Terminology Standards Development Organisation (IHTSDO), and distributed by agreement between IHTSDO and HL7. Implementer use of SNOMED CT is not covered by this agreement. This value set includes content from NUCC Health Care Provider Taxonomy Code Set for providers which is copyright © 2016+ American Medical Association.  For commercial use, including sales or licensing, a license must be obtained.",
   "compose": {
     "include": [
       {
@@ -50,4 +51,4 @@
       }
     ]
   }
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/ValueSet-us-core-careteam-status.json b/lib/resources/us_core/ValueSet-us-core-careteam-status.json
deleted file mode 100755
index aa0d187..0000000
--- a/lib/resources/us_core/ValueSet-us-core-careteam-status.json
+++ /dev/null
@@ -1,21 +0,0 @@
-{
-  "resourceType": "ValueSet",
-  "id": "us-core-careteam-status",
-  "text": {
-    "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>CareTeamStatus</h2><div><p>Indicates whether the team is current , represents future intentions or is now a historical record.</p>\n</div><p>This value set includes codes from the following code systems:</p><ul><li>Include all codes defined in <a href=\"CodeSystem-careteam-status.html\">http://hl7.org/fhir/us/core/CodeSystem/careteam-status</a></li></ul></div>"
-  },
-  "url": "http://hl7.org/fhir/us/core/ValueSet/us-core-careteam-status",
-  "name": "CareTeamStatus",
-  "status": "draft",
-  "publisher": "HL7 (FHIR Project)",
-  "date": "2016-12-06T22:13:05+11:00",
-  "description": "Indicates whether the team is current , represents future intentions or is now a historical record.",
-  "compose": {
-    "include": [
-      {
-        "system": "http://hl7.org/fhir/us/core/CodeSystem/careteam-status"
-      }
-    ]
-  }
-}
\ No newline at end of file
diff --git a/lib/resources/us_core/ValueSet-us-core-condition-category.json b/lib/resources/us_core/ValueSet-us-core-condition-category.json
index fc85637..6e2e093 100755
--- a/lib/resources/us_core/ValueSet-us-core-condition-category.json
+++ b/lib/resources/us_core/ValueSet-us-core-condition-category.json
@@ -3,13 +3,14 @@
   "id": "us-core-condition-category",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>US Core Condition Category Codes</h2><div><p>The US core Condition Category Codes support the separate concepts of problems and health concerns in Condition.category in order for API consumers to be able to separate health concerns and problems. However this is not mandatory for 2015 certification</p>\n</div><p>This value set includes codes from the following code systems:</p><ul><li>Include all codes defined in <a href=\"http://hl7.org/fhir/2017Jan/codesystem-condition-category.html\">http://hl7.org/fhir/condition-category</a></li><li>Include these codes as defined in <a href=\"CodeSystem-condition-category.html\">http://hl7.org/fhir/us/core/CodeSystem/condition-category</a><table class=\"none\"><tr><td><b>Code</b></td><td><b>Display</b></td></tr><tr><td>problem</td><td>Problem</td><td>The patients problems as identified by the provider(s). Items on the provider’s problem list</td></tr><tr><td>health-concern</td><td>Health Concern</td><td>Additional health concerns from other stakeholders which are outside the provider’s problem list.</td></tr></table></li></ul></div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>US Core Condition Category Codes</h2><div><p>The US core Condition Category Codes support the separate concepts of problems and health concerns in Condition.category in order for API consumers to be able to separate health concerns and problems. However this is not mandatory for 2015 certification</p>\n</div><p>This value set includes codes from the following code systems:</p><ul><li>Include all codes defined in <a href=\"http://build.fhir.org/codesystem-condition-category.html\"><code>http://hl7.org/fhir/condition-category</code></a></li><li>Include these codes as defined in <a href=\"CodeSystem-condition-category.html\"><code>http://hl7.org/fhir/us/core/CodeSystem/condition-category</code></a><table class=\"none\"><tr><td><b>Code</b></td><td><b>Display</b></td></tr><tr><td><a href=\"CodeSystem-condition-category.html#condition-category-problem\">problem</a></td><td>Problem</td><td>The patients problems as identified by the provider(s). Items on the provider’s problem list</td></tr><tr><td><a href=\"CodeSystem-condition-category.html#condition-category-health-concern\">health-concern</a></td><td>Health Concern</td><td>Additional health concerns from other stakeholders which are outside the provider’s problem list.</td></tr></table></li></ul></div>"
   },
   "url": "http://hl7.org/fhir/us/core/ValueSet/us-core-condition-category",
+  "version": "1.0.0",
   "name": "US Core Condition Category Codes",
   "status": "draft",
-  "publisher": "HL7 (FHIR Project)",
   "date": "2016-08-10",
+  "publisher": "HL7 US Realm Steering Committee",
   "description": "The US core Condition Category Codes support the separate concepts of problems and health concerns in Condition.category in order for API consumers to be able to separate health concerns and problems. However this is not mandatory for 2015 certification",
   "purpose": "So API consumers can separate health concerns and problems.",
   "compose": {
@@ -32,4 +33,4 @@
       }
     ]
   }
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/ValueSet-us-core-cvx.json b/lib/resources/us_core/ValueSet-us-core-cvx.json
index 7c4ce95..ba294f2 100755
--- a/lib/resources/us_core/ValueSet-us-core-cvx.json
+++ b/lib/resources/us_core/ValueSet-us-core-cvx.json
@@ -3,7 +3,7 @@
   "id": "us-core-cvx",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>Vaccine Administered Value Set (CVX)</h2><div><p>This identifies the vaccine substance administered - CVX codes</p>\n</div><p>This value set includes codes from the following code systems:</p><ul><li>Include all codes defined in http://hl7.org/fhir/sid/cvx</li></ul></div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>Vaccine Administered Value Set (CVX)</h2><div><p>This identifies the vaccine substance administered - CVX codes</p>\n</div><p>This value set includes codes from the following code systems:</p><ul><li>Include all codes defined in <code>http://hl7.org/fhir/sid/cvx</code></li></ul></div>"
   },
   "url": "http://hl7.org/fhir/us/core/ValueSet/us-core-cvx",
   "identifier": [
@@ -12,11 +12,11 @@
       "value": "urn:oid:2.16.840.1.113883.3.88.12.80.22"
     }
   ],
-  "version": "1.6.0",
+  "version": "1.0.0",
   "name": "Vaccine Administered Value Set (CVX)",
   "status": "active",
-  "experimental": true,
-  "publisher": "HL7 FHIR",
+  "date": "2016-08-10",
+  "publisher": "HL7 US Realm Steering Committee",
   "contact": [
     {
       "telecom": [
@@ -27,7 +27,6 @@
       ]
     }
   ],
-  "date": "2016-08-10",
   "description": "This identifies the vaccine substance administered - CVX codes",
   "compose": {
     "include": [
@@ -36,4 +35,4 @@
       }
     ]
   }
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/ValueSet-us-core-immunization-status.json b/lib/resources/us_core/ValueSet-us-core-immunization-status.json
deleted file mode 100755
index 7bde886..0000000
--- a/lib/resources/us_core/ValueSet-us-core-immunization-status.json
+++ /dev/null
@@ -1,57 +0,0 @@
-{
-  "resourceType": "ValueSet",
-  "id": "us-core-immunization-status",
-  "text": {
-    "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n      <p>Immunization codes constrained from the DSTU core to include only 'completed' and 'enter-in-error'  which are the only two clinically relevent values.</p>\n      <p>Codes that may be used for implementation of the Argonaut Immunization IG and MU2015 certification.</p>\n      <p/>\n      <table border=\"1\" cellpadding=\"5\" cellspacing=\"0\">\n        <tr>\n          <th>Code</th>\n          <th>Display</th>\n          <th>Definition</th>\n        </tr>\n        <tr class=\"odd\">\n          <td>completed</td>\n          <td>Completed</td>\n          <td>All actions that are implied by the administration have occurred.</td>\n        </tr>\n        <tr class=\"even\">\n          <td>entered-in-error</td>\n          <td>Entered in Error</td>\n          <td>The administration was entered in error and therefore nullified.</td>\n        </tr>\n      </table>\n    </div>"
-  },
-  "url": "http://hl7.org/fhir/us/core/ValueSet/us-core-immunization-status",
-  "name": "Immunization Status",
-  "status": "draft",
-  "publisher": "FHIR Project Team",
-  "contact": [
-    {
-      "telecom": [
-        {
-          "system": "other",
-          "value": "http://hl7.org/fhir"
-        }
-      ]
-    }
-  ],
-  "date": "2016-12-06T22:13:05+11:00",
-  "description": "Immunization codes constrained from the STU core to include only 'completed' and 'enter-in-error'  which are the only two clinically relevent values.",
-  "purpose": "Codes that may be used for implementation of the Argonaut Immunization IG and MU2015 certification.",
-  "compose": {
-    "include": [
-      {
-        "system": "http://hl7.org/fhir/medication-admin-status",
-        "concept": [
-          {
-            "code": "completed",
-            "display": "Completed",
-            "designation": [
-              {
-                "value": "All actions that are implied by the administration have occurred"
-              }
-            ]
-          }
-        ]
-      },
-      {
-        "system": "http://hl7.org/fhir/medication-admin-status",
-        "concept": [
-          {
-            "code": "entered-in-error",
-            "display": "Entered in Error",
-            "designation": [
-              {
-                "value": "The administration was entered in error and therefore nullified"
-              }
-            ]
-          }
-        ]
-      }
-    ]
-  }
-}
\ No newline at end of file
diff --git a/lib/resources/us_core/ValueSet-us-core-medication-codes.json b/lib/resources/us_core/ValueSet-us-core-medication-codes.json
index 425344c..9dda2eb 100755
--- a/lib/resources/us_core/ValueSet-us-core-medication-codes.json
+++ b/lib/resources/us_core/ValueSet-us-core-medication-codes.json
@@ -18,11 +18,11 @@
       "value": "urn:oid:2.16.840.1.113762.1.4.1010.4"
     }
   ],
-  "version": "1.6.0",
+  "version": "1.0.0",
   "name": "Medication Clinical Drug (RxNorm)",
   "status": "draft",
-  "experimental": true,
-  "publisher": "FHIR Project team",
+  "date": "2016-05-25T16:59:08+10:00",
+  "publisher": "HL7 US Realm Steering Committee",
   "contact": [
     {
       "telecom": [
@@ -33,7 +33,6 @@
       ]
     }
   ],
-  "date": "2016-05-25T16:59:08+10:00",
   "description": "All prescribable medication formulations represented using  either a 'generic' or 'brand-specific' concept. This includes RxNorm codes whose Term Type is SCD (semantic clinical drug), SBD (semantic brand drug), GPCK (generic pack), BPCK (brand pack), SCDG (semantic clinical drug group), SBDG (semantic brand drug group), SCDF (semantic clinical drug form), or SBDF (semantic brand drug form)",
   "compose": {
     "include": [
@@ -49,4 +48,4 @@
       }
     ]
   }
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/ValueSet-us-core-narrative-status.json b/lib/resources/us_core/ValueSet-us-core-narrative-status.json
index 2ba440d..5a69717 100755
--- a/lib/resources/us_core/ValueSet-us-core-narrative-status.json
+++ b/lib/resources/us_core/ValueSet-us-core-narrative-status.json
@@ -3,12 +3,14 @@
   "id": "us-core-narrative-status",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>Narrative Status</h2><div><p>This value set limits the text status for the resource narrative.</p>\n</div><p><b>Copyright Statement:</b> HL7</p><p>This value set includes codes from the following code systems:</p><ul><li>Include these codes as defined in <a href=\"http://hl7.org/fhir/2017Jan/codesystem-narrative-status.html\">http://hl7.org/fhir/narrative-status</a><table class=\"none\"><tr><td><b>Code</b></td><td><b>Display</b></td></tr><tr><td>additional</td><td>additional</td><td>The contents of the narrative may contain additional information not found in the structured data. Note that there is no computable way to determine what the extra information is, other than by human inspection</td></tr><tr><td>generated</td><td>generated</td><td>The contents of the narrative are entirely generated from the structured data in the content.</td></tr></table></li></ul></div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>Narrative Status</h2><div><p>This value set limits the text status for the resource narrative.</p>\n</div><p><b>Copyright Statement:</b> HL7</p><p>This value set includes codes from the following code systems:</p><ul><li>Include these codes as defined in <a href=\"http://build.fhir.org/codesystem-narrative-status.html\"><code>http://hl7.org/fhir/narrative-status</code></a><table class=\"none\"><tr><td><b>Code</b></td><td><b>Display</b></td></tr><tr><td><a href=\"http://build.fhir.org/codesystem-narrative-status.html#narrative-status-additional\">additional</a></td><td>additional</td><td>The contents of the narrative may contain additional information not found in the structured data. Note that there is no computable way to determine what the extra information is, other than by human inspection</td></tr><tr><td><a href=\"http://build.fhir.org/codesystem-narrative-status.html#narrative-status-generated\">generated</a></td><td>generated</td><td>The contents of the narrative are entirely generated from the structured data in the content.</td></tr></table></li></ul></div>"
   },
   "url": "http://hl7.org/fhir/us/core/ValueSet/us-core-narrative-status",
+  "version": "1.0.0",
   "name": "Narrative Status",
   "status": "draft",
-  "publisher": "FHIR Project Team",
+  "date": "2017-03-21T11:28:08+11:00",
+  "publisher": "HL7 US Realm Steering Committee",
   "contact": [
     {
       "telecom": [
@@ -19,7 +21,6 @@
       ]
     }
   ],
-  "date": "2016-12-06T22:13:05+11:00",
   "description": "This value set limits the text status for the resource narrative.",
   "copyright": "HL7",
   "compose": {
@@ -39,4 +40,4 @@
       }
     ]
   }
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/ValueSet-us-core-ndc-vaccine-codes.json b/lib/resources/us_core/ValueSet-us-core-ndc-vaccine-codes.json
index 207a097..c857884 100755
--- a/lib/resources/us_core/ValueSet-us-core-ndc-vaccine-codes.json
+++ b/lib/resources/us_core/ValueSet-us-core-ndc-vaccine-codes.json
@@ -3,13 +3,14 @@
   "id": "us-core-ndc-vaccine-codes",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>Vaccine National Drug Code (NDC)</h2><div><p>This value set includes all the Vaccine National Drug Codes (NDC).  This source of this data is provided by the <a href=\"https://www2a.cdc.gov/vaccines/iis/iisstandards/ndc_crosswalk.asp\">CDC</a></p>\n</div><p>This value set includes codes from the following code systems:</p><ul><li>Include these codes as defined in http://hl7.org/fhir/sid/ndc<table class=\"none\"><tr><td><b>Code</b></td><td><b>Display</b></td></tr><tr><td>49281-0589-58</td><td>Menactra</td><td/></tr><tr><td>49281-0623-78</td><td>FLUZONE QUADRIVALENT</td><td/></tr><tr><td>49281-0515-00</td><td>Fluzone Quadrivalent, peds</td><td/></tr><tr><td>49281-0415-88</td><td>Fluzone Quadrivalent PF</td><td/></tr><tr><td>49281-0415-58</td><td>FLUZONE QUADRIVALENT PF</td><td/></tr><tr><td>33332-0115-11</td><td>AFLURIA</td><td/></tr><tr><td>33332-0015-02</td><td>AFLURIA</td><td/></tr><tr><td>66019-0302-01</td><td>FluMist Quadrivalent</td><td/></tr><tr><td>42874-0015-01</td><td>Flublok</td><td/></tr><tr><td>66521-0118-12</td><td>Fluvirin</td><td/></tr><tr><td>66521-0118-11</td><td>Fluvirin</td><td/></tr><tr><td>58160-0883-41</td><td>FLUARIX</td><td/></tr><tr><td>66521-0000-11</td><td>Fluad</td><td/></tr><tr><td>69401-0000-01</td><td>Vivotif</td><td/></tr><tr><td>66019-0301-01</td><td>FluMist Quadrivalent</td><td/></tr><tr><td>33332-0014-02</td><td>AFLURIA</td><td/></tr><tr><td>33332-0114-11</td><td>AFLURIA</td><td/></tr><tr><td>63851-0613-11</td><td>Flucelvax</td><td/></tr><tr><td>66521-0117-11</td><td>FLUVIRIN</td><td/></tr><tr><td>66521-0117-12</td><td>Fluvirin</td><td/></tr><tr><td>00006-4093-01</td><td>RECOMBIVAX HB</td><td/></tr><tr><td>00006-4094-01</td><td>RECOMBIVAX HB</td><td/></tr><tr><td>00006-4095-01</td><td>VAQTA</td><td/></tr><tr><td>00006-4096-01</td><td>VAQTA</td><td/></tr><tr><td>00006-4963-01</td><td>ZOSTAVAX</td><td/></tr><tr><td>00006-4963-01</td><td>ZOSTAVAX</td><td/></tr><tr><td>42874-0014-01</td><td>Flublok</td><td/></tr><tr><td>49281-0414-88</td><td>Fluzone Quadrivalent PF</td><td/></tr><tr><td>49281-0395-88</td><td>Fluzone HD</td><td/></tr><tr><td>49281-0709-48</td><td>FLUZONE Intradermal</td><td/></tr><tr><td>58160-0881-41</td><td>FLUARIX</td><td/></tr><tr><td>58160-0809-01</td><td>MENHIBRIX</td><td/></tr><tr><td>62577-0613-11</td><td>Flucelvax</td><td/></tr><tr><td>19515-0893-02</td><td>FLULAVAL</td><td/></tr><tr><td>49281-0621-78</td><td>FLUZONE QUADRIVALENT</td><td/></tr><tr><td>00005-0100-01</td><td>Trumenba</td><td/></tr><tr><td>00005-0100-01</td><td>Trumenba</td><td/></tr><tr><td>00005-0100-01</td><td>Trumenba</td><td/></tr><tr><td>00006-4047-01</td><td>RotaTeq</td><td/></tr><tr><td>00006-4109-01</td><td>GARDASIL</td><td/></tr><tr><td>62577-0613-11</td><td>Flucelvax</td><td/></tr><tr><td>00006-4121-01</td><td>GARDASIL 9</td><td/></tr><tr><td>00006-4119-01</td><td>GARDASIL 9</td><td/></tr><tr><td>00006-4119-01</td><td>GARDASIL 9</td><td/></tr><tr><td>63851-0511-11</td><td>RabAvert</td><td/></tr><tr><td>49281-0562-58</td><td>QUADRACEL</td><td/></tr><tr><td>46028-0114-11</td><td>Bexsero</td><td/></tr><tr><td>46028-0114-11</td><td>Bexsero</td><td/></tr><tr><td>00006-4171-01</td><td>ProQuad</td><td/></tr><tr><td>13533-0131-00</td><td>Tetanus and Diphtheria Toxoids Adsorbed</td><td/></tr><tr><td>49281-0396-78</td><td>FLUZONE</td><td/></tr><tr><td>49281-0397-88</td><td>FLUZONE High-Dose</td><td/></tr><tr><td>62577-0614-11</td><td>Flucelvax</td><td/></tr><tr><td>58160-0903-41</td><td>FLUARIX QUADRIVALENT</td><td/></tr><tr><td>19515-0898-01</td><td>Flulaval Quadrivalent</td><td/></tr><tr><td>19515-0901-41</td><td>Flulaval Quadrivalent</td><td/></tr><tr><td>49281-0393-88</td><td>FLUZONE High-Dose</td><td/></tr><tr><td>58160-0810-43</td><td>INFANRIX</td><td/></tr><tr><td>58160-0810-01</td><td>INFANRIX</td><td/></tr><tr><td>49281-0790-38</td><td>Typhim Vi</td><td/></tr><tr><td>49281-0790-88</td><td>Typhim Vi</td><td/></tr><tr><td>49281-0640-15</td><td>INFLUENZA A (H1N1) 2009 MONOVALENT VACCINE</td><td/></tr><tr><td>49281-0650-10</td><td>INFLUENZA A (H1N1) 2009 MONOVALENT VACCINE</td><td/></tr><tr><td>49281-0650-90</td><td>INFLUENZA A (H1N1) 2009 MONOVALENT VACCINE</td><td/></tr><tr><td>49281-0650-25</td><td>INFLUENZA A (H1N1) 2009 MONOVALENT VACCINE</td><td/></tr><tr><td>49281-0650-70</td><td>INFLUENZA A (H1N1) 2009 MONOVALENT VACCINE</td><td/></tr><tr><td>49281-0650-50</td><td>INFLUENZA A (H1N1) 2009 MONOVALENT VACCINE</td><td/></tr><tr><td>49281-0707-48</td><td>FLUZONE</td><td/></tr><tr><td>66019-0110-01</td><td>FluMist</td><td/></tr><tr><td>00006-4681-01</td><td>M-M-R II</td><td/></tr><tr><td>49281-0215-58</td><td>TENIVAC</td><td/></tr><tr><td>49281-0215-88</td><td>TENIVAC</td><td/></tr><tr><td>46028-0218-11</td><td>Meningococcal (Groups A) CRM197 Oligosaccharide Co</td><td/></tr><tr><td>49281-0387-65</td><td>FLUZONE</td><td/></tr><tr><td>49281-0386-15</td><td>FLUZONE</td><td/></tr><tr><td>49281-0010-10</td><td>FLUZONE</td><td/></tr><tr><td>49281-0010-25</td><td>Fluzone</td><td/></tr><tr><td>49281-0010-50</td><td>FLUZONE</td><td/></tr><tr><td>54868-0980-00</td><td>M-M-R II</td><td/></tr><tr><td>58160-0830-43</td><td>CERVARIX</td><td/></tr><tr><td>58160-0830-05</td><td>CERVARIX</td><td/></tr><tr><td>00005-1971-01</td><td>PREVNAR 13</td><td/></tr><tr><td>00005-1971-01</td><td>PREVNAR 13</td><td/></tr><tr><td>00005-1971-01</td><td>PREVNAR 13</td><td/></tr><tr><td>17478-0131-00</td><td>Tetanus and Diphtheria Toxoids Adsorbed</td><td/></tr><tr><td>58160-0812-43</td><td>KINRIX</td><td/></tr><tr><td>58160-0812-01</td><td>KINRIX</td><td/></tr><tr><td>66019-0108-01</td><td>FluMist</td><td/></tr><tr><td>00006-4898-01</td><td>COMVAX</td><td/></tr><tr><td>58160-0809-01</td><td>MENHIBRIX</td><td/></tr><tr><td>63851-0612-11</td><td>Flucelvax</td><td/></tr><tr><td>00006-4992-01</td><td>RECOMBIVAX HB</td><td/></tr><tr><td>00006-4981-01</td><td>RECOMBIVAX HB</td><td/></tr><tr><td>00006-4980-00</td><td>RECOMBIVAX HB</td><td/></tr><tr><td>00006-4093-01</td><td>RECOMBIVAX HB</td><td/></tr><tr><td>00006-4094-01</td><td>RECOMBIVAX HB</td><td/></tr><tr><td>00006-4109-01</td><td>GARDASIL</td><td/></tr><tr><td>66521-0112-02</td><td>FLUVIRIN</td><td/></tr><tr><td>66521-0112-10</td><td>FLUVIRIN</td><td/></tr><tr><td>66019-0107-01</td><td>FluMist</td><td/></tr><tr><td>49281-0225-58</td><td>DIPHTHERIA AND TETANUS TOXOIDS ADSORBED</td><td/></tr><tr><td>49281-0705-55</td><td>FLUZONE</td><td/></tr><tr><td>42515-0001-00</td><td>IXIARO</td><td/></tr><tr><td>58160-0879-41</td><td>FLUARIX</td><td/></tr><tr><td>58160-0880-41</td><td>FLUARIX</td><td/></tr><tr><td>58160-0820-01</td><td>ENGERIX-B</td><td/></tr><tr><td>58160-0820-43</td><td>ENGERIX-B</td><td/></tr><tr><td>58160-0821-01</td><td>ENGERIX-B</td><td/></tr><tr><td>58160-0821-43</td><td>ENGERIX-B</td><td/></tr><tr><td>58160-0821-05</td><td>ENGERIX-B</td><td/></tr><tr><td>42874-0012-01</td><td>Flublok</td><td/></tr><tr><td>49281-0278-10</td><td>DIPHTHERIA AND TETANUS TOXOIDS ADSORBED</td><td/></tr><tr><td>66019-0109-01</td><td>FluMist</td><td/></tr><tr><td>19515-0890-02</td><td>FLULAVAL</td><td/></tr><tr><td>19515-0889-02</td><td>FLULAVAL</td><td/></tr><tr><td>58160-0900-41</td><td>FLUARIX QUADRIVALENT</td><td/></tr><tr><td>49281-0860-78</td><td>IPOL</td><td/></tr><tr><td>49281-0860-88</td><td>IPOL</td><td/></tr><tr><td>49281-0389-65</td><td>FLUZONE High-Dose</td><td/></tr><tr><td>49281-0388-15</td><td>FLUZONE</td><td/></tr><tr><td>49281-0011-10</td><td>FLUZONE</td><td/></tr><tr><td>49281-0011-50</td><td>FLUZONE</td><td/></tr><tr><td>49281-0703-55</td><td>FLUZONE Intradermal</td><td/></tr><tr><td>49281-0111-25</td><td>FLUZONE</td><td/></tr><tr><td>66521-0200-10</td><td>Influenza A (H1N1) 2009 Monovalent Vaccine</td><td/></tr><tr><td>66521-0200-02</td><td>Influenza A (H1N1) 2009 Monovalent Vaccine</td><td/></tr><tr><td>49281-0298-10</td><td>TRIPEDIA</td><td/></tr><tr><td>58160-0806-01</td><td>HIBERIX</td><td/></tr><tr><td>33332-0013-02</td><td>AFLURIA</td><td/></tr><tr><td>33332-0113-11</td><td>AFLURIA</td><td/></tr><tr><td>49281-0391-65</td><td>FLUZONE High-Dose</td><td/></tr><tr><td>49281-0012-50</td><td>FLUZONE</td><td/></tr><tr><td>49281-0012-10</td><td>FLUZONE</td><td/></tr><tr><td>49281-0112-25</td><td>FLUZONE</td><td/></tr><tr><td>49281-0390-15</td><td>FLUZONE</td><td/></tr><tr><td>00006-4897-01</td><td>PedvaxHIB</td><td/></tr><tr><td>49281-0291-83</td><td>DECAVAC</td><td/></tr><tr><td>49281-0291-10</td><td>DECAVAC</td><td/></tr><tr><td>49281-0413-88</td><td>FLUZONE QUADRIVALENT</td><td/></tr><tr><td>49281-0413-58</td><td>FLUZONE QUADRIVALENT</td><td/></tr><tr><td>49281-0513-00</td><td>FLUZONE QUADRIVALENT</td><td/></tr><tr><td>66521-0113-02</td><td>Fluvirin</td><td/></tr><tr><td>66521-0113-10</td><td>Fluvirin</td><td/></tr><tr><td>00005-1970-49</td><td>Prevnar</td><td/></tr><tr><td>00006-4047-01</td><td>RotaTeq</td><td/></tr><tr><td>58160-0811-43</td><td>PEDIARIX</td><td/></tr><tr><td>58160-0811-41</td><td>PEDIARIX</td><td/></tr><tr><td>00006-4827-01</td><td>VARIVAX</td><td/></tr><tr><td>00006-4826-01</td><td>VARIVAX</td><td/></tr><tr><td>58160-0842-41</td><td>BOOSTRIX</td><td/></tr><tr><td>58160-0842-01</td><td>BOOSTRIX</td><td/></tr><tr><td>58160-0842-43</td><td>BOOSTRIX</td><td/></tr><tr><td>58160-0842-05</td><td>BOOSTRIX</td><td/></tr><tr><td>66019-0300-01</td><td>FluMist Quadrivalent</td><td/></tr><tr><td>49281-0589-58</td><td>Menactra</td><td/></tr><tr><td>00006-4095-01</td><td>VAQTA</td><td/></tr><tr><td>00006-4096-01</td><td>VAQTA</td><td/></tr><tr><td>00006-4831-01</td><td>VAQTA</td><td/></tr><tr><td>63851-0511-11</td><td>RabAvert</td><td/></tr><tr><td>66019-0200-01</td><td>Influenza A H1N1 2009 Monovalent Vaccine Live Intr</td><td/></tr><tr><td>14362-0111-03</td><td>Tetanus and Diphtheria Toxoids Adsorbed</td><td/></tr><tr><td>33332-0519-01</td><td>Influenza A</td><td/></tr><tr><td>33332-0519-25</td><td>Influenza A</td><td/></tr><tr><td>33332-0629-10</td><td>Influenza A</td><td/></tr><tr><td>58160-0825-43</td><td>HAVRIX</td><td/></tr><tr><td>58160-0825-01</td><td>HAVRIX</td><td/></tr><tr><td>58160-0826-43</td><td>HAVRIX</td><td/></tr><tr><td>58160-0826-05</td><td>HAVRIX</td><td/></tr><tr><td>58160-0826-01</td><td>HAVRIX</td><td/></tr><tr><td>33332-0010-01</td><td>AFLURIA</td><td/></tr><tr><td>33332-0110-10</td><td>AFLURIA</td><td/></tr><tr><td>66521-0115-10</td><td>Fluvirin</td><td/></tr><tr><td>66521-0115-02</td><td>Fluvirin</td><td/></tr><tr><td>00006-4133-01</td><td>Tetanus and Diphtheria Toxoids Adsorbed</td><td/></tr><tr><td>54868-4320-09</td><td>PNEUMOVAX 23</td><td/></tr><tr><td>54868-3339-09</td><td>PNEUMOVAX 23</td><td/></tr><tr><td>00052-0603-01</td><td>BCG VACCINE</td><td/></tr><tr><td>64678-0211-05</td><td>BioThrax</td><td/></tr><tr><td>00006-4739-01</td><td>PNEUMOVAX 23</td><td/></tr><tr><td>00006-4943-01</td><td>PNEUMOVAX 23</td><td/></tr><tr><td>49281-0013-58</td><td>FLUZONE</td><td/></tr><tr><td>49281-0013-88</td><td>FLUZONE</td><td/></tr><tr><td>49281-0392-78</td><td>FLUZONE</td><td/></tr><tr><td>49281-0113-00</td><td>FLUZONE</td><td/></tr><tr><td>49281-0820-10</td><td>TETANUS TOXOID ADSORBED</td><td/></tr><tr><td>49281-0800-83</td><td>TETANUS TOXOID ADSORBED</td><td/></tr><tr><td>49281-0400-88</td><td>Adacel</td><td/></tr><tr><td>49281-0286-58</td><td>DAPTACEL</td><td/></tr><tr><td>49281-0286-58</td><td>DAPTACEL</td><td/></tr><tr><td>49281-0286-58</td><td>DAPTACEL</td><td/></tr><tr><td>58160-0815-41</td><td>TWINRIX</td><td/></tr><tr><td>58160-0815-43</td><td>TWINRIX</td><td/></tr><tr><td>58160-0815-05</td><td>TWINRIX</td><td/></tr><tr><td>58160-0815-43</td><td>TWINRIX</td><td/></tr><tr><td>58160-0815-01</td><td>TWINRIX</td><td/></tr><tr><td>66521-0114-10</td><td>Fluvirin</td><td/></tr><tr><td>76420-0482-01</td><td>FLUVIRIN</td><td/></tr><tr><td>19515-0895-01</td><td>Flulaval Quadrivalent</td><td/></tr><tr><td>00006-4999-01</td><td>ProQuad</td><td/></tr><tr><td>49281-0545-15</td><td>ACTHIB</td><td/></tr><tr><td>51285-0174-02</td><td>Adenovirus Type 4 Vaccine, Live, Oral</td><td/></tr><tr><td>49281-0248-58</td><td>IMOVAX RABIES</td><td/></tr><tr><td>49281-0487-58</td><td>MENOMUNE - A/C/Y/W-135 COMBINED</td><td/></tr><tr><td>49281-0915-58</td><td>YF-VAX</td><td/></tr><tr><td>49281-0547-58</td><td>ACTHIB</td><td/></tr><tr><td>58160-0851-01</td><td>ROTARIX</td><td/></tr><tr><td>49281-0915-68</td><td>YF-VAX</td><td/></tr><tr><td>49281-0488-78</td><td>MENOMUNE - A/C/Y/W-135 COMBINED</td><td/></tr><tr><td>46028-0219-11</td><td>Meningococcal (Groups C, Y, W-135) CRM197 Oligosac</td><td/></tr><tr><td>51285-0175-02</td><td>Adenovirus Type 7 Vaccine, Live, Oral</td><td/></tr><tr><td>49281-0560-05</td><td>DTAP-IPV</td><td/></tr><tr><td>49281-0400-58</td><td>Adacel</td><td/></tr><tr><td>49281-0400-58</td><td>Adacel</td><td/></tr><tr><td>42874-0013-01</td><td>Flublok</td><td/></tr><tr><td>66521-0116-11</td><td>FLUVIRIN</td><td/></tr><tr><td>66521-0116-12</td><td>FLUVIRIN</td><td/></tr><tr><td>00006-4045-01</td><td>GARDASIL</td><td/></tr><tr><td>00006-4045-01</td><td>GARDASIL</td><td/></tr><tr><td>00006-4995-01</td><td>RECOMBIVAX HB</td><td/></tr><tr><td>00006-4995-01</td><td>RECOMBIVAX HB</td><td/></tr><tr><td>00006-4841-01</td><td>VAQTA</td><td/></tr><tr><td>00006-4841-01</td><td>VAQTA</td><td/></tr><tr><td>58160-0804-01</td><td>INFLUENZA (H5N1), adjuvanted</td><td/></tr><tr><td>58160-0802-02</td><td>AS03 Adjuvant</td><td/></tr><tr><td>58160-0901-41</td><td>FLUARIX QUADRIVALENT</td><td/></tr><tr><td>00006-4837-01</td><td>PNEUMOVAX 23</td><td/></tr><tr><td>19515-0891-01</td><td>Flulaval Quadrivalent</td><td/></tr><tr><td>19515-0893-02</td><td>FLULAVAL</td><td/></tr><tr><td>19515-0894-41</td><td>Flulaval Quadrivalent</td><td/></tr><tr><td>49281-0514-00</td><td>Fluzone Quadrivalent, Peds</td><td/></tr><tr><td>49281-0394-78</td><td>FLUZONE</td><td/></tr><tr><td>49281-0014-88</td><td>FLUZONE</td><td/></tr><tr><td>49281-0414-58</td><td>FLUZONE QUADRIVALENT PF</td><td/></tr></table></li></ul></div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>Vaccine National Drug Code (NDC)</h2><div><p>This value set includes all the Vaccine National Drug Codes (NDC).  This source of this data is provided by the <a href=\"https://www2a.cdc.gov/vaccines/iis/iisstandards/ndc_crosswalk.asp\">CDC</a></p>\n</div><p>This value set includes codes from the following code systems:</p><ul><li>Include these codes as defined in <code>http://hl7.org/fhir/sid/ndc</code><table class=\"none\"><tr><td><b>Code</b></td><td><b>Display</b></td></tr><tr><td>49281-0589-58</td><td>Menactra</td><td/></tr><tr><td>49281-0623-78</td><td>FLUZONE QUADRIVALENT</td><td/></tr><tr><td>49281-0515-00</td><td>Fluzone Quadrivalent, peds</td><td/></tr><tr><td>49281-0415-88</td><td>Fluzone Quadrivalent PF</td><td/></tr><tr><td>49281-0415-58</td><td>FLUZONE QUADRIVALENT PF</td><td/></tr><tr><td>33332-0115-11</td><td>AFLURIA</td><td/></tr><tr><td>33332-0015-02</td><td>AFLURIA</td><td/></tr><tr><td>66019-0302-01</td><td>FluMist Quadrivalent</td><td/></tr><tr><td>42874-0015-01</td><td>Flublok</td><td/></tr><tr><td>66521-0118-12</td><td>Fluvirin</td><td/></tr><tr><td>66521-0118-11</td><td>Fluvirin</td><td/></tr><tr><td>58160-0883-41</td><td>FLUARIX</td><td/></tr><tr><td>66521-0000-11</td><td>Fluad</td><td/></tr><tr><td>69401-0000-01</td><td>Vivotif</td><td/></tr><tr><td>66019-0301-01</td><td>FluMist Quadrivalent</td><td/></tr><tr><td>33332-0014-02</td><td>AFLURIA</td><td/></tr><tr><td>33332-0114-11</td><td>AFLURIA</td><td/></tr><tr><td>63851-0613-11</td><td>Flucelvax</td><td/></tr><tr><td>66521-0117-11</td><td>FLUVIRIN</td><td/></tr><tr><td>66521-0117-12</td><td>Fluvirin</td><td/></tr><tr><td>00006-4093-01</td><td>RECOMBIVAX HB</td><td/></tr><tr><td>00006-4094-01</td><td>RECOMBIVAX HB</td><td/></tr><tr><td>00006-4095-01</td><td>VAQTA</td><td/></tr><tr><td>00006-4096-01</td><td>VAQTA</td><td/></tr><tr><td>00006-4963-01</td><td>ZOSTAVAX</td><td/></tr><tr><td>00006-4963-01</td><td>ZOSTAVAX</td><td/></tr><tr><td>42874-0014-01</td><td>Flublok</td><td/></tr><tr><td>49281-0414-88</td><td>Fluzone Quadrivalent PF</td><td/></tr><tr><td>49281-0395-88</td><td>Fluzone HD</td><td/></tr><tr><td>49281-0709-48</td><td>FLUZONE Intradermal</td><td/></tr><tr><td>58160-0881-41</td><td>FLUARIX</td><td/></tr><tr><td>58160-0809-01</td><td>MENHIBRIX</td><td/></tr><tr><td>62577-0613-11</td><td>Flucelvax</td><td/></tr><tr><td>19515-0893-02</td><td>FLULAVAL</td><td/></tr><tr><td>49281-0621-78</td><td>FLUZONE QUADRIVALENT</td><td/></tr><tr><td>00005-0100-01</td><td>Trumenba</td><td/></tr><tr><td>00005-0100-01</td><td>Trumenba</td><td/></tr><tr><td>00005-0100-01</td><td>Trumenba</td><td/></tr><tr><td>00006-4047-01</td><td>RotaTeq</td><td/></tr><tr><td>00006-4109-01</td><td>GARDASIL</td><td/></tr><tr><td>62577-0613-11</td><td>Flucelvax</td><td/></tr><tr><td>00006-4121-01</td><td>GARDASIL 9</td><td/></tr><tr><td>00006-4119-01</td><td>GARDASIL 9</td><td/></tr><tr><td>00006-4119-01</td><td>GARDASIL 9</td><td/></tr><tr><td>63851-0511-11</td><td>RabAvert</td><td/></tr><tr><td>49281-0562-58</td><td>QUADRACEL</td><td/></tr><tr><td>46028-0114-11</td><td>Bexsero</td><td/></tr><tr><td>46028-0114-11</td><td>Bexsero</td><td/></tr><tr><td>00006-4171-01</td><td>ProQuad</td><td/></tr><tr><td>13533-0131-00</td><td>Tetanus and Diphtheria Toxoids Adsorbed</td><td/></tr><tr><td>49281-0396-78</td><td>FLUZONE</td><td/></tr><tr><td>49281-0397-88</td><td>FLUZONE High-Dose</td><td/></tr><tr><td>62577-0614-11</td><td>Flucelvax</td><td/></tr><tr><td>58160-0903-41</td><td>FLUARIX QUADRIVALENT</td><td/></tr><tr><td>19515-0898-01</td><td>Flulaval Quadrivalent</td><td/></tr><tr><td>19515-0901-41</td><td>Flulaval Quadrivalent</td><td/></tr><tr><td>49281-0393-88</td><td>FLUZONE High-Dose</td><td/></tr><tr><td>58160-0810-43</td><td>INFANRIX</td><td/></tr><tr><td>58160-0810-01</td><td>INFANRIX</td><td/></tr><tr><td>49281-0790-38</td><td>Typhim Vi</td><td/></tr><tr><td>49281-0790-88</td><td>Typhim Vi</td><td/></tr><tr><td>49281-0640-15</td><td>INFLUENZA A (H1N1) 2009 MONOVALENT VACCINE</td><td/></tr><tr><td>49281-0650-10</td><td>INFLUENZA A (H1N1) 2009 MONOVALENT VACCINE</td><td/></tr><tr><td>49281-0650-90</td><td>INFLUENZA A (H1N1) 2009 MONOVALENT VACCINE</td><td/></tr><tr><td>49281-0650-25</td><td>INFLUENZA A (H1N1) 2009 MONOVALENT VACCINE</td><td/></tr><tr><td>49281-0650-70</td><td>INFLUENZA A (H1N1) 2009 MONOVALENT VACCINE</td><td/></tr><tr><td>49281-0650-50</td><td>INFLUENZA A (H1N1) 2009 MONOVALENT VACCINE</td><td/></tr><tr><td>49281-0707-48</td><td>FLUZONE</td><td/></tr><tr><td>66019-0110-01</td><td>FluMist</td><td/></tr><tr><td>00006-4681-01</td><td>M-M-R II</td><td/></tr><tr><td>49281-0215-58</td><td>TENIVAC</td><td/></tr><tr><td>49281-0215-88</td><td>TENIVAC</td><td/></tr><tr><td>46028-0218-11</td><td>Meningococcal (Groups A) CRM197 Oligosaccharide Co</td><td/></tr><tr><td>49281-0387-65</td><td>FLUZONE</td><td/></tr><tr><td>49281-0386-15</td><td>FLUZONE</td><td/></tr><tr><td>49281-0010-10</td><td>FLUZONE</td><td/></tr><tr><td>49281-0010-25</td><td>Fluzone</td><td/></tr><tr><td>49281-0010-50</td><td>FLUZONE</td><td/></tr><tr><td>54868-0980-00</td><td>M-M-R II</td><td/></tr><tr><td>58160-0830-43</td><td>CERVARIX</td><td/></tr><tr><td>58160-0830-05</td><td>CERVARIX</td><td/></tr><tr><td>00005-1971-01</td><td>PREVNAR 13</td><td/></tr><tr><td>00005-1971-01</td><td>PREVNAR 13</td><td/></tr><tr><td>00005-1971-01</td><td>PREVNAR 13</td><td/></tr><tr><td>17478-0131-00</td><td>Tetanus and Diphtheria Toxoids Adsorbed</td><td/></tr><tr><td>58160-0812-43</td><td>KINRIX</td><td/></tr><tr><td>58160-0812-01</td><td>KINRIX</td><td/></tr><tr><td>66019-0108-01</td><td>FluMist</td><td/></tr><tr><td>00006-4898-01</td><td>COMVAX</td><td/></tr><tr><td>58160-0809-01</td><td>MENHIBRIX</td><td/></tr><tr><td>63851-0612-11</td><td>Flucelvax</td><td/></tr><tr><td>00006-4992-01</td><td>RECOMBIVAX HB</td><td/></tr><tr><td>00006-4981-01</td><td>RECOMBIVAX HB</td><td/></tr><tr><td>00006-4980-00</td><td>RECOMBIVAX HB</td><td/></tr><tr><td>00006-4093-01</td><td>RECOMBIVAX HB</td><td/></tr><tr><td>00006-4094-01</td><td>RECOMBIVAX HB</td><td/></tr><tr><td>00006-4109-01</td><td>GARDASIL</td><td/></tr><tr><td>66521-0112-02</td><td>FLUVIRIN</td><td/></tr><tr><td>66521-0112-10</td><td>FLUVIRIN</td><td/></tr><tr><td>66019-0107-01</td><td>FluMist</td><td/></tr><tr><td>49281-0225-58</td><td>DIPHTHERIA AND TETANUS TOXOIDS ADSORBED</td><td/></tr><tr><td>49281-0705-55</td><td>FLUZONE</td><td/></tr><tr><td>42515-0001-00</td><td>IXIARO</td><td/></tr><tr><td>58160-0879-41</td><td>FLUARIX</td><td/></tr><tr><td>58160-0880-41</td><td>FLUARIX</td><td/></tr><tr><td>58160-0820-01</td><td>ENGERIX-B</td><td/></tr><tr><td>58160-0820-43</td><td>ENGERIX-B</td><td/></tr><tr><td>58160-0821-01</td><td>ENGERIX-B</td><td/></tr><tr><td>58160-0821-43</td><td>ENGERIX-B</td><td/></tr><tr><td>58160-0821-05</td><td>ENGERIX-B</td><td/></tr><tr><td>42874-0012-01</td><td>Flublok</td><td/></tr><tr><td>49281-0278-10</td><td>DIPHTHERIA AND TETANUS TOXOIDS ADSORBED</td><td/></tr><tr><td>66019-0109-01</td><td>FluMist</td><td/></tr><tr><td>19515-0890-02</td><td>FLULAVAL</td><td/></tr><tr><td>19515-0889-02</td><td>FLULAVAL</td><td/></tr><tr><td>58160-0900-41</td><td>FLUARIX QUADRIVALENT</td><td/></tr><tr><td>49281-0860-78</td><td>IPOL</td><td/></tr><tr><td>49281-0860-88</td><td>IPOL</td><td/></tr><tr><td>49281-0389-65</td><td>FLUZONE High-Dose</td><td/></tr><tr><td>49281-0388-15</td><td>FLUZONE</td><td/></tr><tr><td>49281-0011-10</td><td>FLUZONE</td><td/></tr><tr><td>49281-0011-50</td><td>FLUZONE</td><td/></tr><tr><td>49281-0703-55</td><td>FLUZONE Intradermal</td><td/></tr><tr><td>49281-0111-25</td><td>FLUZONE</td><td/></tr><tr><td>66521-0200-10</td><td>Influenza A (H1N1) 2009 Monovalent Vaccine</td><td/></tr><tr><td>66521-0200-02</td><td>Influenza A (H1N1) 2009 Monovalent Vaccine</td><td/></tr><tr><td>49281-0298-10</td><td>TRIPEDIA</td><td/></tr><tr><td>58160-0806-01</td><td>HIBERIX</td><td/></tr><tr><td>33332-0013-02</td><td>AFLURIA</td><td/></tr><tr><td>33332-0113-11</td><td>AFLURIA</td><td/></tr><tr><td>49281-0391-65</td><td>FLUZONE High-Dose</td><td/></tr><tr><td>49281-0012-50</td><td>FLUZONE</td><td/></tr><tr><td>49281-0012-10</td><td>FLUZONE</td><td/></tr><tr><td>49281-0112-25</td><td>FLUZONE</td><td/></tr><tr><td>49281-0390-15</td><td>FLUZONE</td><td/></tr><tr><td>00006-4897-01</td><td>PedvaxHIB</td><td/></tr><tr><td>49281-0291-83</td><td>DECAVAC</td><td/></tr><tr><td>49281-0291-10</td><td>DECAVAC</td><td/></tr><tr><td>49281-0413-88</td><td>FLUZONE QUADRIVALENT</td><td/></tr><tr><td>49281-0413-58</td><td>FLUZONE QUADRIVALENT</td><td/></tr><tr><td>49281-0513-00</td><td>FLUZONE QUADRIVALENT</td><td/></tr><tr><td>66521-0113-02</td><td>Fluvirin</td><td/></tr><tr><td>66521-0113-10</td><td>Fluvirin</td><td/></tr><tr><td>00005-1970-49</td><td>Prevnar</td><td/></tr><tr><td>00006-4047-01</td><td>RotaTeq</td><td/></tr><tr><td>58160-0811-43</td><td>PEDIARIX</td><td/></tr><tr><td>58160-0811-41</td><td>PEDIARIX</td><td/></tr><tr><td>00006-4827-01</td><td>VARIVAX</td><td/></tr><tr><td>00006-4826-01</td><td>VARIVAX</td><td/></tr><tr><td>58160-0842-41</td><td>BOOSTRIX</td><td/></tr><tr><td>58160-0842-01</td><td>BOOSTRIX</td><td/></tr><tr><td>58160-0842-43</td><td>BOOSTRIX</td><td/></tr><tr><td>58160-0842-05</td><td>BOOSTRIX</td><td/></tr><tr><td>66019-0300-01</td><td>FluMist Quadrivalent</td><td/></tr><tr><td>49281-0589-58</td><td>Menactra</td><td/></tr><tr><td>00006-4095-01</td><td>VAQTA</td><td/></tr><tr><td>00006-4096-01</td><td>VAQTA</td><td/></tr><tr><td>00006-4831-01</td><td>VAQTA</td><td/></tr><tr><td>63851-0511-11</td><td>RabAvert</td><td/></tr><tr><td>66019-0200-01</td><td>Influenza A H1N1 2009 Monovalent Vaccine Live Intr</td><td/></tr><tr><td>14362-0111-03</td><td>Tetanus and Diphtheria Toxoids Adsorbed</td><td/></tr><tr><td>33332-0519-01</td><td>Influenza A</td><td/></tr><tr><td>33332-0519-25</td><td>Influenza A</td><td/></tr><tr><td>33332-0629-10</td><td>Influenza A</td><td/></tr><tr><td>58160-0825-43</td><td>HAVRIX</td><td/></tr><tr><td>58160-0825-01</td><td>HAVRIX</td><td/></tr><tr><td>58160-0826-43</td><td>HAVRIX</td><td/></tr><tr><td>58160-0826-05</td><td>HAVRIX</td><td/></tr><tr><td>58160-0826-01</td><td>HAVRIX</td><td/></tr><tr><td>33332-0010-01</td><td>AFLURIA</td><td/></tr><tr><td>33332-0110-10</td><td>AFLURIA</td><td/></tr><tr><td>66521-0115-10</td><td>Fluvirin</td><td/></tr><tr><td>66521-0115-02</td><td>Fluvirin</td><td/></tr><tr><td>00006-4133-01</td><td>Tetanus and Diphtheria Toxoids Adsorbed</td><td/></tr><tr><td>54868-4320-09</td><td>PNEUMOVAX 23</td><td/></tr><tr><td>54868-3339-09</td><td>PNEUMOVAX 23</td><td/></tr><tr><td>00052-0603-01</td><td>BCG VACCINE</td><td/></tr><tr><td>64678-0211-05</td><td>BioThrax</td><td/></tr><tr><td>00006-4739-01</td><td>PNEUMOVAX 23</td><td/></tr><tr><td>00006-4943-01</td><td>PNEUMOVAX 23</td><td/></tr><tr><td>49281-0013-58</td><td>FLUZONE</td><td/></tr><tr><td>49281-0013-88</td><td>FLUZONE</td><td/></tr><tr><td>49281-0392-78</td><td>FLUZONE</td><td/></tr><tr><td>49281-0113-00</td><td>FLUZONE</td><td/></tr><tr><td>49281-0820-10</td><td>TETANUS TOXOID ADSORBED</td><td/></tr><tr><td>49281-0800-83</td><td>TETANUS TOXOID ADSORBED</td><td/></tr><tr><td>49281-0400-88</td><td>Adacel</td><td/></tr><tr><td>49281-0286-58</td><td>DAPTACEL</td><td/></tr><tr><td>49281-0286-58</td><td>DAPTACEL</td><td/></tr><tr><td>49281-0286-58</td><td>DAPTACEL</td><td/></tr><tr><td>58160-0815-41</td><td>TWINRIX</td><td/></tr><tr><td>58160-0815-43</td><td>TWINRIX</td><td/></tr><tr><td>58160-0815-05</td><td>TWINRIX</td><td/></tr><tr><td>58160-0815-43</td><td>TWINRIX</td><td/></tr><tr><td>58160-0815-01</td><td>TWINRIX</td><td/></tr><tr><td>66521-0114-10</td><td>Fluvirin</td><td/></tr><tr><td>76420-0482-01</td><td>FLUVIRIN</td><td/></tr><tr><td>19515-0895-01</td><td>Flulaval Quadrivalent</td><td/></tr><tr><td>00006-4999-01</td><td>ProQuad</td><td/></tr><tr><td>49281-0545-15</td><td>ACTHIB</td><td/></tr><tr><td>51285-0174-02</td><td>Adenovirus Type 4 Vaccine, Live, Oral</td><td/></tr><tr><td>49281-0248-58</td><td>IMOVAX RABIES</td><td/></tr><tr><td>49281-0487-58</td><td>MENOMUNE - A/C/Y/W-135 COMBINED</td><td/></tr><tr><td>49281-0915-58</td><td>YF-VAX</td><td/></tr><tr><td>49281-0547-58</td><td>ACTHIB</td><td/></tr><tr><td>58160-0851-01</td><td>ROTARIX</td><td/></tr><tr><td>49281-0915-68</td><td>YF-VAX</td><td/></tr><tr><td>49281-0488-78</td><td>MENOMUNE - A/C/Y/W-135 COMBINED</td><td/></tr><tr><td>46028-0219-11</td><td>Meningococcal (Groups C, Y, W-135) CRM197 Oligosac</td><td/></tr><tr><td>51285-0175-02</td><td>Adenovirus Type 7 Vaccine, Live, Oral</td><td/></tr><tr><td>49281-0560-05</td><td>DTAP-IPV</td><td/></tr><tr><td>49281-0400-58</td><td>Adacel</td><td/></tr><tr><td>49281-0400-58</td><td>Adacel</td><td/></tr><tr><td>42874-0013-01</td><td>Flublok</td><td/></tr><tr><td>66521-0116-11</td><td>FLUVIRIN</td><td/></tr><tr><td>66521-0116-12</td><td>FLUVIRIN</td><td/></tr><tr><td>00006-4045-01</td><td>GARDASIL</td><td/></tr><tr><td>00006-4045-01</td><td>GARDASIL</td><td/></tr><tr><td>00006-4995-01</td><td>RECOMBIVAX HB</td><td/></tr><tr><td>00006-4995-01</td><td>RECOMBIVAX HB</td><td/></tr><tr><td>00006-4841-01</td><td>VAQTA</td><td/></tr><tr><td>00006-4841-01</td><td>VAQTA</td><td/></tr><tr><td>58160-0804-01</td><td>INFLUENZA (H5N1), adjuvanted</td><td/></tr><tr><td>58160-0802-02</td><td>AS03 Adjuvant</td><td/></tr><tr><td>58160-0901-41</td><td>FLUARIX QUADRIVALENT</td><td/></tr><tr><td>00006-4837-01</td><td>PNEUMOVAX 23</td><td/></tr><tr><td>19515-0891-01</td><td>Flulaval Quadrivalent</td><td/></tr><tr><td>19515-0893-02</td><td>FLULAVAL</td><td/></tr><tr><td>19515-0894-41</td><td>Flulaval Quadrivalent</td><td/></tr><tr><td>49281-0514-00</td><td>Fluzone Quadrivalent, Peds</td><td/></tr><tr><td>49281-0394-78</td><td>FLUZONE</td><td/></tr><tr><td>49281-0014-88</td><td>FLUZONE</td><td/></tr><tr><td>49281-0414-58</td><td>FLUZONE QUADRIVALENT PF</td><td/></tr></table></li></ul></div>"
   },
   "url": "http://hl7.org/fhir/us/core/ValueSet/us-core-ndc-vaccine-codes",
+  "version": "1.0.0",
   "name": "Vaccine National Drug Code (NDC)",
   "status": "draft",
-  "publisher": "HL7 (FHIR Project)",
   "date": "2016-08-10",
+  "publisher": "HL7 US Realm Steering Committee",
   "description": "This value set includes all the Vaccine National Drug Codes (NDC).  This source of this data is provided by the [CDC] (https://www2a.cdc.gov/vaccines/iis/iisstandards/ndc_crosswalk.asp)",
   "purpose": "Codes that are used as translations for CVS code for implementation of the Argonaut Immunization IG and MU2015 certification.",
   "compose": {
@@ -2048,4 +2049,4 @@
       }
     ]
   }
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/ValueSet-us-core-observation-ccdasmokingstatus.json b/lib/resources/us_core/ValueSet-us-core-observation-ccdasmokingstatus.json
index c407369..9d4c1cf 100755
--- a/lib/resources/us_core/ValueSet-us-core-observation-ccdasmokingstatus.json
+++ b/lib/resources/us_core/ValueSet-us-core-observation-ccdasmokingstatus.json
@@ -9,7 +9,7 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>Smoking Status</h2><div><p>This value set indicates the current smoking status of a patient.</p>\n</div><p><b>Copyright Statement:</b> This value set includes content from SNOMED CT, which is copyright © 2002+ International Health Terminology Standards Development Organisation (IHTSDO), and distributed by agreement between IHTSDO and HL7. Implementer use of SNOMED CT is not covered by this agreement</p><p>This value set includes codes from the following code systems:</p><ul><li>Include these codes as defined in <a href=\"http://hl7.org/fhir/2017Jan/codesystem-snomedct.html\">http://snomed.info/sct</a><table class=\"none\"><tr><td><b>Code</b></td><td><b>Display</b></td></tr><tr><td>449868002</td><td>Current every day smoker</td><td/></tr><tr><td>428041000124106</td><td>Current some day smoker</td><td/></tr><tr><td>8517006</td><td>Former smoker</td><td/></tr><tr><td>266919005</td><td>Never smoker</td><td/></tr><tr><td>77176002</td><td>Smoker, current status unknown</td><td/></tr><tr><td>266927001</td><td>Unknown if ever smoked</td><td/></tr><tr><td>428071000124103</td><td>Current Heavy tobacco smoker</td><td/></tr><tr><td>428061000124105</td><td>Current Light tobacco smoker</td><td/></tr></table></li></ul></div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>Smoking Status</h2><div><p>This value set indicates the current smoking status of a patient.</p>\n</div><p><b>Copyright Statement:</b> This value set includes content from SNOMED CT, which is copyright © 2002+ International Health Terminology Standards Development Organisation (IHTSDO), and distributed by agreement between IHTSDO and HL7. Implementer use of SNOMED CT is not covered by this agreement</p><p>This value set includes codes from the following code systems:</p><ul><li>Include these codes as defined in <a href=\"http://www.snomed.org/\"><code>http://snomed.info/sct</code></a><table class=\"none\"><tr><td><b>Code</b></td><td><b>Display</b></td></tr><tr><td><a href=\"http://browser.ihtsdotools.org/?perspective=full&amp;conceptId1=449868002\">449868002</a></td><td>Current every day smoker</td><td/></tr><tr><td><a href=\"http://browser.ihtsdotools.org/?perspective=full&amp;conceptId1=428041000124106\">428041000124106</a></td><td>Current some day smoker</td><td/></tr><tr><td><a href=\"http://browser.ihtsdotools.org/?perspective=full&amp;conceptId1=8517006\">8517006</a></td><td>Former smoker</td><td/></tr><tr><td><a href=\"http://browser.ihtsdotools.org/?perspective=full&amp;conceptId1=266919005\">266919005</a></td><td>Never smoker</td><td/></tr><tr><td><a href=\"http://browser.ihtsdotools.org/?perspective=full&amp;conceptId1=77176002\">77176002</a></td><td>Smoker, current status unknown</td><td/></tr><tr><td><a href=\"http://browser.ihtsdotools.org/?perspective=full&amp;conceptId1=266927001\">266927001</a></td><td>Unknown if ever smoked</td><td/></tr><tr><td><a href=\"http://browser.ihtsdotools.org/?perspective=full&amp;conceptId1=428071000124103\">428071000124103</a></td><td>Current Heavy tobacco smoker</td><td/></tr><tr><td><a href=\"http://browser.ihtsdotools.org/?perspective=full&amp;conceptId1=428061000124105\">428061000124105</a></td><td>Current Light tobacco smoker</td><td/></tr></table></li></ul></div>"
   },
   "url": "http://hl7.org/fhir/us/core/ValueSet/us-core-observation-ccdasmokingstatus",
   "identifier": [
@@ -18,11 +18,11 @@
       "value": "urn:oid:2.16.840.1.113883.4.642.2.602"
     }
   ],
-  "version": "1.6.0",
+  "version": "1.0.0",
   "name": "Smoking Status",
   "status": "active",
-  "experimental": true,
-  "publisher": "FHIR OO CDA Template team",
+  "date": "2016-08-10",
+  "publisher": "HL7 US Realm Steering Committee",
   "contact": [
     {
       "telecom": [
@@ -33,7 +33,6 @@
       ]
     }
   ],
-  "date": "2016-08-10",
   "description": "This value set indicates the current smoking status of a patient.",
   "copyright": "This value set includes content from SNOMED CT, which is copyright © 2002+ International Health Terminology Standards Development Organisation (IHTSDO), and distributed by agreement between IHTSDO and HL7. Implementer use of SNOMED CT is not covered by this agreement",
   "compose": {
@@ -77,4 +76,4 @@
       }
     ]
   }
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/ValueSet-us-core-observation-ccdavitalsignresult.json b/lib/resources/us_core/ValueSet-us-core-observation-ccdavitalsignresult.json
deleted file mode 100755
index c23139c..0000000
--- a/lib/resources/us_core/ValueSet-us-core-observation-ccdavitalsignresult.json
+++ /dev/null
@@ -1,80 +0,0 @@
-{
-  "resourceType": "ValueSet",
-  "id": "us-core-observation-ccdavitalsignresult",
-  "text": {
-    "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>US Core Vital Sign Codes</h2><div><p>This value set indicates the allowed vital sign result types. The vocabulary selected for this value set  based on ONC 2015 Edition Common Clinical Data Set (CCDS) for vitals.    Note the concept Blood pressure systolic and diastolic (55284-4) is used to group the related observations Systolic blood pressure (8480-6) and Diastolic blood pressure (8462-4). It SHALL NOT be used alone, but both 8480-6 and 8462-2 SHALL also be valued.</p>\n</div><p><b>Copyright Statement:</b> This content from LOINC® is copyright © 1995 Regenstrief Institute, Inc. and the LOINC Committee, and available at no cost under the license at http://loinc.org/terms-of-use</p><p>This value set includes codes from the following code systems:</p><ul><li>Include these codes as defined in http://loinc.org<table class=\"none\"><tr><td><b>Code</b></td><td><b>Display</b></td></tr><tr><td>8716-3</td><td>Vital signs</td><td/></tr><tr><td>9279-1</td><td>Respiratory rate</td><td/></tr><tr><td>8867-4</td><td>Heart rate</td><td/></tr><tr><td>59408-5</td><td>Oxygen saturation in Arterial blood by Pulse oximetry</td><td/></tr><tr><td>8310-5</td><td>Body temperature</td><td/></tr><tr><td>8302-2</td><td>Body height</td><td/></tr><tr><td>8306-3</td><td>Body height --lying</td><td/></tr><tr><td>8287-5</td><td>Head Occipital-frontal circumference by Tape measure</td><td/></tr><tr><td>29463-7</td><td>Body weight</td><td/></tr><tr><td>39156-5</td><td>Body mass index (BMI) [Ratio]</td><td/></tr><tr><td>55284-4</td><td>Blood pressure systolic and diastolic</td><td/></tr><tr><td>8480-6</td><td>Systolic blood pressure</td><td/></tr><tr><td>8462-4</td><td>Diastolic blood pressure</td><td/></tr></table></li></ul></div>"
-  },
-  "url": "http://hl7.org/fhir/us/core/ValueSet/us-core-observation-ccdavitalsignresult",
-  "identifier": [
-    {
-      "system": "urn:ietf:rfc:3986",
-      "value": "urn:oid:2.16.840.1.113883.3.88.12.80.62"
-    }
-  ],
-  "version": "1.6.0",
-  "name": "US Core Vital Sign Codes",
-  "status": "active",
-  "publisher": "FHIR Project",
-  "contact": [
-    {
-      "telecom": [
-        {
-          "system": "other",
-          "value": "http://hl7.org/fhir"
-        }
-      ]
-    }
-  ],
-  "date": "2016-08-10",
-  "description": "This value set indicates the allowed vital sign result types. The vocabulary selected for this value set  based on ONC 2015 Edition Common Clinical Data Set (CCDS) for vitals.    Note the concept Blood pressure systolic and diastolic (55284-4) is used to group the related observations Systolic blood pressure (8480-6) and Diastolic blood pressure (8462-4). It SHALL NOT be used alone, but both 8480-6 and 8462-2 SHALL also be valued.",
-  "copyright": "This content from LOINC® is copyright © 1995 Regenstrief Institute, Inc. and the LOINC Committee, and available at no cost under the license at http://loinc.org/terms-of-use",
-  "compose": {
-    "include": [
-      {
-        "system": "http://loinc.org",
-        "concept": [
-          {
-            "code": "8716-3"
-          },
-          {
-            "code": "9279-1"
-          },
-          {
-            "code": "8867-4"
-          },
-          {
-            "code": "59408-5"
-          },
-          {
-            "code": "8310-5"
-          },
-          {
-            "code": "8302-2"
-          },
-          {
-            "code": "8306-3"
-          },
-          {
-            "code": "8287-5"
-          },
-          {
-            "code": "29463-7"
-          },
-          {
-            "code": "39156-5"
-          },
-          {
-            "code": "55284-4"
-          },
-          {
-            "code": "8480-6"
-          },
-          {
-            "code": "8462-4"
-          }
-        ]
-      }
-    ]
-  }
-}
\ No newline at end of file
diff --git a/lib/resources/us_core/ValueSet-us-core-observation-value-codes.json b/lib/resources/us_core/ValueSet-us-core-observation-value-codes.json
index 4e651f7..a349ce2 100755
--- a/lib/resources/us_core/ValueSet-us-core-observation-value-codes.json
+++ b/lib/resources/us_core/ValueSet-us-core-observation-value-codes.json
@@ -3,14 +3,14 @@
   "id": "us-core-observation-value-codes",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>Observation Value Codes (SNOMED-CT)</h2><div><p><a href=\"http://www.ihtsdo.org/\">Snomed-CT</a> concept codes for coded results</p>\n</div><p><b>Copyright Statement:</b> This value set includes content from SNOMED CT, which is copyright © 2002+ International Health Terminology Standards Development Organisation (IHTSDO), and distributed by agreement between IHTSDO and HL7. Implementer use of SNOMED CT is not covered by this agreement</p><p>This value set includes codes from the following code systems:</p><ul><li>Include all codes defined in <a href=\"http://hl7.org/fhir/2017Jan/codesystem-snomedct.html\">http://snomed.info/sct</a></li></ul></div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>Observation Value Codes (SNOMED-CT)</h2><div><p><a href=\"http://www.ihtsdo.org/\">Snomed-CT</a> concept codes for coded results</p>\n</div><p><b>Copyright Statement:</b> This value set includes content from SNOMED CT, which is copyright © 2002+ International Health Terminology Standards Development Organisation (IHTSDO), and distributed by agreement between IHTSDO and HL7. Implementer use of SNOMED CT is not covered by this agreement</p><p>This value set includes codes from the following code systems:</p><ul><li>Include all codes defined in <a href=\"http://www.snomed.org/\"><code>http://snomed.info/sct</code></a></li></ul></div>"
   },
   "url": "http://hl7.org/fhir/us/core/ValueSet/us-core-observation-value-codes",
-  "version": "1.6.0",
+  "version": "1.0.0",
   "name": "Observation Value Codes (SNOMED-CT)",
   "status": "draft",
-  "experimental": true,
-  "publisher": "FHIR Project",
+  "date": "2016-08-10",
+  "publisher": "HL7 US Realm Steering Committee",
   "contact": [
     {
       "telecom": [
@@ -25,7 +25,6 @@
       ]
     }
   ],
-  "date": "2016-08-10",
   "description": "[Snomed-CT](http://www.ihtsdo.org/) concept codes for coded results",
   "copyright": "This value set includes content from SNOMED CT, which is copyright © 2002+ International Health Terminology Standards Development Organisation (IHTSDO), and distributed by agreement between IHTSDO and HL7. Implementer use of SNOMED CT is not covered by this agreement",
   "extensible": true,
@@ -36,4 +35,4 @@
       }
     ]
   }
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/ValueSet-us-core-problem.json b/lib/resources/us_core/ValueSet-us-core-problem.json
index 6efed63..2ee4ede 100755
--- a/lib/resources/us_core/ValueSet-us-core-problem.json
+++ b/lib/resources/us_core/ValueSet-us-core-problem.json
@@ -18,11 +18,11 @@
       "value": "urn:oid:2.16.840.1.113883.3.88.12.3221.7.4"
     }
   ],
-  "version": "1.6.0",
+  "version": "1.0.0",
   "name": "Problem Value Set",
   "status": "active",
-  "experimental": true,
-  "publisher": "PHIN VADS",
+  "date": "2016-05-25T16:59:08+10:00",
+  "publisher": "HL7 US Realm Steering Committee",
   "contact": [
     {
       "telecom": [
@@ -33,7 +33,6 @@
       ]
     }
   ],
-  "date": "2016-05-25T16:59:08+10:00",
   "description": "This describes the problem. Diagnosis/Problem List is broadly defined as a series of brief statements that catalog a patient's medical, nursing, dental, social, preventative and psychiatric events and issues that are relevant to that patient's healthcare (e.g., signs, symptoms, and defined conditions)",
   "copyright": "This value set includes content from SNOMED CT, which is copyright © 2002+ International Health Terminology Standards Development Organisation (IHTSDO), and distributed by agreement between IHTSDO and HL7. Implementer use of SNOMED CT is not covered by this agreement",
   "compose": {
@@ -68,4 +67,4 @@
       }
     ]
   }
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/ValueSet-us-core-procedure-type.json b/lib/resources/us_core/ValueSet-us-core-procedure-code.json
similarity index 59%
rename from lib/resources/us_core/ValueSet-us-core-procedure-type.json
rename to lib/resources/us_core/ValueSet-us-core-procedure-code.json
index 666c3f9..efb0b07 100755
--- a/lib/resources/us_core/ValueSet-us-core-procedure-type.json
+++ b/lib/resources/us_core/ValueSet-us-core-procedure-code.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "ValueSet",
-  "id": "us-core-procedure-type",
+  "id": "us-core-procedure-code",
   "meta": {
     "lastUpdated": "2016-05-25T16:59:08.250+10:00",
     "profile": [
@@ -9,20 +9,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>US CoreProcedureType</h2><div><p>This example value set defines a set of codes that can be used to indicate the type of procedure: a specific code indicating type of procedure performed, from CPT or SNOMED CT.</p>\n</div><p><b>Copyright Statement:</b> CPT copyright 2014 American Medical Association. All rights reserved. This value set includes content from SNOMED CT, which is copyright © 2002+ International Health Terminology Standards Development Organisation (IHTSDO), and distributed by agreement between IHTSDO and HL7. Implementer use of SNOMED CT is not covered by this agreement</p><p>This value set includes codes from the following code systems:</p><ul><li>Include all codes defined in http://www.ama-assn.org/go/cpt</li><li>Include codes from <a href=\"http://hl7.org/fhir/2017Jan/codesystem-snomedct.html\">http://snomed.info/sct</a> where concept  is-a  71388002</li></ul></div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>US Core Procedure Codes</h2><div><p>This example value set defines a set of codes that can be used to indicate the type of procedure: a specific code indicating type of procedure performed, from CPT or SNOMED CT.</p>\n</div><p><b>Copyright Statement:</b> CPT copyright 2014 American Medical Association. All rights reserved. This value set includes content from SNOMED CT, which is copyright © 2002+ International Health Terminology Standards Development Organisation (IHTSDO), and distributed by agreement between IHTSDO and HL7. Implementer use of SNOMED CT is not covered by this agreement</p><p>This value set includes codes from the following code systems:</p><ul><li>Include all codes defined in <code>http://www.ama-assn.org/go/cpt</code></li><li>Include codes from <a href=\"http://www.snomed.org/\"><code>http://snomed.info/sct</code></a> where concept  is-a  71388002 (Procedure)</li></ul></div>"
   },
-  "url": "http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-type",
+  "url": "http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code",
   "identifier": [
     {
       "system": "urn:ietf:rfc:3986",
       "value": "urn:oid:2.16.840.1.113883.4.642.2.607"
     }
   ],
-  "version": "1.6.0",
-  "name": "US CoreProcedureType",
+  "version": "1.0.0",
+  "name": "US Core Procedure Codes",
   "status": "draft",
-  "experimental": true,
-  "publisher": "FHIR Project team",
+  "date": "2016-05-25T16:59:08+10:00",
+  "publisher": "HL7 US Realm Steering Committee",
   "contact": [
     {
       "telecom": [
@@ -33,7 +33,6 @@
       ]
     }
   ],
-  "date": "2016-05-25T16:59:08+10:00",
   "description": "This example value set defines a set of codes that can be used to indicate the type of procedure: a specific code indicating type of procedure performed, from CPT or SNOMED CT.",
   "copyright": "CPT copyright 2014 American Medical Association. All rights reserved. This value set includes content from SNOMED CT, which is copyright © 2002+ International Health Terminology Standards Development Organisation (IHTSDO), and distributed by agreement between IHTSDO and HL7. Implementer use of SNOMED CT is not covered by this agreement",
   "compose": {
@@ -53,4 +52,4 @@
       }
     ]
   }
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/ValueSet-us-core-procedure-icd10pcs.json b/lib/resources/us_core/ValueSet-us-core-procedure-icd10pcs.json
index d9ff561..85d35f7 100755
--- a/lib/resources/us_core/ValueSet-us-core-procedure-icd10pcs.json
+++ b/lib/resources/us_core/ValueSet-us-core-procedure-icd10pcs.json
@@ -9,14 +9,14 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>US Core Procedure Type ICD-10-PCS Codes</h2><div><p>This value set defines a set of codes from ICD10-PCS that can be used to indicate a type of procedure performed</p>\n</div><p><b>Copyright Statement:</b> The International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS) was developed for the Centers for Medicare and Medicaid Services (CMS).  CMS is the U.S. governmental agency responsible for overseeing all changes and modifications to the ICD-10-PCS.</p><p>This value set includes codes from the following code systems:</p><ul><li>Include all codes defined in http://www.icd10data.com/icd10pcs</li></ul></div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>US Core ICD-10-PCS Procedure Codes</h2><div><p>This value set defines a set of codes from ICD10-PCS that can be used to indicate a type of procedure performed</p>\n</div><p><b>Copyright Statement:</b> The International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS) was developed for the Centers for Medicare and Medicaid Services (CMS).  CMS is the U.S. governmental agency responsible for overseeing all changes and modifications to the ICD-10-PCS.</p><p>This value set includes codes from the following code systems:</p><ul><li>Include all codes defined in <code>http://www.icd10data.com/icd10pcs</code></li></ul></div>"
   },
   "url": "http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-icd10pcs",
-  "version": "1.6.0",
-  "name": "US Core Procedure Type ICD-10-PCS Codes",
+  "version": "1.0.0",
+  "name": "US Core ICD-10-PCS Procedure Codes",
   "status": "draft",
-  "experimental": true,
-  "publisher": "FHIR Project team",
+  "date": "2016-08-10",
+  "publisher": "HL7 US Realm Steering Committee",
   "contact": [
     {
       "telecom": [
@@ -27,7 +27,6 @@
       ]
     }
   ],
-  "date": "2016-08-10",
   "description": "This value set defines a set of codes from ICD10-PCS that can be used to indicate a type of procedure performed",
   "copyright": "The International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS) was developed for the Centers for Medicare and Medicaid Services (CMS).  CMS is the U.S. governmental agency responsible for overseeing all changes and modifications to the ICD-10-PCS.",
   "compose": {
@@ -37,4 +36,4 @@
       }
     ]
   }
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/ValueSet-us-core-provider-role.json b/lib/resources/us_core/ValueSet-us-core-provider-role.json
index 3827e43..2a878a4 100755
--- a/lib/resources/us_core/ValueSet-us-core-provider-role.json
+++ b/lib/resources/us_core/ValueSet-us-core-provider-role.json
@@ -3,12 +3,14 @@
   "id": "us-core-provider-role",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n\t\t\t<h2>US Core Provider Role (NUCC)</h2>\n\t\t\t<div>\n\t\t\t\t<p>Provider roles codes which are composed of the NUCC Health Care Provider Taxonomy\n\t\t\t\t\tCode Set for providers. Only concepts with a classification and no specialization are included.</p>\n\t\t\t</div>\n\t\t\t<p><b>Copyright Statement:</b> TODO: Permission to Use and Distribute the Health Care\n\t\t\t\tProvider Taxonomy Code Set</p>\n\t\t\t<p>This value set includes codes from the following code systems:</p>\n\t\t\t<ul>\n\t\t\t\t<li>Include only concepts with a classification and no specialization from: http://nucc.org/provider-taxonomy</li>\n\t\t\t</ul>\n\t\t</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n\t\t\t<h2>US Core Provider Role (NUCC)</h2>\n\t\t\t<div>\n\t\t\t\t<p>Provider roles codes which are composed of the NUCC Health Care Provider Taxonomy\n\t\t\t\t\tCode Set for providers. Only concepts with a classification and no specialization are included.</p>\n\t\t\t</div>\n\t\t\t<p>\n\t\t\t\t<b>Copyright Statement:</b> TODO: Permission to Use and Distribute the Health Care\n\t\t\t\tProvider Taxonomy Code Set</p>\n\t\t\t<p>This value set includes codes from the following code systems:</p>\n\t\t\t<ul>\n\t\t\t\t<li>Include only concepts with a classification and no specialization from: http://nucc.org/provider-taxonomy</li>\n\t\t\t</ul>\n\t\t</div>"
   },
   "url": "http://hl7.org/fhir/us/core/ValueSet/us-core-provider-role",
+  "version": "1.0.0",
   "name": "US Core Provider Role (NUCC)",
   "status": "draft",
-  "publisher": "FHIR Project Team",
+  "date": "2016-08-10",
+  "publisher": "HL7 US Realm Steering Committee",
   "contact": [
     {
       "telecom": [
@@ -19,9 +21,8 @@
       ]
     }
   ],
-  "date": "2016-08-10",
   "description": "Provider roles codes which are composed of the NUCC Health Care Provider Taxonomy Code Set classification codes for providers. Only concepts with a classification and no specialization are included. ",
-  "copyright": "TODO: Permission to Use and Distribute the Health Care Provider Taxonomy Code Set",
+  "copyright": "This value set includes content from NUCC Health Care Provider Taxonomy Code Set for providers which is copyright © 2016+ American Medical Association.  For commercial use, including sales or licensing, a license must be obtained.",
   "compose": {
     "include": [
       {
@@ -29,4 +30,4 @@
       }
     ]
   }
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/ValueSet-us-core-provider-specialty.json b/lib/resources/us_core/ValueSet-us-core-provider-specialty.json
index 103d2da..0b96665 100755
--- a/lib/resources/us_core/ValueSet-us-core-provider-specialty.json
+++ b/lib/resources/us_core/ValueSet-us-core-provider-specialty.json
@@ -3,12 +3,14 @@
   "id": "us-core-provider-specialty",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>US Core Provider Speciality (NUCC)</h2><div><p>Provider speciality roles codes which are composed of the NUCC Health Care Provider Taxonomy Code Set for providers</p>\n</div><p><b>Copyright Statement:</b> TODO: Permission to Use and Distribute the Health Care Provider Taxonomy Code Set</p><p>This value set includes codes from the following code systems:</p><ul><li>Include all codes defined in http://nucc.org/provider-taxonomy</li></ul></div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>US Core Provider Speciality (NUCC)</h2><div><p>Provider speciality roles codes which are composed of the NUCC Health Care Provider Taxonomy Code Set for providers</p>\n</div><p><b>Copyright Statement:</b> This value set includes content from NUCC Health Care Provider Taxonomy Code Set for providers which is copyright © 2016+ American Medical Association.  For commercial use, including sales or licensing, a license must be obtained.</p><p>This value set includes codes from the following code systems:</p><ul><li>Include all codes defined in <code>http://nucc.org/provider-taxonomy</code></li></ul></div>"
   },
   "url": "http://hl7.org/fhir/us/core/ValueSet/us-core-provider-specialty",
+  "version": "1.0.0",
   "name": "US Core Provider Speciality (NUCC)",
   "status": "draft",
-  "publisher": "FHIR Project Team",
+  "date": "2016-08-10",
+  "publisher": "HL7 US Realm Steering Committee",
   "contact": [
     {
       "telecom": [
@@ -19,9 +21,8 @@
       ]
     }
   ],
-  "date": "2016-08-10",
   "description": "Provider speciality roles codes which are composed of the NUCC Health Care Provider Taxonomy Code Set for providers",
-  "copyright": "TODO: Permission to Use and Distribute the Health Care Provider Taxonomy Code Set",
+  "copyright": "This value set includes content from NUCC Health Care Provider Taxonomy Code Set for providers which is copyright © 2016+ American Medical Association.  For commercial use, including sales or licensing, a license must be obtained.",
   "compose": {
     "include": [
       {
@@ -29,4 +30,4 @@
       }
     ]
   }
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/ValueSet-us-core-substance-ndfrt.json b/lib/resources/us_core/ValueSet-us-core-substance-ndfrt.json
index 80c2c1d..94bc68e 100755
--- a/lib/resources/us_core/ValueSet-us-core-substance-ndfrt.json
+++ b/lib/resources/us_core/ValueSet-us-core-substance-ndfrt.json
@@ -6,7 +6,7 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>US Core Substance ND-FRT codes</h2><div><p>All ND-FRT NUIs for concepts that are subsumed by 'Mechanism of Action - N0000000223', 'Physiologic Effect - N0000009802' or 'Chemical Structure - N0000000002'.</p>\n</div><p>This value set includes codes from the following code systems:</p><ul><li>Include codes from http://hl7.org/fhir/ndfrt where concept  is-a  N0000000223</li><li>Include codes from http://hl7.org/fhir/ndfrt where concept  is-a  N0000009802</li><li>Include codes from http://hl7.org/fhir/ndfrt where concept  is-a  N0000000002</li></ul></div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>US Core Substance ND-FRT codes</h2><div><p>All ND-FRT NUIs for concepts that are subsumed by 'Mechanism of Action - N0000000223', 'Physiologic Effect - N0000009802' or 'Chemical Structure - N0000000002'.</p>\n</div><p>This value set includes codes from the following code systems:</p><ul><li>Include codes from <code>http://hl7.org/fhir/ndfrt</code> where concept  is-a  N0000000223</li><li>Include codes from <code>http://hl7.org/fhir/ndfrt</code> where concept  is-a  N0000009802</li><li>Include codes from <code>http://hl7.org/fhir/ndfrt</code> where concept  is-a  N0000000002</li></ul></div>"
   },
   "url": "http://hl7.org/fhir/us/core/ValueSet/us-core-substance-ndfrt",
   "identifier": [
@@ -15,9 +15,11 @@
       "value": "urn:oid:2.16.840.1.113883.3.88.12.80.18"
     }
   ],
+  "version": "1.0.0",
   "name": "US Core Substance ND-FRT codes",
   "status": "draft",
-  "publisher": "FHIR Project team",
+  "date": "2017-03-21T11:28:08+11:00",
+  "publisher": "HL7 US Realm Steering Committee",
   "contact": [
     {
       "telecom": [
@@ -28,7 +30,6 @@
       ]
     }
   ],
-  "date": "2016-12-06T22:13:05+11:00",
   "description": "All ND-FRT NUIs for concepts that are subsumed by 'Mechanism of Action - N0000000223', 'Physiologic Effect - N0000009802' or 'Chemical Structure - N0000000002'.",
   "compose": {
     "include": [
@@ -64,4 +65,4 @@
       }
     ]
   }
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/ValueSet-us-core-substance-rxnorm.json b/lib/resources/us_core/ValueSet-us-core-substance-rxnorm.json
index c9745af..67a3e26 100755
--- a/lib/resources/us_core/ValueSet-us-core-substance-rxnorm.json
+++ b/lib/resources/us_core/ValueSet-us-core-substance-rxnorm.json
@@ -6,7 +6,7 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>US Core Substance RxNorm Codes</h2><div><p>All RxNorm codes that have TTY = IN,PIN,MIN,BN, but TTY != OCD.</p>\n</div><p>This value set includes codes from the following code systems:</p><ul><li>Include codes from http://www.nlm.nih.gov/research/umls/rxnorm where TTY  in  IN,PIN,MIN,BN</li><li>Exclude codes from http://www.nlm.nih.gov/research/umls/rxnorm where TTY  =  OCD</li></ul></div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>US Core Substance RxNorm Codes</h2><div><p>All RxNorm codes that have TTY = IN,PIN,MIN,BN, but TTY != OCD.</p>\n</div><p>This value set includes codes from the following code systems:</p><ul><li>Include codes from <a href=\"http://www.nlm.nih.gov/research/umls/rxnorm\"><code>http://www.nlm.nih.gov/research/umls/rxnorm</code></a> where TTY  in  IN,PIN,MIN,BN</li><li>Exclude codes from <a href=\"http://www.nlm.nih.gov/research/umls/rxnorm\"><code>http://www.nlm.nih.gov/research/umls/rxnorm</code></a> where TTY  =  OCD</li></ul></div>"
   },
   "url": "http://hl7.org/fhir/us/core/ValueSet/us-core-substance-rxnorm",
   "identifier": [
@@ -15,9 +15,11 @@
       "value": "urn:oid:2.16.840.1.113762.1.4.1010.7"
     }
   ],
+  "version": "1.0.0",
   "name": "US Core Substance RxNorm Codes",
   "status": "draft",
-  "publisher": "FHIR Project team",
+  "date": "2017-03-21T11:28:08+11:00",
+  "publisher": "HL7 US Realm Steering Committee",
   "contact": [
     {
       "telecom": [
@@ -28,7 +30,6 @@
       ]
     }
   ],
-  "date": "2016-12-06T22:13:05+11:00",
   "description": "All RxNorm codes that have TTY = IN,PIN,MIN,BN, but TTY != OCD.",
   "compose": {
     "include": [
@@ -56,4 +57,4 @@
       }
     ]
   }
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/ValueSet-us-core-substance-sct.json b/lib/resources/us_core/ValueSet-us-core-substance-sct.json
index 5e31d1f..fd50c5b 100755
--- a/lib/resources/us_core/ValueSet-us-core-substance-sct.json
+++ b/lib/resources/us_core/ValueSet-us-core-substance-sct.json
@@ -3,7 +3,7 @@
   "id": "us-core-substance-sct",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>US Core SNOMED CT Substances Other Than Clinical Drugs</h2><div><p>SNOMED CT concepts from SCTID 716186003 No Known allergy (situation) and substance concepts Other Than Clinical Drug Substances that are not represented by RXNORM  drug concepts or FDA UNII substance concepts. This value set is meant to be quite broad and includes many substances that may never be prescribed or be a reactant. It does not remove all overlap with RXNORM and UNII; for those concepts, the alternative code system should be chosen.</p>\n</div><p><b>Copyright Statement:</b> This value set includes content from SNOMED CT, which is copyright © 2002+ International Health Terminology Standards Development Organisation (IHTSDO), and distributed by agreement between IHTSDO and HL7. Implementer use of SNOMED CT is not covered by this agreement.</p><p>This value set includes codes from the following code systems:</p><ul><li>Include codes from <a href=\"http://hl7.org/fhir/2017Jan/codesystem-snomedct.html\">http://snomed.info/sct</a> where concept  is-a  716186003</li><li>Include codes from <a href=\"http://hl7.org/fhir/2017Jan/codesystem-snomedct.html\">http://snomed.info/sct</a> where concept  is-a  105590001</li><li>Exclude codes from <a href=\"http://hl7.org/fhir/2017Jan/codesystem-snomedct.html\">http://snomed.info/sct</a> where concept  is-a  410942007</li><li>Exclude codes from <a href=\"http://hl7.org/fhir/2017Jan/codesystem-snomedct.html\">http://snomed.info/sct</a> where concept  is-a  438951008</li><li>Exclude codes from <a href=\"http://hl7.org/fhir/2017Jan/codesystem-snomedct.html\">http://snomed.info/sct</a> where concept  is-a  312412007</li><li>Exclude codes from <a href=\"http://hl7.org/fhir/2017Jan/codesystem-snomedct.html\">http://snomed.info/sct</a> where concept  is-a  312413002</li><li>Exclude codes from <a href=\"http://hl7.org/fhir/2017Jan/codesystem-snomedct.html\">http://snomed.info/sct</a> where concept  is-a  312417001</li></ul></div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>US Core SNOMED CT Substances Other Than Clinical Drugs</h2><div><p>SNOMED CT concepts from SCTID 716186003 No Known allergy (situation) and substance concepts Other Than Clinical Drug Substances that are not represented by RXNORM  drug concepts or FDA UNII substance concepts. This value set is meant to be quite broad and includes many substances that may never be prescribed or be a reactant. It does not remove all overlap with RXNORM and UNII; for those concepts, the alternative code system should be chosen.</p>\n</div><p><b>Copyright Statement:</b> This value set includes content from SNOMED CT, which is copyright © 2002+ International Health Terminology Standards Development Organisation (IHTSDO), and distributed by agreement between IHTSDO and HL7. Implementer use of SNOMED CT is not covered by this agreement.</p><p>This value set includes codes from the following code systems:</p><ul><li>Include codes from <a href=\"http://www.snomed.org/\"><code>http://snomed.info/sct</code></a> where concept  is-a  716186003 (No known allergy (situation))</li><li>Include codes from <a href=\"http://www.snomed.org/\"><code>http://snomed.info/sct</code></a> where concept  is-a  105590001 (Substance)</li><li>Exclude codes from <a href=\"http://www.snomed.org/\"><code>http://snomed.info/sct</code></a> where concept  is-a  410942007 (Drug or medicament (substance))</li><li>Exclude codes from <a href=\"http://www.snomed.org/\"><code>http://snomed.info/sct</code></a> where concept  is-a  438951008 (Substance categorized by hazard characteristics (substance))</li><li>Exclude codes from <a href=\"http://www.snomed.org/\"><code>http://snomed.info/sct</code></a> where concept  is-a  312412007 (Substance categorized functionally)</li><li>Exclude codes from <a href=\"http://www.snomed.org/\"><code>http://snomed.info/sct</code></a> where concept  is-a  312413002 (Substance categorised structurally)</li><li>Exclude codes from <a href=\"http://www.snomed.org/\"><code>http://snomed.info/sct</code></a> where concept  is-a  312417001 (Substance of abuse)</li></ul></div>"
   },
   "url": "http://hl7.org/fhir/us/core/ValueSet/us-core-substance-sct",
   "identifier": [
@@ -12,9 +12,11 @@
       "value": "urn:oid:2.16.840.1.113762.1.4.1010.9"
     }
   ],
+  "version": "1.0.0",
   "name": "US Core SNOMED CT Substances Other Than Clinical Drugs",
   "status": "draft",
-  "publisher": "FHIR Project team",
+  "date": "2016-12-02",
+  "publisher": "HL7 US Realm Steering Committee",
   "contact": [
     {
       "telecom": [
@@ -25,7 +27,6 @@
       ]
     }
   ],
-  "date": "2016-12-02",
   "description": "SNOMED CT concepts from SCTID 716186003 No Known allergy (situation) and substance concepts Other Than Clinical Drug Substances that are not represented by RXNORM  drug concepts or FDA UNII substance concepts. This value set is meant to be quite broad and includes many substances that may never be prescribed or be a reactant. It does not remove all overlap with RXNORM and UNII; for those concepts, the alternative code system should be chosen.",
   "copyright": "This value set includes content from SNOMED CT, which is copyright © 2002+ International Health Terminology Standards Development Organisation (IHTSDO), and distributed by agreement between IHTSDO and HL7. Implementer use of SNOMED CT is not covered by this agreement.",
   "compose": {
@@ -104,4 +105,4 @@
       }
     ]
   }
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/ValueSet-us-core-substance.json b/lib/resources/us_core/ValueSet-us-core-substance.json
index 3ef4f8a..5bd636b 100755
--- a/lib/resources/us_core/ValueSet-us-core-substance.json
+++ b/lib/resources/us_core/ValueSet-us-core-substance.json
@@ -12,17 +12,11 @@
     "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>US Core Substance-Reactant for Intolerance and Negation Codes</h2><div><p>A substance or other type of agent (e.g., sunshine) that may be associated with an intolerance reaction event or a propensity to such an event. These concepts are expected to be at a more general level of abstraction (ingredients versus more specific formulations). This value set is quite general and includes concepts that may never cause an adverse event, particularly the included SNOMED CT concepts. The code system-specific value sets in this grouping value set are intended to provide broad coverage of all kinds of agents, but the expectation for use is that the chosen concept identifier for a substance should be appropriately specific and drawn from the available code systems in the following priority order:  1. NDF-RT codes for drug class allergies  2. RxNorm codes limited to term types (TTY) , 'BN' Brand Name, 'IN' ingredient, 'MIN' multiple ingredient, and 'PIN' precise ingredient for drug ingredient allergies  3. SNOMED CT including concepts from SCTID 716186003 No Known allergy (situation) and if no other code from above code systems are available</p>\n</div><p><b>Copyright Statement:</b> This value set includes content from SNOMED CT, which is copyright © 2002+ International Health Terminology Standards Development Organisation (IHTSDO), and distributed by agreement between IHTSDO and HL7. Implementer use of SNOMED CT is not covered by this agreement</p><p>This value set includes codes from the following code systems:</p><ul><li/><li>Import all the codes that are contained in <a href=\"ValueSet-us-core-substance-ndfrt.html\">http://hl7.org/fhir/us/core/ValueSet/us-core-substance-ndfrt</a></li><li/><li>Import all the codes that are contained in <a href=\"ValueSet-us-core-substance-rxnorm.html\">http://hl7.org/fhir/us/core/ValueSet/us-core-substance-rxnorm</a></li><li/><li>Import all the codes that are contained in <a href=\"ValueSet-us-core-substance-sct.html\">http://hl7.org/fhir/us/core/ValueSet/us-core-substance-sct</a></li></ul></div>"
   },
   "url": "http://hl7.org/fhir/us/core/ValueSet/us-core-substance",
-  "identifier": [
-    {
-      "system": "urn:ietf:rfc:3986",
-      "value": "urn:oid:2.16.840.1.113762.1.4.1010.1"
-    }
-  ],
-  "version": "1.6.0",
+  "version": "1.0.0",
   "name": "US Core Substance-Reactant for Intolerance and Negation Codes",
   "status": "draft",
-  "experimental": true,
-  "publisher": "FHIR Project team",
+  "date": "2016-05-25T16:59:08+10:00",
+  "publisher": "HL7 US Realm Steering Committee",
   "contact": [
     {
       "telecom": [
@@ -33,7 +27,6 @@
       ]
     }
   ],
-  "date": "2016-05-25T16:59:08+10:00",
   "description": "A substance or other type of agent (e.g., sunshine) that may be associated with an intolerance reaction event or a propensity to such an event. These concepts are expected to be at a more general level of abstraction (ingredients versus more specific formulations). This value set is quite general and includes concepts that may never cause an adverse event, particularly the included SNOMED CT concepts. The code system-specific value sets in this grouping value set are intended to provide broad coverage of all kinds of agents, but the expectation for use is that the chosen concept identifier for a substance should be appropriately specific and drawn from the available code systems in the following priority order:  1. NDF-RT codes for drug class allergies  2. RxNorm codes limited to term types (TTY) , 'BN' Brand Name, 'IN' ingredient, 'MIN' multiple ingredient, and 'PIN' precise ingredient for drug ingredient allergies  3. SNOMED CT including concepts from SCTID 716186003 No Known allergy (situation) and if no other code from above code systems are available ",
   "copyright": "This value set includes content from SNOMED CT, which is copyright © 2002+ International Health Terminology Standards Development Organisation (IHTSDO), and distributed by agreement between IHTSDO and HL7. Implementer use of SNOMED CT is not covered by this agreement",
   "compose": {
@@ -55,4 +48,4 @@
       }
     ]
   }
-}
\ No newline at end of file
+}
diff --git a/lib/resources/us_core/ValueSet-us-core-ucum.json b/lib/resources/us_core/ValueSet-us-core-ucum.json
deleted file mode 100755
index 65cb998..0000000
--- a/lib/resources/us_core/ValueSet-us-core-ucum.json
+++ /dev/null
@@ -1,39 +0,0 @@
-{
-  "resourceType": "ValueSet",
-  "id": "us-core-ucum",
-  "text": {
-    "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>UCUM units</h2><div><p><a href=\"http://unitsofmeasure.org/\">UCUM</a> unit for coded form of units</p>\n</div><p><b>Copyright Statement:</b> UCUM is Copyright © 1999-2013 Regenstrief Institute, Inc. and The UCUM Organization, Indianapolis, IN. All rights reserved. See http://unitsofmeasure.org/trac//wiki/TermsOfUse for details</p><p>This value set includes codes from the following code systems:</p><ul><li>Include all codes defined in http://unitsofmeasure.org</li></ul></div>"
-  },
-  "url": "http://hl7.org/fhir/us/core/ValueSet/us-core-ucum",
-  "version": "1.6.0",
-  "name": "UCUM units",
-  "status": "draft",
-  "experimental": true,
-  "publisher": "FHIR Project",
-  "contact": [
-    {
-      "telecom": [
-        {
-          "system": "other",
-          "value": "http://hl7.org/fhir"
-        },
-        {
-          "system": "email",
-          "value": "fhir@lists.hl7.org"
-        }
-      ]
-    }
-  ],
-  "date": "2016-08-10",
-  "description": "[UCUM](http://unitsofmeasure.org/) unit for coded form of units",
-  "copyright": "UCUM is Copyright © 1999-2013 Regenstrief Institute, Inc. and The UCUM Organization, Indianapolis, IN. All rights reserved. See http://unitsofmeasure.org/trac//wiki/TermsOfUse for details",
-  "extensible": true,
-  "compose": {
-    "include": [
-      {
-        "system": "http://unitsofmeasure.org"
-      }
-    ]
-  }
-}
\ No newline at end of file
diff --git a/lib/resources/us_core/spec.internals b/lib/resources/us_core/spec.internals
index 34447d8..f9e0dd5 100755
--- a/lib/resources/us_core/spec.internals
+++ b/lib/resources/us_core/spec.internals
@@ -1,8 +1,8 @@
 {
-  "version": "1.8.0",
-  "build": "10514",
+  "version": "3.0.0",
+  "build": "11681",
   "webUrl": "http://hl7.org/fhir/us/core",
-  "date": "2016-12-06",
+  "date": "2017-03-21",
   "paths": {
     "http://hl7.org/fhir/us/core/ImplementationGuide/ig": "ImplementationGuide-ig.html",
     "http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance": "StructureDefinition-us-core-allergyintolerance.html",
@@ -19,14 +19,9 @@
     "http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationstatement": "StructureDefinition-us-core-medicationstatement.html",
     "http://hl7.org/fhir/us/core/StructureDefinition/us-core-observationresults": "StructureDefinition-us-core-observationresults.html",
     "http://hl7.org/fhir/us/core/StructureDefinition/us-core-smokingstatus": "StructureDefinition-us-core-smokingstatus.html",
-    "http://hl7.org/fhir/us/core/StructureDefinition/us-core-vitalsigns": "StructureDefinition-us-core-vitalsigns.html",
     "http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization": "StructureDefinition-us-core-organization.html",
-    "http://hl7.org/fhir/us/core/StructureDefinition/us-core-direct": "StructureDefinition-us-core-direct.html",
-    "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex": "StructureDefinition-us-core-birthsex.html",
-    "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race": "StructureDefinition-us-core-race.html",
-    "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity": "StructureDefinition-us-core-ethnicity.html",
     "http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient": "StructureDefinition-us-core-patient.html",
-    "http://hl7.org/fhir/us/core/StructureDefinition/us-core-pract": "StructureDefinition-us-core-pract.html",
+    "http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner": "StructureDefinition-us-core-practitioner.html",
     "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure": "StructureDefinition-us-core-procedure.html",
     "http://hl7.org/fhir/us/core/Observation/weight": "Observation-weight.html",
     "http://hl7.org/fhir/us/core/Observation/vitals-panel": "Observation-vitals-panel.html",
@@ -69,6 +64,7 @@
     "http://hl7.org/fhir/us/core/Observation/serum-calcium": "Observation-serum-calcium.html",
     "http://hl7.org/fhir/us/core/Observation/respiratory-rate": "Observation-respiratory-rate.html",
     "http://hl7.org/fhir/us/core/Procedure/rehab": "Procedure-rehab.html",
+    "http://hl7.org/fhir/us/core/Practitioner/practitioner-2": "Practitioner-practitioner-2.html",
     "http://hl7.org/fhir/us/core/Practitioner/practitioner-1": "Practitioner-practitioner-1.html",
     "http://hl7.org/fhir/us/core/Patient/example": "Patient-example.html",
     "http://hl7.org/fhir/us/core/Observation/oxygen-saturation": "Observation-oxygen-saturation.html",
@@ -85,47 +81,52 @@
     "http://hl7.org/fhir/us/core/Condition/hc1": "Condition-hc1.html",
     "http://hl7.org/fhir/us/core/Goal/goal-1": "Goal-goal-1.html",
     "http://hl7.org/fhir/us/core/Observation/erythrocytes": "Observation-erythrocytes.html",
+    "http://hl7.org/fhir/us/core/Encounter/1036": "Encounter-1036.html",
     "http://hl7.org/fhir/us/core/Condition/example": "Condition-example.html",
-    "http://hl7.org/fhir/us/core/CarePlan/colonoscopy": "Careplan-colonoscopy.html",
+    "http://hl7.org/fhir/us/core/CarePlan/colonoscopy": "CarePlan-colonoscopy.html",
     "http://hl7.org/fhir/us/core/DiagnosticReport/cbc": "DiagnosticReport-cbc.html",
-    "http://hl7.org/fhir/us/core/CareTeam/example": "Careteam-example.html",
-    "http://hl7.org/fhir/us/core/Observation/BUN": "Observation-BUN.html",
+    "http://hl7.org/fhir/us/core/CareTeam/example": "CareTeam-example.html",
+    "http://hl7.org/fhir/us/core/Observation/bun": "Observation-bun.html",
     "http://hl7.org/fhir/us/core/Observation/bp-data-absent": "Observation-bp-data-absent.html",
     "http://hl7.org/fhir/us/core/Observation/bmi": "Observation-bmi.html",
     "http://hl7.org/fhir/us/core/Observation/blood-pressure": "Observation-blood-pressure.html",
     "http://hl7.org/fhir/us/core/Observation/blood-glucose": "Observation-blood-glucose.html",
     "http://hl7.org/fhir/us/core/AllergyIntolerance/example": "AllergyIntolerance-example.html",
     "http://hl7.org/fhir/us/core/Organization/acme-lab": "Organization-acme-lab.html",
-    "http://hl7.org/fhir/us/core/ValueSet/us-core-ucum": "ValueSet-us-core-ucum.html",
     "http://hl7.org/fhir/us/core/ValueSet/us-core-substance": "ValueSet-us-core-substance.html",
     "http://hl7.org/fhir/us/core/ValueSet/us-core-substance-sct": "ValueSet-us-core-substance-sct.html",
     "http://hl7.org/fhir/us/core/ValueSet/us-core-substance-rxnorm": "ValueSet-us-core-substance-rxnorm.html",
     "http://hl7.org/fhir/us/core/ValueSet/us-core-substance-ndfrt": "ValueSet-us-core-substance-ndfrt.html",
     "http://hl7.org/fhir/us/core/ValueSet/us-core-provider-specialty": "ValueSet-us-core-provider-specialty.html",
     "http://hl7.org/fhir/us/core/ValueSet/us-core-provider-role": "ValueSet-us-core-provider-role.html",
-    "http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-type": "ValueSet-us-core-procedure-type.html",
     "http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-icd10pcs": "ValueSet-us-core-procedure-icd10pcs.html",
+    "http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code": "ValueSet-us-core-procedure-code.html",
     "http://hl7.org/fhir/us/core/ValueSet/us-core-problem": "ValueSet-us-core-problem.html",
     "http://hl7.org/fhir/us/core/ValueSet/us-core-observation-value-codes": "ValueSet-us-core-observation-value-codes.html",
-    "http://hl7.org/fhir/us/core/ValueSet/us-core-observation-ccdavitalsignresult": "ValueSet-us-core-observation-ccdavitalsignresult.html",
     "http://hl7.org/fhir/us/core/ValueSet/us-core-observation-ccdasmokingstatus": "ValueSet-us-core-observation-ccdasmokingstatus.html",
     "http://hl7.org/fhir/us/core/ValueSet/us-core-ndc-vaccine-codes": "ValueSet-us-core-ndc-vaccine-codes.html",
     "http://hl7.org/fhir/us/core/ValueSet/us-core-narrative-status": "ValueSet-us-core-narrative-status.html",
     "http://hl7.org/fhir/us/core/ValueSet/us-core-medication-codes": "ValueSet-us-core-medication-codes.html",
-    "http://hl7.org/fhir/us/core/ValueSet/us-core-immunization-status": "ValueSet-us-core-immunization-status.html",
     "http://hl7.org/fhir/us/core/ValueSet/us-core-cvx": "ValueSet-us-core-cvx.html",
     "http://hl7.org/fhir/us/core/ValueSet/us-core-condition-category": "ValueSet-us-core-condition-category.html",
-    "http://hl7.org/fhir/us/core/ValueSet/us-core-careteam-status": "ValueSet-us-core-careteam-status.html",
     "http://hl7.org/fhir/us/core/ValueSet/us-core-careteam-provider-roles": "ValueSet-us-core-careteam-provider-roles.html",
     "http://hl7.org/fhir/us/core/ValueSet/us-core-birthsex": "ValueSet-us-core-birthsex.html",
-    "http://hl7.org/fhir/us/core/ValueSet/omb-race": "ValueSet-omb-race.html",
-    "http://hl7.org/fhir/us/core/ValueSet/omb-ethnicity": "ValueSet-omb-ethnicity.html",
+    "http://hl7.org/fhir/us/core/ValueSet/simple-language": "ValueSet-simple-language.html",
+    "http://hl7.org/fhir/us/core/ValueSet/omb-race-category": "ValueSet-omb-race-category.html",
+    "http://hl7.org/fhir/us/core/ValueSet/omb-ethnicity-category": "ValueSet-omb-ethnicity-category.html",
     "http://hl7.org/fhir/us/core/ValueSet/detailed-race": "ValueSet-detailed-race.html",
     "http://hl7.org/fhir/us/core/ValueSet/detailed-ethnicity": "ValueSet-detailed-ethnicity.html",
+    "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race": "StructureDefinition-us-core-race.html",
+    "http://hl7.org/fhir/us/core/StructureDefinition/us-core-profile-link": "StructureDefinition-us-core-profile-link.html",
+    "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity": "StructureDefinition-us-core-ethnicity.html",
+    "http://hl7.org/fhir/us/core/StructureDefinition/us-core-direct": "StructureDefinition-us-core-direct.html",
+    "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex": "StructureDefinition-us-core-birthsex.html",
     "http://hl7.org/fhir/us/core/SearchParameter/us-core-race": "SearchParameter-us-core-race.html",
     "http://hl7.org/fhir/us/core/SearchParameter/us-core-ethnicity": "SearchParameter-us-core-ethnicity.html",
+    "http://hl7.org/fhir/us/core/ConceptMap/ndc-cvx": "ConceptMap-ndc-cvx.html",
     "http://hl7.org/fhir/us/core/CodeSystem/condition-category": "CodeSystem-condition-category.html",
-    "http://hl7.org/fhir/us/core/CodeSystem/careteam-status": "CodeSystem-careteam-status.html",
+    "urn:oid:2.16.840.1.113883.6.238": "CodeSystem-cdcrec.html",
+    "http://hl7.org/fhir/us/core/CodeSystem/cdcrec": "CodeSystem-cdcrec.html",
     "http://hl7.org/fhir/us/core/CodeSystem/careplan-category": "CodeSystem-careplan-category.html",
     "http://hl7.org/fhir/us/core/CapabilityStatement/server": "CapabilityStatement-server.html",
     "http://hl7.org/fhir/us/core/CapabilityStatement/client": "CapabilityStatement-client.html"
@@ -137,6 +138,7 @@
     "AllergyIntolerance-example.json.html",
     "AllergyIntolerance-example.ttl.html",
     "AllergyIntolerance-example.xml.html",
+    "Any.html",
     "Bundle-uscore-mo3.html",
     "Bundle-uscore-mo3.json.html",
     "Bundle-uscore-mo3.ttl.html",
@@ -154,11 +156,11 @@
     "CapabilityStatement-server.ttl.html",
     "CapabilityStatement-server.xml.html",
     "capstmnts.html",
-    "Careplan-colonoscopy.html",
+    "CarePlan-colonoscopy.html",
     "CarePlan-colonoscopy.json.html",
     "CarePlan-colonoscopy.ttl.html",
     "CarePlan-colonoscopy.xml.html",
-    "Careteam-example.html",
+    "CareTeam-example.html",
     "CareTeam-example.json.html",
     "CareTeam-example.ttl.html",
     "CareTeam-example.xml.html",
@@ -166,14 +168,18 @@
     "CodeSystem-careplan-category.json.html",
     "CodeSystem-careplan-category.ttl.html",
     "CodeSystem-careplan-category.xml.html",
-    "CodeSystem-careteam-status.html",
-    "CodeSystem-careteam-status.json.html",
-    "CodeSystem-careteam-status.ttl.html",
-    "CodeSystem-careteam-status.xml.html",
+    "CodeSystem-cdcrec.html",
+    "CodeSystem-cdcrec.json.html",
+    "CodeSystem-cdcrec.ttl.html",
+    "CodeSystem-cdcrec.xml.html",
     "CodeSystem-condition-category.html",
     "CodeSystem-condition-category.json.html",
     "CodeSystem-condition-category.ttl.html",
     "CodeSystem-condition-category.xml.html",
+    "ConceptMap-ndc-cvx.html",
+    "ConceptMap-ndc-cvx.json.html",
+    "ConceptMap-ndc-cvx.ttl.html",
+    "ConceptMap-ndc-cvx.xml.html",
     "Condition-example.html",
     "Condition-example.json.html",
     "Condition-example.ttl.html",
@@ -182,7 +188,6 @@
     "Condition-hc1.json.html",
     "Condition-hc1.ttl.html",
     "Condition-hc1.xml.html",
-    "definitions.html",
     "Device-udi-1.html",
     "Device-udi-1.json.html",
     "Device-udi-1.ttl.html",
@@ -200,11 +205,16 @@
     "DiagnosticReport-urinalysis.ttl.html",
     "DiagnosticReport-urinalysis.xml.html",
     "downloads.html",
+    "Encounter-1036.html",
+    "Encounter-1036.json.html",
+    "Encounter-1036.ttl.html",
+    "Encounter-1036.xml.html",
     "extensions.html",
     "Goal-goal-1.html",
     "Goal-goal-1.json.html",
     "Goal-goal-1.ttl.html",
     "Goal-goal-1.xml.html",
+    "guidance.html",
     "history.html",
     "Immunization-imm-1.html",
     "Immunization-imm-1.json.html",
@@ -259,10 +269,10 @@
     "Observation-bp-data-absent.json.html",
     "Observation-bp-data-absent.ttl.html",
     "Observation-bp-data-absent.xml.html",
-    "Observation-BUN.html",
-    "Observation-BUN.json.html",
-    "Observation-BUN.ttl.html",
-    "Observation-BUN.xml.html",
+    "Observation-bun.html",
+    "Observation-bun.json.html",
+    "Observation-bun.ttl.html",
+    "Observation-bun.xml.html",
     "Observation-erythrocytes.html",
     "Observation-erythrocytes.json.html",
     "Observation-erythrocytes.ttl.html",
@@ -431,6 +441,10 @@
     "Practitioner-practitioner-1.json.html",
     "Practitioner-practitioner-1.ttl.html",
     "Practitioner-practitioner-1.xml.html",
+    "Practitioner-practitioner-2.html",
+    "Practitioner-practitioner-2.json.html",
+    "Practitioner-practitioner-2.ttl.html",
+    "Practitioner-practitioner-2.xml.html",
     "Procedure-rehab.html",
     "Procedure-rehab.json.html",
     "Procedure-rehab.ttl.html",
@@ -542,7 +556,7 @@
     "StructureDefinition-us-core-observationresults.json.html",
     "StructureDefinition-us-core-observationresults.ttl.html",
     "StructureDefinition-us-core-observationresults.xml.html",
-    "StructureDefinition-us-core-Organization-definitions.html",
+    "StructureDefinition-us-core-organization-definitions.html",
     "StructureDefinition-us-core-organization-mappings.html",
     "StructureDefinition-us-core-organization.html",
     "StructureDefinition-us-core-organization.json.html",
@@ -554,18 +568,24 @@
     "StructureDefinition-us-core-patient.json.html",
     "StructureDefinition-us-core-patient.ttl.html",
     "StructureDefinition-us-core-patient.xml.html",
-    "StructureDefinition-us-core-pract-definitions.html",
-    "StructureDefinition-us-core-pract-mappings.html",
-    "StructureDefinition-us-core-pract.html",
-    "StructureDefinition-us-core-pract.json.html",
-    "StructureDefinition-us-core-pract.ttl.html",
-    "StructureDefinition-us-core-pract.xml.html",
+    "StructureDefinition-us-core-practitioner-definitions.html",
+    "StructureDefinition-us-core-practitioner-mappings.html",
+    "StructureDefinition-us-core-practitioner.html",
+    "StructureDefinition-us-core-practitioner.json.html",
+    "StructureDefinition-us-core-practitioner.ttl.html",
+    "StructureDefinition-us-core-practitioner.xml.html",
     "StructureDefinition-us-core-procedure-definitions.html",
     "StructureDefinition-us-core-procedure-mappings.html",
     "StructureDefinition-us-core-procedure.html",
     "StructureDefinition-us-core-procedure.json.html",
     "StructureDefinition-us-core-procedure.ttl.html",
     "StructureDefinition-us-core-procedure.xml.html",
+    "StructureDefinition-us-core-profile-link-definitions.html",
+    "StructureDefinition-us-core-profile-link-mappings.html",
+    "StructureDefinition-us-core-profile-link.html",
+    "StructureDefinition-us-core-profile-link.json.html",
+    "StructureDefinition-us-core-profile-link.ttl.html",
+    "StructureDefinition-us-core-profile-link.xml.html",
     "StructureDefinition-us-core-race-definitions.html",
     "StructureDefinition-us-core-race-mappings.html",
     "StructureDefinition-us-core-race.html",
@@ -578,12 +598,9 @@
     "StructureDefinition-us-core-smokingstatus.json.html",
     "StructureDefinition-us-core-smokingstatus.ttl.html",
     "StructureDefinition-us-core-smokingstatus.xml.html",
-    "StructureDefinition-us-core-vitalsigns-definitions.html",
-    "StructureDefinition-us-core-vitalsigns-mappings.html",
-    "StructureDefinition-us-core-vitalsigns.html",
-    "StructureDefinition-us-core-vitalsigns.json.html",
-    "StructureDefinition-us-core-vitalsigns.ttl.html",
-    "StructureDefinition-us-core-vitalsigns.xml.html",
+    "terminology.html",
+    "us-core-vitalsigns.html",
+    "uscore-change-notes.html",
     "ValueSet-detailed-ethnicity.html",
     "ValueSet-detailed-ethnicity.json.html",
     "ValueSet-detailed-ethnicity.ttl.html",
@@ -592,14 +609,18 @@
     "ValueSet-detailed-race.json.html",
     "ValueSet-detailed-race.ttl.html",
     "ValueSet-detailed-race.xml.html",
-    "ValueSet-omb-ethnicity.html",
-    "ValueSet-omb-ethnicity.json.html",
-    "ValueSet-omb-ethnicity.ttl.html",
-    "ValueSet-omb-ethnicity.xml.html",
-    "ValueSet-omb-race.html",
-    "ValueSet-omb-race.json.html",
-    "ValueSet-omb-race.ttl.html",
-    "ValueSet-omb-race.xml.html",
+    "ValueSet-omb-ethnicity-category.html",
+    "ValueSet-omb-ethnicity-category.json.html",
+    "ValueSet-omb-ethnicity-category.ttl.html",
+    "ValueSet-omb-ethnicity-category.xml.html",
+    "ValueSet-omb-race-category.html",
+    "ValueSet-omb-race-category.json.html",
+    "ValueSet-omb-race-category.ttl.html",
+    "ValueSet-omb-race-category.xml.html",
+    "ValueSet-simple-language.html",
+    "ValueSet-simple-language.json.html",
+    "ValueSet-simple-language.ttl.html",
+    "ValueSet-simple-language.xml.html",
     "ValueSet-us-core-birthsex.html",
     "ValueSet-us-core-birthsex.json.html",
     "ValueSet-us-core-birthsex.ttl.html",
@@ -608,10 +629,6 @@
     "ValueSet-us-core-careteam-provider-roles.json.html",
     "ValueSet-us-core-careteam-provider-roles.ttl.html",
     "ValueSet-us-core-careteam-provider-roles.xml.html",
-    "ValueSet-us-core-careteam-status.html",
-    "ValueSet-us-core-careteam-status.json.html",
-    "ValueSet-us-core-careteam-status.ttl.html",
-    "ValueSet-us-core-careteam-status.xml.html",
     "ValueSet-us-core-condition-category.html",
     "ValueSet-us-core-condition-category.json.html",
     "ValueSet-us-core-condition-category.ttl.html",
@@ -620,10 +637,6 @@
     "ValueSet-us-core-cvx.json.html",
     "ValueSet-us-core-cvx.ttl.html",
     "ValueSet-us-core-cvx.xml.html",
-    "ValueSet-us-core-immunization-status.html",
-    "ValueSet-us-core-immunization-status.json.html",
-    "ValueSet-us-core-immunization-status.ttl.html",
-    "ValueSet-us-core-immunization-status.xml.html",
     "ValueSet-us-core-medication-codes.html",
     "ValueSet-us-core-medication-codes.json.html",
     "ValueSet-us-core-medication-codes.ttl.html",
@@ -640,10 +653,6 @@
     "ValueSet-us-core-observation-ccdasmokingstatus.json.html",
     "ValueSet-us-core-observation-ccdasmokingstatus.ttl.html",
     "ValueSet-us-core-observation-ccdasmokingstatus.xml.html",
-    "ValueSet-us-core-observation-ccdavitalsignresult.html",
-    "ValueSet-us-core-observation-ccdavitalsignresult.json.html",
-    "ValueSet-us-core-observation-ccdavitalsignresult.ttl.html",
-    "ValueSet-us-core-observation-ccdavitalsignresult.xml.html",
     "ValueSet-us-core-observation-value-codes.html",
     "ValueSet-us-core-observation-value-codes.json.html",
     "ValueSet-us-core-observation-value-codes.ttl.html",
@@ -652,14 +661,14 @@
     "ValueSet-us-core-problem.json.html",
     "ValueSet-us-core-problem.ttl.html",
     "ValueSet-us-core-problem.xml.html",
+    "ValueSet-us-core-procedure-code.html",
+    "ValueSet-us-core-procedure-code.json.html",
+    "ValueSet-us-core-procedure-code.ttl.html",
+    "ValueSet-us-core-procedure-code.xml.html",
     "ValueSet-us-core-procedure-icd10pcs.html",
     "ValueSet-us-core-procedure-icd10pcs.json.html",
     "ValueSet-us-core-procedure-icd10pcs.ttl.html",
     "ValueSet-us-core-procedure-icd10pcs.xml.html",
-    "ValueSet-us-core-procedure-type.html",
-    "ValueSet-us-core-procedure-type.json.html",
-    "ValueSet-us-core-procedure-type.ttl.html",
-    "ValueSet-us-core-procedure-type.xml.html",
     "ValueSet-us-core-provider-role.html",
     "ValueSet-us-core-provider-role.json.html",
     "ValueSet-us-core-provider-role.ttl.html",
@@ -683,12 +692,7 @@
     "ValueSet-us-core-substance.html",
     "ValueSet-us-core-substance.json.html",
     "ValueSet-us-core-substance.ttl.html",
-    "ValueSet-us-core-substance.xml.html",
-    "ValueSet-us-core-ucum.html",
-    "ValueSet-us-core-ucum.json.html",
-    "ValueSet-us-core-ucum.ttl.html",
-    "ValueSet-us-core-ucum.xml.html",
-    "valuesets.html"
+    "ValueSet-us-core-substance.xml.html"
   ],
   "images": []
 }
\ No newline at end of file

From a2abc3be25612f8578a319a787571b1bcc86c734 Mon Sep 17 00:00:00 2001
From: Jason Walonoski <jwalonoski@mitre.org>
Date: Wed, 26 Apr 2017 15:31:11 -0400
Subject: [PATCH 3/5] Update SHR.

---
 ...System-shr-actor-LanguageQualifierCS.json} |   15 +-
 ...CodeSystem-shr-base-GenericAnswersCS.json} |   15 +-
 ...System-shr-base-MissingValueReasonCS.json} |   15 +-
 ...r-behavior-AlcoholUseScreeningToolCS.json} |   15 +-
 ...-shr-behavior-DietNutritionConcernCS.json} |   15 +-
 ...ehavior-PhysicalActivityLimitationCS.json} |   15 +-
 ...r-behavior-ReligiousPracticeStatusCS.json} |   15 +-
 ...-shr-behavior-ReligiousRestrictionCS.json} |   15 +-
 ...em-shr-behavior-SleepQualityReasonCS.json} |   15 +-
 ...m-shr-behavior-SpecialDietFollowedCS.json} |   15 +-
 ...havior-SubstanceAbuseTreatmentTypeCS.json} |   15 +-
 ...odeSystem-shr-core-CodingQualifierCS.json} |   15 +-
 ...m-shr-core-PerformanceGradingScaleCS.json} |   15 +-
 ...ystem-shr-core-QualitativeDateTimeCS.json} |   15 +-
 ...stem-shr-core-QualitativeFrequencyCS.json} |   15 +-
 ...tem-shr-core-QualitativeLikelihoodCS.json} |   15 +-
 ...tem-shr-core-QualitativeValueScaleCS.json} |   15 +-
 ...-shr-core-SemiquantitativeDurationCS.json} |   15 +-
 ...shr-core-SemiquantitativeFrequencyCS.json} |   15 +-
 ...son => CodeSystem-shr-core-SettingCS.json} |   15 +-
 ... CodeSystem-shr-core-ThreePriorityCS.json} |   15 +-
 ...odeSystem-shr-core-ThreeValueLogicCS.json} |   15 +-
 ...System-shr-demographics-AddressUseCS.json} |   15 +-
 ...demographics-InsuranceProviderTypeCS.json} |   15 +-
 ...-shr-demographics-TelecomQualifierCS.json} |   15 +-
 ...tem-shr-demographics-TelephoneTypeCS.json} |   15 +-
 ...shr-device-RespiratoryAssistDeviceCS.json} |   15 +-
 ...-shr-device-RespiratoryRateSettingCS.json} |   15 +-
 ...System-shr-encounter-EncounterTypeCS.json} |   15 +-
 ...-encounter-EpisodeOfCareCompletionCS.json} |   15 +-
 ...ounter-ReasonEncounterDidNotHappenCS.json} |   15 +-
 ...m-shr-encounter-ReferralSourceTypeCS.json} |   15 +-
 ...shr-encounter-TreatmentCooperationCS.json} |   15 +-
 ...tem-shr-environment-AnimalExposureCS.json} |   15 +-
 ...ystem-shr-environment-CoinhabitantCS.json} |   15 +-
 ...hr-environment-HomeEnvironmentRiskCS.json} |   15 +-
 ...ystem-shr-environment-IncomeSourceCS.json} |   15 +-
 ...tem-shr-environment-NonCashBenefitCS.json} |   15 +-
 ...-shr-environment-ResourceStabilityCS.json} |   15 +-
 ...> CodeSystem-shr-lab-RequestStatusCS.json} |   15 +-
 ...-lifehistory-EducationalAttainmentCS.json} |   15 +-
 ...m-shr-lifehistory-EmploymentStatusCS.json} |   15 +-
 ...ory-MilitaryServiceDischargeStatusCS.json} |   15 +-
 ...shr-lifehistory-MilitaryServiceEraCS.json} |   15 +-
 ...tem-shr-lifehistory-MilitaryStatusCS.json} |   15 +-
 ...deSystem-shr-lifehistory-TeratogenCS.json} |   15 +-
 ...m-shr-lifehistory-USMilitaryBranchCS.json} |   15 +-
 ...-medication-MedicationChangeReasonCS.json} |   15 +-
 ...hr-medication-MedicationChangeTypeCS.json} |   15 +-
 ...medication-ReasonMedicationNotUsedCS.json} |   15 +-
 ...tem-shr-observation-ExposureReasonCS.json} |   15 +-
 ...servation-ObservationNotMadeReasonCS.json} |   15 +-
 ...System-shr-problem-EvidenceQualityCS.json} |   15 +-
 ...odeSystem-shr-problem-GradeOrStageCS.json} |   15 +-
 ...System-shr-problem-ProblemCategoryCS.json} |   15 +-
 ...System-shr-sex-ContraceptiveMethodCS.json} |   15 +-
 ...-shr-sex-ContraceptiveMethodReasonCS.json} |   15 +-
 ...shr-sex-ContraceptiveNotUsedReasonCS.json} |   15 +-
 ... CodeSystem-shr-sex-GenderIdentityCS.json} |   15 +-
 ...-shr-skin-PressureUlcerAssociationCS.json} |   15 +-
 ...hr-skin-SupportSurfaceBodyPositionCS.json} |   15 +-
 ...em-shr-skin-SupportSurfaceCategoryCS.json} |   15 +-
 ...m-shr-skin-SupportSurfaceComponentCS.json} |   15 +-
 ...tem-shr-skin-SupportSurfaceFeatureCS.json} |   15 +-
 ...stem-shr-vital-BloodPressureMethodCS.json} |   15 +-
 ...m-shr-vital-BloodPressureQualifierCS.json} |   15 +-
 ...stem-shr-vital-BodyHeightQualifierCS.json} |   15 +-
 ...shr-vital-BodyTemperatureQualifierCS.json} |   15 +-
 ...stem-shr-vital-BodyWeightQualifierCS.json} |   15 +-
 ...deSystem-shr-vital-HeartRateMethodCS.json} |   15 +-
 ...ystem-shr-vital-HeartRateQualifierCS.json} |   15 +-
 ...em-shr-vital-RespiratoryRateMethodCS.json} |   15 +-
 ...shr-vital-RespiratoryRateQualifierCS.json} |   15 +-
 ...nGuide.json => ImplementationGuide-1.json} |  569 ++++---
 ...tion-primitive-base64Binary-extension.json |   11 +-
 ...efinition-primitive-boolean-extension.json |   11 +-
 ...reDefinition-primitive-code-extension.json |   11 +-
 ...reDefinition-primitive-date-extension.json |   11 +-
 ...finition-primitive-dateTime-extension.json |   11 +-
 ...efinition-primitive-decimal-extension.json |   11 +-
 ...tureDefinition-primitive-id-extension.json |   11 +-
 ...efinition-primitive-instant-extension.json |   11 +-
 ...efinition-primitive-integer-extension.json |   11 +-
 ...finition-primitive-markdown-extension.json |   11 +-
 ...ureDefinition-primitive-oid-extension.json |   11 +-
 ...ition-primitive-positiveInt-extension.json |   11 +-
 ...Definition-primitive-string-extension.json |   11 +-
 ...reDefinition-primitive-time-extension.json |   11 +-
 ...ition-primitive-unsignedInt-extension.json |   11 +-
 ...ureDefinition-primitive-uri-extension.json |   11 +-
 ...eDefinition-primitive-xhtml-extension.json |   11 +-
 ...tion-shr-actor-Affiliation-extension.json} |   54 +-
 ...nition-shr-actor-AgeAtDeath-extension.json |   11 +-
 ...nition-shr-actor-Anonymized-extension.json |    6 +-
 ...ition-shr-actor-DateOfDeath-extension.json |   13 +-
 ...finition-shr-actor-Deceased-extension.json |   11 +-
 ...Definition-shr-actor-EmergencyContact.json |  222 ++-
 ...n-shr-actor-FictionalPerson-extension.json |    6 +-
 ...shr-actor-LanguageQualifier-extension.json |   12 +-
 ...tion-shr-actor-LanguageUsed-extension.json |   11 +-
 ...shr-actor-MedicalSpecialty-extension.json} |   64 +-
 ...ition-shr-actor-NoPrimaryCareProvider.json |  229 ++-
 ...tureDefinition-shr-actor-Organization.json |   63 +-
 ...ition-shr-actor-Participant-extension.json |   13 +-
 ...shr-actor-ParticipationType-extension.json |    6 +-
 ...tion-shr-actor-Practitioner-extension.json |    6 +-
 ...tureDefinition-shr-actor-Practitioner.json |  560 ++-----
 ...inition-shr-actor-PrimaryCareProvider.json |  216 ++-
 ...nition-shr-actor-ProviderRelationship.json |  222 ++-
 ...ion-shr-actor-RelatedPerson-extension.json |    6 +-
 ...ureDefinition-shr-actor-RelatedPerson.json |   57 +-
 ...r-SpokenLanguageProficiency-extension.json |   10 +-
 ...-WrittenLanguageProficiency-extension.json |   10 +-
 ...shr-adverse-AdverseReaction-extension.json |    6 +-
 ...efinition-shr-adverse-AdverseReaction.json |  191 ++-
 ...-AdverseReactionAttribution-extension.json |   13 +-
 ...dverse-AttributionCertainty-extension.json |    6 +-
 ...nition-shr-allergy-AllergyIntolerance.json |  199 ++-
 ...ureDefinition-shr-allergy-DrugAllergy.json |  197 ++-
 ...ion-shr-allergy-FoodAllergy-extension.json |    6 +-
 ...ureDefinition-shr-allergy-FoodAllergy.json |  197 ++-
 ...Definition-shr-allergy-NoKnownAllergy.json |  214 ++-
 ...nition-shr-allergy-NoKnownDrugAllergy.json |  200 ++-
 ...r-allergy-NoKnownEnvironmentalAllergy.json |  200 ++-
 ...nition-shr-allergy-NoKnownFoodAllergy.json |  200 ++-
 ...inition-shr-base-ActionCode-extension.json |    6 +-
 ...hr-base-AssociatedEncounter-extension.json |    6 +-
 ...eDefinition-shr-base-Author-extension.json |    6 +-
 .../StructureDefinition-shr-base-Entry.json   |  313 +++-
 ...ition-shr-base-FocalSubject-extension.json |    6 +-
 ...finition-shr-base-Informant-extension.json |    6 +-
 ...efinition-shr-base-Language-extension.json |    6 +-
 ...tructureDefinition-shr-base-Narrative.json |   25 +-
 ...-base-NonOccurrenceModifier-extension.json |   11 +-
 ...r-base-OriginalCreationDate-extension.json |    6 +-
 ...hr-base-PatientInstructions-extension.json |    6 +-
 ...-base-PerformerInstructions-extension.json |    6 +-
 ...tNotToPerformActionModifier-extension.json |  404 -----
 ...reDefinition-shr-base-ShrId-extension.json |    6 +-
 ...SubjectIsThirdPartyModifier-extension.json |    6 +-
 ...avior-AlcoholBingeFrequency-extension.json |   18 +-
 ...ureDefinition-shr-behavior-AlcoholUse.json |  517 +++++-
 ...shr-behavior-AssessmentTool-extension.json |    6 +-
 ...on-shr-behavior-BehavioralObservation.json |  483 +++++-
 ...inition-shr-behavior-DietAndNutrition.json |  501 +++++-
 ...havior-DietNutritionConcern-extension.json |   10 +-
 ...havior-ExerciseHoursPerWeek-extension.json |    6 +-
 ...-behavior-HasSufficientFood-extension.json |   12 +-
 ...behavior-HoursSleepPerNight-extension.json |    6 +-
 ...ition-shr-behavior-IntravenousDrugUse.json |  516 +++++-
 ...reDefinition-shr-behavior-NicotineUse.json |  512 +++++-
 ...inition-shr-behavior-ONCSmokingStatus.json |  481 +++++-
 ...on-shr-behavior-PhysicalActivityLevel.json |  503 +++++-
 ...-PhysicalActivityLimitation-extension.json |   10 +-
 ...-behavior-ReadinessToChange-extension.json |   10 +-
 ...nition-shr-behavior-ReligiousPractice.json |  490 +++++-
 ...ior-ReligiousPracticeStatus-extension.json |   10 +-
 ...havior-ReligiousRestriction-extension.json |   10 +-
 ...eDefinition-shr-behavior-SleepQuality.json |  506 +++++-
 ...behavior-SleepQualityReason-extension.json |   10 +-
 ...ehavior-SpecialDietFollowed-extension.json |   10 +-
 ...-shr-behavior-SubstanceAbuseTreatment.json |  626 ++++---
 ...eDefinition-shr-behavior-SubstanceUse.json |  496 +++++-
 ...havior-TroubleFallingAsleep-extension.json |   10 +-
 ...havior-TroubleStayingAsleep-extension.json |   10 +-
 ...tion-shr-behavior-ViolentBehaviorRisk.json |   48 +-
 ...ehavior-ViolentRiskToOthers-extension.json |   17 +-
 ...-behavior-ViolentRiskToSelf-extension.json |   17 +-
 ...-behavior-WakeFeelingRested-extension.json |   10 +-
 .../StructureDefinition-shr-core-Address.json |   42 +-
 ...tureDefinition-shr-core-Age-extension.json |    6 +-
 .../StructureDefinition-shr-core-Age.json     |   39 +-
 ...efinition-shr-core-AgeGroup-extension.json |   10 +-
 ...efinition-shr-core-AgeRange-extension.json |   11 +-
 ...ructureDefinition-shr-core-Annotation.json |   19 +-
 ...ureDefinition-shr-core-Area-extension.json |    6 +-
 ...efinition-shr-core-BodySite-extension.json |    6 +-
 ...StructureDefinition-shr-core-BodySite.json |  259 ++-
 ...tion-shr-core-Circumference-extension.json |   13 +-
 ...ion-shr-core-ClockDirection-extension.json |   12 +-
 ...on-shr-core-CodeableConcept-extension.json |    6 +-
 ...reDefinition-shr-core-CodeableConcept.json |   37 +-
 .../StructureDefinition-shr-core-Coding.json  |   40 +-
 ...on-shr-core-CodingQualifier-extension.json |   10 +-
 ...reDefinition-shr-core-Count-extension.json |    6 +-
 ...Definition-shr-core-Country-extension.json |    6 +-
 ...reDefinition-shr-core-Depth-extension.json |    6 +-
 ...Definition-shr-core-Details-extension.json |    6 +-
 ...ctureDefinition-shr-core-DollarAmount.json |   37 +-
 ...efinition-shr-core-Duration-extension.json |    6 +-
 ...StructureDefinition-shr-core-Duration.json |   39 +-
 ...tion-shr-core-EffectiveDate-extension.json |    6 +-
 ...hr-core-EffectiveTimePeriod-extension.json |    6 +-
 ...finition-shr-core-EffectiveTimePeriod.json |   23 +-
 ...nition-shr-core-Explanation-extension.json |    6 +-
 ...finition-shr-core-Frequency-extension.json |   13 +-
 ...ion-shr-core-GeneralizedAge-extension.json |   11 +-
 ...hr-core-GeneralizedDateTime-extension.json |   11 +-
 ...-core-GeneralizedLikelihood-extension.json |   13 +-
 ...-GeneralizedTemporalContext-extension.json |   13 +-
 ...inition-shr-core-GeopoliticalLocation.json |   42 +-
 ...uctureDefinition-shr-core-Geoposition.json |  106 +-
 ...ion-shr-core-GestationalAge-extension.json |    6 +-
 ...-GestationalTemporalContext-extension.json |   13 +-
 ...-core-GestationalTimePeriod-extension.json |    6 +-
 ...tructureDefinition-shr-core-HumanName.json |   36 +-
 ...ructureDefinition-shr-core-Identifier.json |   47 +-
 ...eDefinition-shr-core-Length-extension.json |    6 +-
 ...inition-shr-core-Likelihood-extension.json |    6 +-
 ...efinition-shr-core-Location-extension.json |    6 +-
 ...inition-shr-core-LowerBound-extension.json |    6 +-
 ...ructureDefinition-shr-core-LowerBound.json |   42 +-
 ...ion-shr-core-OccurrenceTime-extension.json |    6 +-
 ...inition-shr-core-Percentage-extension.json |    6 +-
 ...uctureDefinition-shr-core-PeriodOfUse.json |   23 +-
 ...efinition-shr-core-Priority-extension.json |    6 +-
 ...hr-core-QualitativeDateTime-extension.json |   10 +-
 ...-core-QualitativeLikelihood-extension.json |   10 +-
 ...efinition-shr-core-Quantity-extension.json |    6 +-
 ...StructureDefinition-shr-core-Quantity.json |   37 +-
 ...eDefinition-shr-core-Reason-extension.json |    6 +-
 ...Definition-shr-core-Setting-extension.json |   10 +-
 ...reDefinition-shr-core-State-extension.json |    6 +-
 ...tructureDefinition-shr-core-Statistic.json |   46 +-
 ...tion-shr-core-StatisticType-extension.json |   10 +-
 ...finition-shr-core-Substance-extension.json |    6 +-
 ...inition-shr-core-TimePeriod-extension.json |    6 +-
 ...ructureDefinition-shr-core-TimePeriod.json |   23 +-
 ...finition-shr-core-UnitedStatesAddress.json |   42 +-
 ...inition-shr-core-UpperBound-extension.json |    6 +-
 ...ructureDefinition-shr-core-UpperBound.json |   42 +-
 ...eDefinition-shr-core-Volume-extension.json |    6 +-
 ...reDefinition-shr-core-Width-extension.json |    6 +-
 ...demographics-CountryOfIssue-extension.json |   13 +-
 ...aphics-DriversLicenseNumber-extension.json |   13 +-
 ...aphics-FamilialRelationship-extension.json |   13 +-
 ...hr-demographics-FathersName-extension.json |    6 +-
 ...tion-shr-demographics-HealthInsurance.json |  143 +-
 ...-shr-demographics-HomeTelephoneNumber.json |   64 +-
 ...demographics-PassportNumber-extension.json |   13 +-
 ...demographics-PersonOfRecord-extension.json |    6 +-
 ...ition-shr-demographics-PersonOfRecord.json |  175 +-
 ...aphics-SocialSecurityNumber-extension.json |    6 +-
 ...r-demographics-StateOfIssue-extension.json |   13 +-
 ...reDefinition-shr-demographics-Telecom.json |   48 +-
 ...mographics-TelecomTypeOther-extension.json |    6 +-
 ...tion-shr-demographics-TelephoneNumber.json |   48 +-
 ...-shr-demographics-WorkTelephoneNumber.json |   64 +-
 ...StructureDefinition-shr-device-Device.json |  458 ++++-
 ...uctureDefinition-shr-device-DeviceUse.json |  326 ++--
 ...-shr-device-DeviceUseStatus-extension.json |    8 +-
 ...nition-shr-device-Implanted-extension.json |    6 +-
 ...ureDefinition-shr-encounter-Encounter.json |  621 +++++--
 ...ounterNonOccurrenceModifier-extension.json |   14 +-
 ...tion-shr-encounter-Facility-extension.json |    6 +-
 ...tureDefinition-shr-encounter-Facility.json |  112 +-
 ...hr-encounter-MobileFacility-extension.json |    6 +-
 ...shr-encounter-PaymentSource-extension.json |   13 +-
 ...-shr-encounter-ReferralDate-extension.json |    6 +-
 ...ncounter-ReferralSourceType-extension.json |   10 +-
 ...ounter-TreatmentCooperation-extension.json |   10 +-
 ...-environment-AnimalExposure-extension.json |    6 +-
 ...nition-shr-environment-AnimalExposure.json |  499 +++++-
 ...hr-environment-AnnualIncome-extension.json |    6 +-
 ...finition-shr-environment-AnnualIncome.json |  511 +++++-
 ...ironment-CanAffordChildCare-extension.json |    6 +-
 ...on-shr-environment-CanAffordChildCare.json |  485 +++++-
 ...vironment-CanAffordClothing-extension.json |    6 +-
 ...ion-shr-environment-CanAffordClothing.json |  485 +++++-
 ...ronment-CanAffordDentalCare-extension.json |    6 +-
 ...n-shr-environment-CanAffordDentalCare.json |  485 +++++-
 ...r-environment-CanAffordFood-extension.json |    6 +-
 ...inition-shr-environment-CanAffordFood.json |  485 +++++-
 ...nvironment-CanAffordHousing-extension.json |    6 +-
 ...tion-shr-environment-CanAffordHousing.json |  485 +++++-
 ...ronment-CanAffordMedication-extension.json |    6 +-
 ...n-shr-environment-CanAffordMedication.json |  485 +++++-
 ...ent-CanAffordTransportation-extension.json |    6 +-
 ...r-environment-CanAffordTransportation.json |  485 +++++-
 ...ironment-CanAffordUtilities-extension.json |    6 +-
 ...on-shr-environment-CanAffordUtilities.json |  485 +++++-
 ...hr-environment-Coinhabitant-extension.json |    6 +-
 ...finition-shr-environment-Coinhabitant.json |  475 +++++-
 ...nvironment-DomesticViolence-extension.json |    6 +-
 ...tion-shr-environment-DomesticViolence.json |  487 +++++-
 ...environment-EmotionalSafety-extension.json |    8 +-
 ...ition-shr-environment-EmotionalSafety.json |  486 +++++-
 ...vironment-EnvironmentalExposuresPanel.json |  397 ++++-
 ...-environment-ExposureMethod-extension.json |    6 +-
 ...-environment-ExposureReason-extension.json |   10 +-
 ...ment-ExposureSourceOrVector-extension.json |    6 +-
 ...n-shr-environment-ExposureToSubstance.json |  494 +++++-
 ...r-environment-FinancialSituationPanel.json |  408 ++++-
 ...ronment-HomeEnvironmentRisk-extension.json |    6 +-
 ...n-shr-environment-HomeEnvironmentRisk.json |  486 +++++-
 ...r-environment-HouseholdSituationPanel.json |  399 ++++-
 ...r-environment-HouseholdSize-extension.json |    6 +-
 ...inition-shr-environment-HouseholdSize.json |  471 +++++-
 ...environment-HousingSecurity-extension.json |    6 +-
 ...ition-shr-environment-HousingSecurity.json |  486 +++++-
 ...hr-environment-IncomeSource-extension.json |    6 +-
 ...finition-shr-environment-IncomeSource.json |  485 +++++-
 ...environment-IncomeStability-extension.json |    6 +-
 ...ition-shr-environment-IncomeStability.json |  485 +++++-
 ...-environment-NonCashBenefit-extension.json |    6 +-
 ...nition-shr-environment-NonCashBenefit.json |  486 +++++-
 ...ironment-NumberOfDependents-extension.json |    6 +-
 ...on-shr-environment-NumberOfDependents.json |  471 +++++-
 ...-environment-PhysicalSafety-extension.json |    8 +-
 ...nition-shr-environment-PhysicalSafety.json |  486 +++++-
 ...hr-environment-SocialEnvironmentPanel.json |  402 ++++-
 ...-TransportationAvailability-extension.json |    6 +-
 ...nvironment-TransportationAvailability.json |  486 +++++-
 ...inition-shr-immunization-Immunization.json |  536 ++++--
 ...immunization-ImmunizationAdministered.json |  536 ++++--
 ...shr-immunization-ImmunizationNotGiven.json |  548 ++++--
 ...finition-shr-lab-ChangeFlag-extension.json |   10 +-
 ...reDefinition-shr-lab-HIVScreeningTest.json |  553 ++++--
 ...ition-shr-lab-HIVScreeningTestRequest.json | 1392 +++++++++++----
 ...efinition-shr-lab-HIVSupplementalTest.json |  553 ++++--
 ...on-shr-lab-HIVSupplementalTestRequest.json | 1392 +++++++++++----
 ...tureDefinition-shr-lab-Test-extension.json |    6 +-
 .../StructureDefinition-shr-lab-Test.json     |  550 ++++--
 ...ructureDefinition-shr-lab-TestRequest.json | 1370 +++++++++++----
 ...r-lifehistory-CongenitalAbnormalities.json |  475 +++++-
 ...shr-lifehistory-EducationalAttainment.json |  475 +++++-
 ...on-shr-lifehistory-Employer-extension.json |    6 +-
 ...Definition-shr-lifehistory-Employment.json |  473 +++++-
 ...ifehistory-EmploymentStatus-extension.json |   10 +-
 ...-lifehistory-MilitaryBranch-extension.json |   10 +-
 ...ition-shr-lifehistory-MilitaryService.json |  403 ++++-
 ...itaryServiceDischargeStatus-extension.json |   10 +-
 ...ehistory-MilitaryServiceEra-extension.json |   10 +-
 ...-lifehistory-MilitaryStatus-extension.json |    6 +-
 ...nition-shr-lifehistory-MilitaryStatus.json |  475 +++++-
 ...Definition-shr-lifehistory-Occupation.json |  471 +++++-
 ...tion-shr-lifehistory-PrenatalExposure.json |  500 +++++-
 ...-ServiceConnectedDisability-extension.json |   13 +-
 ...tureDefinition-shr-lifehistory-Travel.json |  487 +++++-
 ...on-shr-medication-Adherence-extension.json |   13 +-
 ...r-medication-AdherenceLevel-extension.json |   10 +-
 ...r-medication-MaximumDosePerTimePeriod.json |  238 +++
 ...eDefinition-shr-medication-Medication.json |  743 ++++----
 ...ation-MedicationAfterChange-extension.json |    6 +-
 ...tion-MedicationBeforeChange-extension.json |    6 +-
 ...ition-shr-medication-MedicationChange.json |   50 +-
 ...-medication-MedicationNotAdministered.json |  974 +++++++++--
 ...hr-medication-MedicationNotPrescribed.json | 1490 ++++++++++++++---
 ...cationNotPrescribedModifier-extension.json |   18 +-
 ...shr-medication-MedicationPrescription.json | 1490 ++++++++++++++---
 ...finition-shr-medication-MedicationUse.json |  942 +++++++++--
 ...dication-NonAdherenceReason-extension.json |   10 +-
 ...r-medication-OverTheCounter-extension.json |  216 ---
 ...hr-medication-RouteIntoBody-extension.json |    6 +-
 ...shr-medication-TypeOfChange-extension.json |   10 +-
 ...bservation-CodeableConceptObservation.json |  467 +++++-
 ...on-shr-observation-HistoryObservation.json |  487 +++++-
 ...efinition-shr-observation-Observation.json |  470 +++++-
 ...observation-ObservationCode-extension.json |    8 +-
 ...vationNonOccurrenceModifier-extension.json |   18 +-
 ...vation-ObservationQualifier-extension.json |    6 +-
 ...servation-ObservationReason-extension.json |    6 +-
 ...ctureDefinition-shr-observation-Panel.json |  396 ++++-
 ...inition-shr-observation-SocialHistory.json |  487 +++++-
 ...ition-shr-problem-Abatement-extension.json |   13 +-
 ...efinition-shr-problem-AcademicProblem.json |  163 +-
 ...uctureDefinition-shr-problem-Asplenia.json |  163 +-
 ...ion-shr-problem-Criticality-extension.json |    6 +-
 ...roblem-IncludeOnProblemList-extension.json |    8 +-
 ...tructureDefinition-shr-problem-Injury.json |  165 +-
 ...n-shr-problem-Manifestation-extension.json |    6 +-
 ...eDefinition-shr-problem-Manifestation.json |  470 +++++-
 ...ition-shr-problem-MentalHealthProblem.json |  170 +-
 ...ion-shr-problem-Preexisting-extension.json |    6 +-
 ...ructureDefinition-shr-problem-Problem.json |  163 +-
 ...nition-shr-problem-Severity-extension.json |    6 +-
 ...m-SupportingEvidenceQuality-extension.json |   10 +-
 ...em-WhenClinicallyRecognized-extension.json |   13 +-
 ...ureDefinition-shr-procedure-Procedure.json |  622 ++++---
 ...sex-ContraceptiveMethodRecommendation.json |   53 +-
 ...tion-shr-sex-ContraceptiveMethodsUsed.json |  475 +++++-
 ...-sex-CurrentPregnancyStatus-extension.json |    6 +-
 ...x-DifficultyWithIntercourse-extension.json |   10 +-
 ...efinition-shr-sex-Dispensed-extension.json |    6 +-
 ...tion-shr-sex-GenderIdentity-extension.json |    8 +-
 ...tureDefinition-shr-sex-GenderIdentity.json |  475 +++++-
 ...-sex-NumberOfLivingChildren-extension.json |    6 +-
 ...NumberOfPreviousPregnancies-extension.json |    6 +-
 ...berOfSexualPartnersPastYear-extension.json |    6 +-
 ...reDefinition-shr-sex-PregnancyHistory.json |  399 ++++-
 ...Definition-shr-sex-PregnancyIntention.json |  475 +++++-
 ...otRecommendingContraceptive-extension.json |   10 +-
 ...tion-shr-sex-SexualActivity-extension.json |   10 +-
 ...tureDefinition-shr-sex-SexualBehavior.json |  401 ++++-
 ...tureDefinition-shr-sex-SexualIdentity.json |  400 ++++-
 ...n-shr-sex-SexualOrientation-extension.json |   10 +-
 ...on-shr-skin-CausativeFactor-extension.json |   20 +-
 ...ion-shr-skin-ImmersionDepth-extension.json |    6 +-
 ...tureDefinition-shr-skin-PressureUlcer.json |  164 +-
 ...nition-shr-skin-PressureUlcerBodySite.json |  259 ++-
 ...n-shr-skin-PressureUlcerManifestation.json |  477 +++++-
 ...tion-shr-skin-PressureUlcerNotPresent.json |  167 +-
 ...ureDefinition-shr-skin-SupportSurface.json |  466 +++++-
 ...-SupportSurfaceBodyPosition-extension.json |   10 +-
 ...skin-SupportSurfaceCategory-extension.json |   10 +-
 ...kin-SupportSurfaceComponent-extension.json |   10 +-
 ...ition-shr-skin-SupportSurfaceEmployed.json |  328 ++--
 ...in-VisibleInternalStructure-extension.json |   10 +-
 ...on-shr-skin-WoundBedAndEdge-extension.json |   15 +-
 ...hr-skin-WoundEdgeAppearance-extension.json |   10 +-
 ...ition-shr-skin-WoundExudate-extension.json |   13 +-
 ...finition-shr-skin-WoundSize-extension.json |   13 +-
 ...on-shr-skin-WoundTunnelling-extension.json |   13 +-
 ...n-shr-skin-WoundUndermining-extension.json |   15 +-
 ...ureDefinition-shr-vital-BloodPressure.json |  741 ++++++--
 ...uctureDefinition-shr-vital-BodyHeight.json |  592 +++++--
 ...uctureDefinition-shr-vital-BodyLength.json |  592 +++++--
 ...ureDefinition-shr-vital-BodyMassIndex.json |  879 ++++++++--
 ...eDefinition-shr-vital-BodyTemperature.json |  592 +++++--
 ...uctureDefinition-shr-vital-BodyWeight.json |  592 +++++--
 ...efinition-shr-vital-DiastolicPressure.json |  471 +++++-
 ...efinition-shr-vital-HeadCircumference.json |  587 +++++--
 ...ion-shr-vital-HeadTiltAngle-extension.json |    6 +-
 ...ructureDefinition-shr-vital-HeartRate.json |  590 +++++--
 ...Definition-shr-vital-OxygenSaturation.json |  587 +++++--
 ...eDefinition-shr-vital-RespiratoryRate.json |  590 +++++--
 ...Definition-shr-vital-SystolicPressure.json |  471 +++++-
 ...ructureDefinition-shr-vital-VitalSign.json |  573 +++++--
 .../ValueSet-shr-actor-AgeGroupVS.json        |    7 +-
 .../ValueSet-shr-actor-HealthcareRoleVS.json  |    7 +-
 ...alueSet-shr-actor-LanguageQualifierVS.json |    9 +-
 .../ValueSet-shr-adverse-MedDRAVS.json        |   43 +
 ...lueSet-shr-allergy-AllergenIrritantVS.json |    7 +-
 ...r-allergy-AllergyVerificationStatusVS.json |    7 +-
 ...ValueSet-shr-allergy-DrugIngredientVS.json |    5 +-
 .../ValueSet-shr-allergy-FoodSubstanceVS.json |    9 +-
 .../ValueSet-shr-base-GenericAnswersVS.json   |    9 +-
 ...alueSet-shr-base-MissingValueReasonVS.json |    7 +-
 ...hr-behavior-AlcoholUseScreeningToolVS.json |    9 +-
 ...t-shr-behavior-DietNutritionConcernVS.json |    9 +-
 ...behavior-PhysicalActivityLimitationVS.json |    9 +-
 ...hr-behavior-ReligiousPracticeStatusVS.json |    9 +-
 ...t-shr-behavior-ReligiousRestrictionVS.json |    7 +-
 ...Set-shr-behavior-SleepQualityReasonVS.json |    9 +-
 ...et-shr-behavior-SpecialDietFollowedVS.json |    9 +-
 ...ehavior-SubstanceAbuseTreatmentTypeVS.json |    9 +-
 ...ueSet-shr-behavior-SubstanceOfAbuseVS.json |    7 +-
 .../ValueSet-shr-core-BodyPositionVS.json     |    5 +-
 .../ValueSet-shr-core-BodySiteVS.json         |    5 +-
 ...eSet-shr-core-ClinicalFindingAbsentVS.json |    7 +-
 .../ValueSet-shr-core-ClockDirectionVS.json   |    7 +-
 .../ValueSet-shr-core-CodingQualifierVS.json  |    9 +-
 .../ValueSet-shr-core-DirectionalityVS.json   |    5 +-
 .../ValueSet-shr-core-DiseaseFindingVS.json   |    7 +-
 .../ValueSet-shr-core-LateralityVS.json       |    5 +-
 .../ValueSet-shr-core-LowerBoundTypeVS.json   |    9 +-
 .../ValueSet-shr-core-ManifestationVS.json    |    7 +-
 ...et-shr-core-PerformanceGradingScaleVS.json |    7 +-
 .../ValueSet-shr-core-PortionTotalityVS.json  |    5 +-
 ...lueSet-shr-core-QualitativeDateTimeVS.json |    9 +-
 ...ueSet-shr-core-QualitativeFrequencyVS.json |    9 +-
 ...eSet-shr-core-QualitativeLikelihoodVS.json |    9 +-
 ...eSet-shr-core-QualitativeValueScaleVS.json |    9 +-
 ...t-shr-core-SemiquantitativeDurationVS.json |    9 +-
 ...-shr-core-SemiquantitativeFrequencyVS.json |    9 +-
 .../ValueSet-shr-core-SettingVS.json          |    7 +-
 .../ValueSet-shr-core-StatisticTypeVS.json    |    5 +-
 .../ValueSet-shr-core-ThreePriorityVS.json    |    9 +-
 .../ValueSet-shr-core-ThreeValueLogicVS.json  |    9 +-
 ...ValueSet-shr-core-TimeUnitOfMeasureVS.json |    7 +-
 .../ValueSet-shr-core-UpperBoundTypeVS.json   |    9 +-
 ...alueSet-shr-demographics-AddressUseVS.json |    7 +-
 ...-demographics-InsuranceProviderTypeVS.json |    9 +-
 ...t-shr-demographics-TelecomQualifierVS.json |    9 +-
 ...eSet-shr-demographics-TelephoneTypeVS.json |    9 +-
 ...-shr-device-RespiratoryAssistDeviceVS.json |    9 +-
 ...t-shr-device-RespiratoryRateSettingVS.json |    9 +-
 ...alueSet-shr-encounter-EncounterTypeVS.json |    9 +-
 ...eSet-shr-encounter-EncounterUrgencyVS.json |    7 +-
 ...r-encounter-EpisodeOfCareCompletionVS.json |    9 +-
 ...counter-ReasonEncounterDidNotHappenVS.json |    9 +-
 ...et-shr-encounter-ReferralSourceTypeVS.json |    9 +-
 ...-shr-encounter-TreatmentCooperationVS.json |    9 +-
 ...eSet-shr-environment-AnimalExposureVS.json |    9 +-
 ...lueSet-shr-environment-CoinhabitantVS.json |    9 +-
 ...shr-environment-HomeEnvironmentRiskVS.json |    9 +-
 ...lueSet-shr-environment-IncomeSourceVS.json |    9 +-
 ...eSet-shr-environment-NonCashBenefitVS.json |    9 +-
 ...t-shr-environment-ResourceStabilityVS.json |    9 +-
 ...nization-ImmunizationNotGivenReasonVS.json |    5 +-
 .../ValueSet-shr-lab-ChangeFlagVS.json        |    7 +-
 ...lueSet-shr-lab-HIVScreeningTestCodeVS.json |    9 +-
 ...eSet-shr-lab-HIVScreeningTestResultVS.json |    7 +-
 ...Set-shr-lab-HIVSupplementalTestCodeVS.json |    9 +-
 ...t-shr-lab-HIVSupplementalTestResultVS.json |    7 +-
 .../ValueSet-shr-lab-RequestStatusVS.json     |    9 +-
 ...ValueSet-shr-lab-TestInterpretationVS.json |    7 +-
 ...lifehistory-CongenitalAbnormalitiesVS.json |    7 +-
 ...r-lifehistory-EducationalAttainmentVS.json |    9 +-
 ...et-shr-lifehistory-EmploymentStatusVS.json |    9 +-
 ...tory-MilitaryServiceDischargeStatusVS.json |    9 +-
 ...-shr-lifehistory-MilitaryServiceEraVS.json |    7 +-
 ...eSet-shr-lifehistory-MilitaryStatusVS.json |    9 +-
 .../ValueSet-shr-lifehistory-TeratogenVS.json |    9 +-
 ...et-shr-lifehistory-USMilitaryBranchVS.json |    9 +-
 ...r-medication-MedicationChangeReasonVS.json |    9 +-
 ...shr-medication-MedicationChangeTypeVS.json |    9 +-
 ...cation-MedicationNonAdherenceReasonVS.json |    7 +-
 .../ValueSet-shr-medication-MedicationVS.json |   43 +
 ...-medication-ReasonMedicationNotUsedVS.json |    9 +-
 ...eSet-shr-observation-ExposureReasonVS.json |    7 +-
 ...observation-NonLabObservationStatusVS.json |    5 +-
 ...bservation-ObservationNotMadeReasonVS.json |    7 +-
 .../ValueSet-shr-problem-DSMVS.json           |   43 +
 ...alueSet-shr-problem-EvidenceQualityVS.json |    9 +-
 .../ValueSet-shr-problem-GradeOrStageVS.json  |    9 +-
 ...alueSet-shr-problem-ProblemCategoryVS.json |    9 +-
 ...shr-sex-CommonPregnancyComplicationVS.json |    7 +-
 ...t-shr-sex-ContraceptiveMethodReasonVS.json |    9 +-
 ...alueSet-shr-sex-ContraceptiveMethodVS.json |    9 +-
 ...-shr-sex-ContraceptiveNotUsedReasonVS.json |    9 +-
 ...t-shr-sex-DifficultyWithIntercourseVS.json |    7 +-
 .../ValueSet-shr-sex-GenderIdentityVS.json    |    9 +-
 .../ValueSet-shr-sex-SexualActivityVS.json    |    7 +-
 .../ValueSet-shr-sex-SexualOrientationVS.json |    7 +-
 ...t-shr-skin-PressureUlcerAssociationVS.json |    9 +-
 ...eSet-shr-skin-PressureUlcerBodySiteVS.json |    7 +-
 ...shr-skin-SupportSurfaceBodyPositionVS.json |    9 +-
 ...Set-shr-skin-SupportSurfaceCategoryVS.json |    9 +-
 ...et-shr-skin-SupportSurfaceComponentVS.json |    9 +-
 ...eSet-shr-skin-SupportSurfaceFeatureVS.json |    9 +-
 .../ValueSet-shr-skin-SupportSurfaceVS.json   |    7 +-
 ...t-shr-skin-VisibleInternalStructureVS.json |    7 +-
 ...lueSet-shr-skin-WoundEdgeAppearanceVS.json |    7 +-
 ...Set-shr-vital-BloodPressureBodySiteVS.json |    7 +-
 ...ueSet-shr-vital-BloodPressureMethodVS.json |    7 +-
 ...et-shr-vital-BloodPressureQualifierVS.json |    7 +-
 ...ueSet-shr-vital-BodyHeightQualifierVS.json |    9 +-
 ...t-shr-vital-BodyTemperatureBodySiteVS.json |    7 +-
 ...-shr-vital-BodyTemperatureQualifierVS.json |    9 +-
 ...ueSet-shr-vital-BodyWeightQualifierVS.json |    9 +-
 .../ValueSet-shr-vital-HeartRateMethodVS.json |    7 +-
 ...lueSet-shr-vital-HeartRateQualifierVS.json |    7 +-
 ...-shr-vital-OxygenSaturationBodySiteVS.json |    7 +-
 ...Set-shr-vital-RespiratoryRateMethodVS.json |    7 +-
 ...-shr-vital-RespiratoryRateQualifierVS.json |    7 +-
 .../standard_health_record/spec.internals     |  984 ++++++-----
 547 files changed, 51092 insertions(+), 13880 deletions(-)
 rename lib/resources/standard_health_record/{CodeSystem-shr-actor-LanguageQualifierVS.json => CodeSystem-shr-actor-LanguageQualifierCS.json} (82%)
 mode change 100755 => 100644
 rename lib/resources/standard_health_record/{CodeSystem-shr-base-GenericAnswersVS.json => CodeSystem-shr-base-GenericAnswersCS.json} (82%)
 mode change 100755 => 100644
 rename lib/resources/standard_health_record/{CodeSystem-shr-base-MissingValueReasonVS.json => CodeSystem-shr-base-MissingValueReasonCS.json} (88%)
 mode change 100755 => 100644
 rename lib/resources/standard_health_record/{CodeSystem-shr-behavior-AlcoholUseScreeningToolVS.json => CodeSystem-shr-behavior-AlcoholUseScreeningToolCS.json} (69%)
 mode change 100755 => 100644
 rename lib/resources/standard_health_record/{CodeSystem-shr-behavior-DietNutritionConcernVS.json => CodeSystem-shr-behavior-DietNutritionConcernCS.json} (87%)
 mode change 100755 => 100644
 rename lib/resources/standard_health_record/{CodeSystem-shr-behavior-PhysicalActivityLimitationVS.json => CodeSystem-shr-behavior-PhysicalActivityLimitationCS.json} (82%)
 mode change 100755 => 100644
 rename lib/resources/standard_health_record/{CodeSystem-shr-behavior-ReligiousPracticeStatusVS.json => CodeSystem-shr-behavior-ReligiousPracticeStatusCS.json} (74%)
 mode change 100755 => 100644
 rename lib/resources/standard_health_record/{CodeSystem-shr-behavior-ReligiousRestrictionVS.json => CodeSystem-shr-behavior-ReligiousRestrictionCS.json} (77%)
 mode change 100755 => 100644
 rename lib/resources/standard_health_record/{CodeSystem-shr-behavior-SleepQualityReasonVS.json => CodeSystem-shr-behavior-SleepQualityReasonCS.json} (84%)
 mode change 100755 => 100644
 rename lib/resources/standard_health_record/{CodeSystem-shr-behavior-SpecialDietFollowedVS.json => CodeSystem-shr-behavior-SpecialDietFollowedCS.json} (76%)
 mode change 100755 => 100644
 rename lib/resources/standard_health_record/{CodeSystem-shr-behavior-SubstanceAbuseTreatmentTypeVS.json => CodeSystem-shr-behavior-SubstanceAbuseTreatmentTypeCS.json} (83%)
 mode change 100755 => 100644
 rename lib/resources/standard_health_record/{CodeSystem-shr-core-CodingQualifierVS.json => CodeSystem-shr-core-CodingQualifierCS.json} (89%)
 mode change 100755 => 100644
 rename lib/resources/standard_health_record/{CodeSystem-shr-core-PerformanceGradingScaleVS.json => CodeSystem-shr-core-PerformanceGradingScaleCS.json} (76%)
 mode change 100755 => 100644
 rename lib/resources/standard_health_record/{CodeSystem-shr-core-QualitativeDateTimeVS.json => CodeSystem-shr-core-QualitativeDateTimeCS.json} (89%)
 mode change 100755 => 100644
 rename lib/resources/standard_health_record/{CodeSystem-shr-core-QualitativeFrequencyVS.json => CodeSystem-shr-core-QualitativeFrequencyCS.json} (76%)
 mode change 100755 => 100644
 rename lib/resources/standard_health_record/{CodeSystem-shr-core-QualitativeLikelihoodVS.json => CodeSystem-shr-core-QualitativeLikelihoodCS.json} (83%)
 mode change 100755 => 100644
 rename lib/resources/standard_health_record/{CodeSystem-shr-core-QualitativeValueScaleVS.json => CodeSystem-shr-core-QualitativeValueScaleCS.json} (74%)
 mode change 100755 => 100644
 rename lib/resources/standard_health_record/{CodeSystem-shr-core-SemiquantitativeDurationVS.json => CodeSystem-shr-core-SemiquantitativeDurationCS.json} (82%)
 mode change 100755 => 100644
 rename lib/resources/standard_health_record/{CodeSystem-shr-core-SemiquantitativeFrequencyVS.json => CodeSystem-shr-core-SemiquantitativeFrequencyCS.json} (83%)
 mode change 100755 => 100644
 rename lib/resources/standard_health_record/{CodeSystem-shr-core-SettingVS.json => CodeSystem-shr-core-SettingCS.json} (95%)
 mode change 100755 => 100644
 rename lib/resources/standard_health_record/{CodeSystem-shr-core-ThreePriorityVS.json => CodeSystem-shr-core-ThreePriorityCS.json} (78%)
 mode change 100755 => 100644
 rename lib/resources/standard_health_record/{CodeSystem-shr-core-ThreeValueLogicVS.json => CodeSystem-shr-core-ThreeValueLogicCS.json} (73%)
 mode change 100755 => 100644
 rename lib/resources/standard_health_record/{CodeSystem-shr-demographics-AddressUseVS.json => CodeSystem-shr-demographics-AddressUseCS.json} (86%)
 mode change 100755 => 100644
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 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-encounter-ReferralSourceTypeVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-encounter-TreatmentCooperationVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-environment-AnimalExposureVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-environment-CoinhabitantVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-environment-HomeEnvironmentRiskVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-environment-IncomeSourceVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-environment-NonCashBenefitVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-environment-ResourceStabilityVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-immunization-ImmunizationNotGivenReasonVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-lab-ChangeFlagVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-lab-HIVScreeningTestCodeVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-lab-HIVScreeningTestResultVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-lab-HIVSupplementalTestCodeVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-lab-HIVSupplementalTestResultVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-lab-RequestStatusVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-lab-TestInterpretationVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-lifehistory-CongenitalAbnormalitiesVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-lifehistory-EducationalAttainmentVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-lifehistory-EmploymentStatusVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-lifehistory-MilitaryServiceDischargeStatusVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-lifehistory-MilitaryServiceEraVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-lifehistory-MilitaryStatusVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-lifehistory-TeratogenVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-lifehistory-USMilitaryBranchVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-medication-MedicationChangeReasonVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-medication-MedicationChangeTypeVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-medication-MedicationNonAdherenceReasonVS.json
 create mode 100644 lib/resources/standard_health_record/ValueSet-shr-medication-MedicationVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-medication-ReasonMedicationNotUsedVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-observation-ExposureReasonVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-observation-NonLabObservationStatusVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-observation-ObservationNotMadeReasonVS.json
 create mode 100644 lib/resources/standard_health_record/ValueSet-shr-problem-DSMVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-problem-EvidenceQualityVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-problem-GradeOrStageVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-problem-ProblemCategoryVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-sex-CommonPregnancyComplicationVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-sex-ContraceptiveMethodReasonVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-sex-ContraceptiveMethodVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-sex-ContraceptiveNotUsedReasonVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-sex-DifficultyWithIntercourseVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-sex-GenderIdentityVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-sex-SexualActivityVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-sex-SexualOrientationVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-skin-PressureUlcerAssociationVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-skin-PressureUlcerBodySiteVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-skin-SupportSurfaceBodyPositionVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-skin-SupportSurfaceCategoryVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-skin-SupportSurfaceComponentVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-skin-SupportSurfaceFeatureVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-skin-SupportSurfaceVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-skin-VisibleInternalStructureVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-skin-WoundEdgeAppearanceVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-vital-BloodPressureBodySiteVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-vital-BloodPressureMethodVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-vital-BloodPressureQualifierVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-vital-BodyHeightQualifierVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-vital-BodyTemperatureBodySiteVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-vital-BodyTemperatureQualifierVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-vital-BodyWeightQualifierVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-vital-HeartRateMethodVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-vital-HeartRateQualifierVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-vital-OxygenSaturationBodySiteVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-vital-RespiratoryRateMethodVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/ValueSet-shr-vital-RespiratoryRateQualifierVS.json
 mode change 100755 => 100644 lib/resources/standard_health_record/spec.internals

diff --git a/lib/resources/standard_health_record/CodeSystem-shr-actor-LanguageQualifierVS.json b/lib/resources/standard_health_record/CodeSystem-shr-actor-LanguageQualifierCS.json
old mode 100755
new mode 100644
similarity index 82%
rename from lib/resources/standard_health_record/CodeSystem-shr-actor-LanguageQualifierVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-actor-LanguageQualifierCS.json
index 4aab537..7dee30e
--- a/lib/resources/standard_health_record/CodeSystem-shr-actor-LanguageQualifierVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-actor-LanguageQualifierCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-actor-LanguageQualifierVS",
+  "id": "shr-actor-LanguageQualifierCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR LanguageQualifierVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR LanguageQualifierCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-actor-LanguageQualifierVS",
+  "url": "http://standardhealthrecord.org/shr/actor/cs/LanguageQualifierCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.actor.LanguageQualifierVS"
+    "value": "shr.actor.LanguageQualifierCS"
   },
-  "name": "SHR LanguageQualifierVS CodeSystem",
-  "title": "SHR LanguageQualifierVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR LanguageQualifierCS CodeSystem",
+  "title": "SHR LanguageQualifierCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.481Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.805Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 8,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-base-GenericAnswersVS.json b/lib/resources/standard_health_record/CodeSystem-shr-base-GenericAnswersCS.json
old mode 100755
new mode 100644
similarity index 82%
rename from lib/resources/standard_health_record/CodeSystem-shr-base-GenericAnswersVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-base-GenericAnswersCS.json
index 27dcfd4..379b8e8
--- a/lib/resources/standard_health_record/CodeSystem-shr-base-GenericAnswersVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-base-GenericAnswersCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-base-GenericAnswersVS",
+  "id": "shr-base-GenericAnswersCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR GenericAnswersVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR GenericAnswersCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-base-GenericAnswersVS",
+  "url": "http://standardhealthrecord.org/shr/base/cs/GenericAnswersCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.base.GenericAnswersVS"
+    "value": "shr.base.GenericAnswersCS"
   },
-  "name": "SHR GenericAnswersVS CodeSystem",
-  "title": "SHR GenericAnswersVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR GenericAnswersCS CodeSystem",
+  "title": "SHR GenericAnswersCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.482Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.805Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 3,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-base-MissingValueReasonVS.json b/lib/resources/standard_health_record/CodeSystem-shr-base-MissingValueReasonCS.json
old mode 100755
new mode 100644
similarity index 88%
rename from lib/resources/standard_health_record/CodeSystem-shr-base-MissingValueReasonVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-base-MissingValueReasonCS.json
index e5307fb..1ec64c2
--- a/lib/resources/standard_health_record/CodeSystem-shr-base-MissingValueReasonVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-base-MissingValueReasonCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-base-MissingValueReasonVS",
+  "id": "shr-base-MissingValueReasonCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR MissingValueReasonVS CodeSystem</b></p>\n<p>Reasons that a value associated with a test or other observation is missing.</p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR MissingValueReasonCS CodeSystem</b></p>\n<p>Reasons that a value associated with a test or other observation is missing.</p>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-base-MissingValueReasonVS",
+  "url": "http://standardhealthrecord.org/shr/base/cs/MissingValueReasonCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.base.MissingValueReasonVS"
+    "value": "shr.base.MissingValueReasonCS"
   },
-  "name": "SHR MissingValueReasonVS CodeSystem",
-  "title": "SHR MissingValueReasonVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR MissingValueReasonCS CodeSystem",
+  "title": "SHR MissingValueReasonCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.481Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.805Z",
   "description": "Reasons that a value associated with a test or other observation is missing.",
   "caseSensitive": true,
   "content": "complete",
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-behavior-AlcoholUseScreeningToolVS.json b/lib/resources/standard_health_record/CodeSystem-shr-behavior-AlcoholUseScreeningToolCS.json
old mode 100755
new mode 100644
similarity index 69%
rename from lib/resources/standard_health_record/CodeSystem-shr-behavior-AlcoholUseScreeningToolVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-behavior-AlcoholUseScreeningToolCS.json
index 35809cd..c001b5a
--- a/lib/resources/standard_health_record/CodeSystem-shr-behavior-AlcoholUseScreeningToolVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-behavior-AlcoholUseScreeningToolCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-behavior-AlcoholUseScreeningToolVS",
+  "id": "shr-behavior-AlcoholUseScreeningToolCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR AlcoholUseScreeningToolVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR AlcoholUseScreeningToolCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-behavior-AlcoholUseScreeningToolVS",
+  "url": "http://standardhealthrecord.org/shr/behavior/cs/AlcoholUseScreeningToolCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.behavior.AlcoholUseScreeningToolVS"
+    "value": "shr.behavior.AlcoholUseScreeningToolCS"
   },
-  "name": "SHR AlcoholUseScreeningToolVS CodeSystem",
-  "title": "SHR AlcoholUseScreeningToolVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR AlcoholUseScreeningToolCS CodeSystem",
+  "title": "SHR AlcoholUseScreeningToolCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.482Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.805Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 3,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-behavior-DietNutritionConcernVS.json b/lib/resources/standard_health_record/CodeSystem-shr-behavior-DietNutritionConcernCS.json
old mode 100755
new mode 100644
similarity index 87%
rename from lib/resources/standard_health_record/CodeSystem-shr-behavior-DietNutritionConcernVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-behavior-DietNutritionConcernCS.json
index b5ff661..c909c73
--- a/lib/resources/standard_health_record/CodeSystem-shr-behavior-DietNutritionConcernVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-behavior-DietNutritionConcernCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-behavior-DietNutritionConcernVS",
+  "id": "shr-behavior-DietNutritionConcernCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR DietNutritionConcernVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR DietNutritionConcernCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-behavior-DietNutritionConcernVS",
+  "url": "http://standardhealthrecord.org/shr/behavior/cs/DietNutritionConcernCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.behavior.DietNutritionConcernVS"
+    "value": "shr.behavior.DietNutritionConcernCS"
   },
-  "name": "SHR DietNutritionConcernVS CodeSystem",
-  "title": "SHR DietNutritionConcernVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR DietNutritionConcernCS CodeSystem",
+  "title": "SHR DietNutritionConcernCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.482Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.805Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 18,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-behavior-PhysicalActivityLimitationVS.json b/lib/resources/standard_health_record/CodeSystem-shr-behavior-PhysicalActivityLimitationCS.json
old mode 100755
new mode 100644
similarity index 82%
rename from lib/resources/standard_health_record/CodeSystem-shr-behavior-PhysicalActivityLimitationVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-behavior-PhysicalActivityLimitationCS.json
index 2bcf73a..c818db3
--- a/lib/resources/standard_health_record/CodeSystem-shr-behavior-PhysicalActivityLimitationVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-behavior-PhysicalActivityLimitationCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-behavior-PhysicalActivityLimitationVS",
+  "id": "shr-behavior-PhysicalActivityLimitationCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR PhysicalActivityLimitationVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR PhysicalActivityLimitationCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-behavior-PhysicalActivityLimitationVS",
+  "url": "http://standardhealthrecord.org/shr/behavior/cs/PhysicalActivityLimitationCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.behavior.PhysicalActivityLimitationVS"
+    "value": "shr.behavior.PhysicalActivityLimitationCS"
   },
-  "name": "SHR PhysicalActivityLimitationVS CodeSystem",
-  "title": "SHR PhysicalActivityLimitationVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR PhysicalActivityLimitationCS CodeSystem",
+  "title": "SHR PhysicalActivityLimitationCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.482Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.805Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 12,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-behavior-ReligiousPracticeStatusVS.json b/lib/resources/standard_health_record/CodeSystem-shr-behavior-ReligiousPracticeStatusCS.json
old mode 100755
new mode 100644
similarity index 74%
rename from lib/resources/standard_health_record/CodeSystem-shr-behavior-ReligiousPracticeStatusVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-behavior-ReligiousPracticeStatusCS.json
index 0e98ba2..9dcdd70
--- a/lib/resources/standard_health_record/CodeSystem-shr-behavior-ReligiousPracticeStatusVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-behavior-ReligiousPracticeStatusCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-behavior-ReligiousPracticeStatusVS",
+  "id": "shr-behavior-ReligiousPracticeStatusCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ReligiousPracticeStatusVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ReligiousPracticeStatusCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-behavior-ReligiousPracticeStatusVS",
+  "url": "http://standardhealthrecord.org/shr/behavior/cs/ReligiousPracticeStatusCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.behavior.ReligiousPracticeStatusVS"
+    "value": "shr.behavior.ReligiousPracticeStatusCS"
   },
-  "name": "SHR ReligiousPracticeStatusVS CodeSystem",
-  "title": "SHR ReligiousPracticeStatusVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR ReligiousPracticeStatusCS CodeSystem",
+  "title": "SHR ReligiousPracticeStatusCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.482Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.805Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 3,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-behavior-ReligiousRestrictionVS.json b/lib/resources/standard_health_record/CodeSystem-shr-behavior-ReligiousRestrictionCS.json
old mode 100755
new mode 100644
similarity index 77%
rename from lib/resources/standard_health_record/CodeSystem-shr-behavior-ReligiousRestrictionVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-behavior-ReligiousRestrictionCS.json
index ff06905..bb0d712
--- a/lib/resources/standard_health_record/CodeSystem-shr-behavior-ReligiousRestrictionVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-behavior-ReligiousRestrictionCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-behavior-ReligiousRestrictionVS",
+  "id": "shr-behavior-ReligiousRestrictionCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ReligiousRestrictionVS CodeSystem</b></p>\n<p>Includes religious restrictions that could impact care, other than dietary restrictions (handled elsewhere).</p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ReligiousRestrictionCS CodeSystem</b></p>\n<p>Includes religious restrictions that could impact care, other than dietary restrictions (handled elsewhere).</p>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-behavior-ReligiousRestrictionVS",
+  "url": "http://standardhealthrecord.org/shr/behavior/cs/ReligiousRestrictionCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.behavior.ReligiousRestrictionVS"
+    "value": "shr.behavior.ReligiousRestrictionCS"
   },
-  "name": "SHR ReligiousRestrictionVS CodeSystem",
-  "title": "SHR ReligiousRestrictionVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR ReligiousRestrictionCS CodeSystem",
+  "title": "SHR ReligiousRestrictionCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.482Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.805Z",
   "description": "Includes religious restrictions that could impact care, other than dietary restrictions (handled elsewhere).",
   "caseSensitive": true,
   "content": "complete",
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-behavior-SleepQualityReasonVS.json b/lib/resources/standard_health_record/CodeSystem-shr-behavior-SleepQualityReasonCS.json
old mode 100755
new mode 100644
similarity index 84%
rename from lib/resources/standard_health_record/CodeSystem-shr-behavior-SleepQualityReasonVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-behavior-SleepQualityReasonCS.json
index 11bf840..4091268
--- a/lib/resources/standard_health_record/CodeSystem-shr-behavior-SleepQualityReasonVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-behavior-SleepQualityReasonCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-behavior-SleepQualityReasonVS",
+  "id": "shr-behavior-SleepQualityReasonCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR SleepQualityReasonVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR SleepQualityReasonCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-behavior-SleepQualityReasonVS",
+  "url": "http://standardhealthrecord.org/shr/behavior/cs/SleepQualityReasonCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.behavior.SleepQualityReasonVS"
+    "value": "shr.behavior.SleepQualityReasonCS"
   },
-  "name": "SHR SleepQualityReasonVS CodeSystem",
-  "title": "SHR SleepQualityReasonVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR SleepQualityReasonCS CodeSystem",
+  "title": "SHR SleepQualityReasonCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.482Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.805Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 11,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-behavior-SpecialDietFollowedVS.json b/lib/resources/standard_health_record/CodeSystem-shr-behavior-SpecialDietFollowedCS.json
old mode 100755
new mode 100644
similarity index 76%
rename from lib/resources/standard_health_record/CodeSystem-shr-behavior-SpecialDietFollowedVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-behavior-SpecialDietFollowedCS.json
index 8fd78dc..af7846d
--- a/lib/resources/standard_health_record/CodeSystem-shr-behavior-SpecialDietFollowedVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-behavior-SpecialDietFollowedCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-behavior-SpecialDietFollowedVS",
+  "id": "shr-behavior-SpecialDietFollowedCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR SpecialDietFollowedVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR SpecialDietFollowedCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-behavior-SpecialDietFollowedVS",
+  "url": "http://standardhealthrecord.org/shr/behavior/cs/SpecialDietFollowedCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.behavior.SpecialDietFollowedVS"
+    "value": "shr.behavior.SpecialDietFollowedCS"
   },
-  "name": "SHR SpecialDietFollowedVS CodeSystem",
-  "title": "SHR SpecialDietFollowedVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR SpecialDietFollowedCS CodeSystem",
+  "title": "SHR SpecialDietFollowedCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.482Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.805Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 6,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-behavior-SubstanceAbuseTreatmentTypeVS.json b/lib/resources/standard_health_record/CodeSystem-shr-behavior-SubstanceAbuseTreatmentTypeCS.json
old mode 100755
new mode 100644
similarity index 83%
rename from lib/resources/standard_health_record/CodeSystem-shr-behavior-SubstanceAbuseTreatmentTypeVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-behavior-SubstanceAbuseTreatmentTypeCS.json
index 023b8ef..7f574dd
--- a/lib/resources/standard_health_record/CodeSystem-shr-behavior-SubstanceAbuseTreatmentTypeVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-behavior-SubstanceAbuseTreatmentTypeCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-behavior-SubstanceAbuseTreatmentTypeVS",
+  "id": "shr-behavior-SubstanceAbuseTreatmentTypeCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR SubstanceAbuseTreatmentTypeVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR SubstanceAbuseTreatmentTypeCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-behavior-SubstanceAbuseTreatmentTypeVS",
+  "url": "http://standardhealthrecord.org/shr/behavior/cs/SubstanceAbuseTreatmentTypeCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.behavior.SubstanceAbuseTreatmentTypeVS"
+    "value": "shr.behavior.SubstanceAbuseTreatmentTypeCS"
   },
-  "name": "SHR SubstanceAbuseTreatmentTypeVS CodeSystem",
-  "title": "SHR SubstanceAbuseTreatmentTypeVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR SubstanceAbuseTreatmentTypeCS CodeSystem",
+  "title": "SHR SubstanceAbuseTreatmentTypeCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.482Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.805Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 11,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-core-CodingQualifierVS.json b/lib/resources/standard_health_record/CodeSystem-shr-core-CodingQualifierCS.json
old mode 100755
new mode 100644
similarity index 89%
rename from lib/resources/standard_health_record/CodeSystem-shr-core-CodingQualifierVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-core-CodingQualifierCS.json
index 586b036..be7e929
--- a/lib/resources/standard_health_record/CodeSystem-shr-core-CodingQualifierVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-core-CodingQualifierCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-core-CodingQualifierVS",
+  "id": "shr-core-CodingQualifierCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR CodingQualifierVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR CodingQualifierCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-core-CodingQualifierVS",
+  "url": "http://standardhealthrecord.org/shr/core/cs/CodingQualifierCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.core.CodingQualifierVS"
+    "value": "shr.core.CodingQualifierCS"
   },
-  "name": "SHR CodingQualifierVS CodeSystem",
-  "title": "SHR CodingQualifierVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR CodingQualifierCS CodeSystem",
+  "title": "SHR CodingQualifierCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.482Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.806Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 7,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-core-PerformanceGradingScaleVS.json b/lib/resources/standard_health_record/CodeSystem-shr-core-PerformanceGradingScaleCS.json
old mode 100755
new mode 100644
similarity index 76%
rename from lib/resources/standard_health_record/CodeSystem-shr-core-PerformanceGradingScaleVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-core-PerformanceGradingScaleCS.json
index 3b9e7de..2bdaad5
--- a/lib/resources/standard_health_record/CodeSystem-shr-core-PerformanceGradingScaleVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-core-PerformanceGradingScaleCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-core-PerformanceGradingScaleVS",
+  "id": "shr-core-PerformanceGradingScaleCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR PerformanceGradingScaleVS CodeSystem</b></p>\n<p>A simple performance grading scale. Also useful for grading quality.</p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR PerformanceGradingScaleCS CodeSystem</b></p>\n<p>A simple performance grading scale. Also useful for grading quality.</p>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-core-PerformanceGradingScaleVS",
+  "url": "http://standardhealthrecord.org/shr/core/cs/PerformanceGradingScaleCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.core.PerformanceGradingScaleVS"
+    "value": "shr.core.PerformanceGradingScaleCS"
   },
-  "name": "SHR PerformanceGradingScaleVS CodeSystem",
-  "title": "SHR PerformanceGradingScaleVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR PerformanceGradingScaleCS CodeSystem",
+  "title": "SHR PerformanceGradingScaleCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.482Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.807Z",
   "description": "A simple performance grading scale. Also useful for grading quality.",
   "caseSensitive": true,
   "content": "complete",
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-core-QualitativeDateTimeVS.json b/lib/resources/standard_health_record/CodeSystem-shr-core-QualitativeDateTimeCS.json
old mode 100755
new mode 100644
similarity index 89%
rename from lib/resources/standard_health_record/CodeSystem-shr-core-QualitativeDateTimeVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-core-QualitativeDateTimeCS.json
index 297ee75..be0e4ef
--- a/lib/resources/standard_health_record/CodeSystem-shr-core-QualitativeDateTimeVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-core-QualitativeDateTimeCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-core-QualitativeDateTimeVS",
+  "id": "shr-core-QualitativeDateTimeCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR QualitativeDateTimeVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR QualitativeDateTimeCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-core-QualitativeDateTimeVS",
+  "url": "http://standardhealthrecord.org/shr/core/cs/QualitativeDateTimeCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.core.QualitativeDateTimeVS"
+    "value": "shr.core.QualitativeDateTimeCS"
   },
-  "name": "SHR QualitativeDateTimeVS CodeSystem",
-  "title": "SHR QualitativeDateTimeVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR QualitativeDateTimeCS CodeSystem",
+  "title": "SHR QualitativeDateTimeCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.482Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.806Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 20,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-core-QualitativeFrequencyVS.json b/lib/resources/standard_health_record/CodeSystem-shr-core-QualitativeFrequencyCS.json
old mode 100755
new mode 100644
similarity index 76%
rename from lib/resources/standard_health_record/CodeSystem-shr-core-QualitativeFrequencyVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-core-QualitativeFrequencyCS.json
index d33b956..812cfff
--- a/lib/resources/standard_health_record/CodeSystem-shr-core-QualitativeFrequencyVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-core-QualitativeFrequencyCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-core-QualitativeFrequencyVS",
+  "id": "shr-core-QualitativeFrequencyCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR QualitativeFrequencyVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR QualitativeFrequencyCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-core-QualitativeFrequencyVS",
+  "url": "http://standardhealthrecord.org/shr/core/cs/QualitativeFrequencyCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.core.QualitativeFrequencyVS"
+    "value": "shr.core.QualitativeFrequencyCS"
   },
-  "name": "SHR QualitativeFrequencyVS CodeSystem",
-  "title": "SHR QualitativeFrequencyVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR QualitativeFrequencyCS CodeSystem",
+  "title": "SHR QualitativeFrequencyCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.482Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.807Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 5,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-core-QualitativeLikelihoodVS.json b/lib/resources/standard_health_record/CodeSystem-shr-core-QualitativeLikelihoodCS.json
old mode 100755
new mode 100644
similarity index 83%
rename from lib/resources/standard_health_record/CodeSystem-shr-core-QualitativeLikelihoodVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-core-QualitativeLikelihoodCS.json
index c5d6387..7a68154
--- a/lib/resources/standard_health_record/CodeSystem-shr-core-QualitativeLikelihoodVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-core-QualitativeLikelihoodCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-core-QualitativeLikelihoodVS",
+  "id": "shr-core-QualitativeLikelihoodCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR QualitativeLikelihoodVS CodeSystem</b></p>\n<p>The likelihood of an event or state, expressed qualitatively. Qualitative likelihoods are associated with judgments and assessments. Values are based on US Intelligence Community&#039;s standard language used to describe judgements of likelihood.</p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR QualitativeLikelihoodCS CodeSystem</b></p>\n<p>The likelihood of an event or state, expressed qualitatively. Qualitative likelihoods are associated with judgments and assessments. Values are based on US Intelligence Community's standard language used to describe judgements of likelihood.</p>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-core-QualitativeLikelihoodVS",
+  "url": "http://standardhealthrecord.org/shr/core/cs/QualitativeLikelihoodCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.core.QualitativeLikelihoodVS"
+    "value": "shr.core.QualitativeLikelihoodCS"
   },
-  "name": "SHR QualitativeLikelihoodVS CodeSystem",
-  "title": "SHR QualitativeLikelihoodVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR QualitativeLikelihoodCS CodeSystem",
+  "title": "SHR QualitativeLikelihoodCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.482Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.807Z",
   "description": "The likelihood of an event or state, expressed qualitatively. Qualitative likelihoods are associated with judgments and assessments. Values are based on US Intelligence Community's standard language used to describe judgements of likelihood.",
   "caseSensitive": true,
   "content": "complete",
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-core-QualitativeValueScaleVS.json b/lib/resources/standard_health_record/CodeSystem-shr-core-QualitativeValueScaleCS.json
old mode 100755
new mode 100644
similarity index 74%
rename from lib/resources/standard_health_record/CodeSystem-shr-core-QualitativeValueScaleVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-core-QualitativeValueScaleCS.json
index 5f22b31..bd28a4a
--- a/lib/resources/standard_health_record/CodeSystem-shr-core-QualitativeValueScaleVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-core-QualitativeValueScaleCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-core-QualitativeValueScaleVS",
+  "id": "shr-core-QualitativeValueScaleCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR QualitativeValueScaleVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR QualitativeValueScaleCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-core-QualitativeValueScaleVS",
+  "url": "http://standardhealthrecord.org/shr/core/cs/QualitativeValueScaleCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.core.QualitativeValueScaleVS"
+    "value": "shr.core.QualitativeValueScaleCS"
   },
-  "name": "SHR QualitativeValueScaleVS CodeSystem",
-  "title": "SHR QualitativeValueScaleVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR QualitativeValueScaleCS CodeSystem",
+  "title": "SHR QualitativeValueScaleCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.482Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.807Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 5,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-core-SemiquantitativeDurationVS.json b/lib/resources/standard_health_record/CodeSystem-shr-core-SemiquantitativeDurationCS.json
old mode 100755
new mode 100644
similarity index 82%
rename from lib/resources/standard_health_record/CodeSystem-shr-core-SemiquantitativeDurationVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-core-SemiquantitativeDurationCS.json
index 68eb597..46af247
--- a/lib/resources/standard_health_record/CodeSystem-shr-core-SemiquantitativeDurationVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-core-SemiquantitativeDurationCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-core-SemiquantitativeDurationVS",
+  "id": "shr-core-SemiquantitativeDurationCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR SemiquantitativeDurationVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR SemiquantitativeDurationCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-core-SemiquantitativeDurationVS",
+  "url": "http://standardhealthrecord.org/shr/core/cs/SemiquantitativeDurationCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.core.SemiquantitativeDurationVS"
+    "value": "shr.core.SemiquantitativeDurationCS"
   },
-  "name": "SHR SemiquantitativeDurationVS CodeSystem",
-  "title": "SHR SemiquantitativeDurationVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR SemiquantitativeDurationCS CodeSystem",
+  "title": "SHR SemiquantitativeDurationCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.482Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.806Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 9,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-core-SemiquantitativeFrequencyVS.json b/lib/resources/standard_health_record/CodeSystem-shr-core-SemiquantitativeFrequencyCS.json
old mode 100755
new mode 100644
similarity index 83%
rename from lib/resources/standard_health_record/CodeSystem-shr-core-SemiquantitativeFrequencyVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-core-SemiquantitativeFrequencyCS.json
index c1d280e..9b3bbaf
--- a/lib/resources/standard_health_record/CodeSystem-shr-core-SemiquantitativeFrequencyVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-core-SemiquantitativeFrequencyCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-core-SemiquantitativeFrequencyVS",
+  "id": "shr-core-SemiquantitativeFrequencyCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR SemiquantitativeFrequencyVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR SemiquantitativeFrequencyCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-core-SemiquantitativeFrequencyVS",
+  "url": "http://standardhealthrecord.org/shr/core/cs/SemiquantitativeFrequencyCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.core.SemiquantitativeFrequencyVS"
+    "value": "shr.core.SemiquantitativeFrequencyCS"
   },
-  "name": "SHR SemiquantitativeFrequencyVS CodeSystem",
-  "title": "SHR SemiquantitativeFrequencyVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR SemiquantitativeFrequencyCS CodeSystem",
+  "title": "SHR SemiquantitativeFrequencyCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.482Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.807Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 13,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-core-SettingVS.json b/lib/resources/standard_health_record/CodeSystem-shr-core-SettingCS.json
old mode 100755
new mode 100644
similarity index 95%
rename from lib/resources/standard_health_record/CodeSystem-shr-core-SettingVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-core-SettingCS.json
index 7d5f603..12be877
--- a/lib/resources/standard_health_record/CodeSystem-shr-core-SettingVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-core-SettingCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-core-SettingVS",
+  "id": "shr-core-SettingCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR SettingVS CodeSystem</b></p>\n<p>What type of place is found at a given location. More than one descriptor may be applicable.</p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR SettingCS CodeSystem</b></p>\n<p>What type of place is found at a given location. More than one descriptor may be applicable.</p>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-core-SettingVS",
+  "url": "http://standardhealthrecord.org/shr/core/cs/SettingCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.core.SettingVS"
+    "value": "shr.core.SettingCS"
   },
-  "name": "SHR SettingVS CodeSystem",
-  "title": "SHR SettingVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR SettingCS CodeSystem",
+  "title": "SHR SettingCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.482Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.807Z",
   "description": "What type of place is found at a given location. More than one descriptor may be applicable.",
   "caseSensitive": true,
   "content": "complete",
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-core-ThreePriorityVS.json b/lib/resources/standard_health_record/CodeSystem-shr-core-ThreePriorityCS.json
old mode 100755
new mode 100644
similarity index 78%
rename from lib/resources/standard_health_record/CodeSystem-shr-core-ThreePriorityVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-core-ThreePriorityCS.json
index 7b95a6f..9cd1433
--- a/lib/resources/standard_health_record/CodeSystem-shr-core-ThreePriorityVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-core-ThreePriorityCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-core-ThreePriorityVS",
+  "id": "shr-core-ThreePriorityCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ThreePriorityVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ThreePriorityCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-core-ThreePriorityVS",
+  "url": "http://standardhealthrecord.org/shr/core/cs/ThreePriorityCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.core.ThreePriorityVS"
+    "value": "shr.core.ThreePriorityCS"
   },
-  "name": "SHR ThreePriorityVS CodeSystem",
-  "title": "SHR ThreePriorityVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR ThreePriorityCS CodeSystem",
+  "title": "SHR ThreePriorityCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.482Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.807Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 3,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-core-ThreeValueLogicVS.json b/lib/resources/standard_health_record/CodeSystem-shr-core-ThreeValueLogicCS.json
old mode 100755
new mode 100644
similarity index 73%
rename from lib/resources/standard_health_record/CodeSystem-shr-core-ThreeValueLogicVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-core-ThreeValueLogicCS.json
index c825ed8..f7ab9c7
--- a/lib/resources/standard_health_record/CodeSystem-shr-core-ThreeValueLogicVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-core-ThreeValueLogicCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-core-ThreeValueLogicVS",
+  "id": "shr-core-ThreeValueLogicCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ThreeValueLogicVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ThreeValueLogicCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-core-ThreeValueLogicVS",
+  "url": "http://standardhealthrecord.org/shr/core/cs/ThreeValueLogicCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.core.ThreeValueLogicVS"
+    "value": "shr.core.ThreeValueLogicCS"
   },
-  "name": "SHR ThreeValueLogicVS CodeSystem",
-  "title": "SHR ThreeValueLogicVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR ThreeValueLogicCS CodeSystem",
+  "title": "SHR ThreeValueLogicCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.482Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.807Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 3,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-demographics-AddressUseVS.json b/lib/resources/standard_health_record/CodeSystem-shr-demographics-AddressUseCS.json
old mode 100755
new mode 100644
similarity index 86%
rename from lib/resources/standard_health_record/CodeSystem-shr-demographics-AddressUseVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-demographics-AddressUseCS.json
index 43820dc..ccc4563
--- a/lib/resources/standard_health_record/CodeSystem-shr-demographics-AddressUseVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-demographics-AddressUseCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-demographics-AddressUseVS",
+  "id": "shr-demographics-AddressUseCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR AddressUseVS CodeSystem</b></p>\n<p>How an address is used by the subject, for example, as a dwelling or as a mailing address.</p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR AddressUseCS CodeSystem</b></p>\n<p>How an address is used by the subject, for example, as a dwelling or as a mailing address.</p>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-demographics-AddressUseVS",
+  "url": "http://standardhealthrecord.org/shr/demographics/cs/AddressUseCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.demographics.AddressUseVS"
+    "value": "shr.demographics.AddressUseCS"
   },
-  "name": "SHR AddressUseVS CodeSystem",
-  "title": "SHR AddressUseVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR AddressUseCS CodeSystem",
+  "title": "SHR AddressUseCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.482Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.807Z",
   "description": "How an address is used by the subject, for example, as a dwelling or as a mailing address.",
   "caseSensitive": true,
   "content": "complete",
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-demographics-InsuranceProviderTypeVS.json b/lib/resources/standard_health_record/CodeSystem-shr-demographics-InsuranceProviderTypeCS.json
old mode 100755
new mode 100644
similarity index 79%
rename from lib/resources/standard_health_record/CodeSystem-shr-demographics-InsuranceProviderTypeVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-demographics-InsuranceProviderTypeCS.json
index db53258..55d71e6
--- a/lib/resources/standard_health_record/CodeSystem-shr-demographics-InsuranceProviderTypeVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-demographics-InsuranceProviderTypeCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-demographics-InsuranceProviderTypeVS",
+  "id": "shr-demographics-InsuranceProviderTypeCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR InsuranceProviderTypeVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR InsuranceProviderTypeCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-demographics-InsuranceProviderTypeVS",
+  "url": "http://standardhealthrecord.org/shr/demographics/cs/InsuranceProviderTypeCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.demographics.InsuranceProviderTypeVS"
+    "value": "shr.demographics.InsuranceProviderTypeCS"
   },
-  "name": "SHR InsuranceProviderTypeVS CodeSystem",
-  "title": "SHR InsuranceProviderTypeVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR InsuranceProviderTypeCS CodeSystem",
+  "title": "SHR InsuranceProviderTypeCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.482Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.807Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 7,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-demographics-TelecomQualifierVS.json b/lib/resources/standard_health_record/CodeSystem-shr-demographics-TelecomQualifierCS.json
old mode 100755
new mode 100644
similarity index 86%
rename from lib/resources/standard_health_record/CodeSystem-shr-demographics-TelecomQualifierVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-demographics-TelecomQualifierCS.json
index f6fcc04..ec743bf
--- a/lib/resources/standard_health_record/CodeSystem-shr-demographics-TelecomQualifierVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-demographics-TelecomQualifierCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-demographics-TelecomQualifierVS",
+  "id": "shr-demographics-TelecomQualifierCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR TelecomQualifierVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR TelecomQualifierCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-demographics-TelecomQualifierVS",
+  "url": "http://standardhealthrecord.org/shr/demographics/cs/TelecomQualifierCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.demographics.TelecomQualifierVS"
+    "value": "shr.demographics.TelecomQualifierCS"
   },
-  "name": "SHR TelecomQualifierVS CodeSystem",
-  "title": "SHR TelecomQualifierVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR TelecomQualifierCS CodeSystem",
+  "title": "SHR TelecomQualifierCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.482Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.807Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 12,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-demographics-TelephoneTypeVS.json b/lib/resources/standard_health_record/CodeSystem-shr-demographics-TelephoneTypeCS.json
old mode 100755
new mode 100644
similarity index 71%
rename from lib/resources/standard_health_record/CodeSystem-shr-demographics-TelephoneTypeVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-demographics-TelephoneTypeCS.json
index d00cf13..b1bbc8c
--- a/lib/resources/standard_health_record/CodeSystem-shr-demographics-TelephoneTypeVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-demographics-TelephoneTypeCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-demographics-TelephoneTypeVS",
+  "id": "shr-demographics-TelephoneTypeCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR TelephoneTypeVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR TelephoneTypeCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-demographics-TelephoneTypeVS",
+  "url": "http://standardhealthrecord.org/shr/demographics/cs/TelephoneTypeCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.demographics.TelephoneTypeVS"
+    "value": "shr.demographics.TelephoneTypeCS"
   },
-  "name": "SHR TelephoneTypeVS CodeSystem",
-  "title": "SHR TelephoneTypeVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR TelephoneTypeCS CodeSystem",
+  "title": "SHR TelephoneTypeCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.482Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.807Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 2,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-device-RespiratoryAssistDeviceVS.json b/lib/resources/standard_health_record/CodeSystem-shr-device-RespiratoryAssistDeviceCS.json
old mode 100755
new mode 100644
similarity index 76%
rename from lib/resources/standard_health_record/CodeSystem-shr-device-RespiratoryAssistDeviceVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-device-RespiratoryAssistDeviceCS.json
index 8078805..5f5ff63
--- a/lib/resources/standard_health_record/CodeSystem-shr-device-RespiratoryAssistDeviceVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-device-RespiratoryAssistDeviceCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-device-RespiratoryAssistDeviceVS",
+  "id": "shr-device-RespiratoryAssistDeviceCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR RespiratoryAssistDeviceVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR RespiratoryAssistDeviceCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-device-RespiratoryAssistDeviceVS",
+  "url": "http://standardhealthrecord.org/shr/device/cs/RespiratoryAssistDeviceCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.device.RespiratoryAssistDeviceVS"
+    "value": "shr.device.RespiratoryAssistDeviceCS"
   },
-  "name": "SHR RespiratoryAssistDeviceVS CodeSystem",
-  "title": "SHR RespiratoryAssistDeviceVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR RespiratoryAssistDeviceCS CodeSystem",
+  "title": "SHR RespiratoryAssistDeviceCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.483Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.807Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 5,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-device-RespiratoryRateSettingVS.json b/lib/resources/standard_health_record/CodeSystem-shr-device-RespiratoryRateSettingCS.json
old mode 100755
new mode 100644
similarity index 76%
rename from lib/resources/standard_health_record/CodeSystem-shr-device-RespiratoryRateSettingVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-device-RespiratoryRateSettingCS.json
index b0503f2..51cb64b
--- a/lib/resources/standard_health_record/CodeSystem-shr-device-RespiratoryRateSettingVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-device-RespiratoryRateSettingCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-device-RespiratoryRateSettingVS",
+  "id": "shr-device-RespiratoryRateSettingCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR RespiratoryRateSettingVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR RespiratoryRateSettingCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-device-RespiratoryRateSettingVS",
+  "url": "http://standardhealthrecord.org/shr/device/cs/RespiratoryRateSettingCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.device.RespiratoryRateSettingVS"
+    "value": "shr.device.RespiratoryRateSettingCS"
   },
-  "name": "SHR RespiratoryRateSettingVS CodeSystem",
-  "title": "SHR RespiratoryRateSettingVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR RespiratoryRateSettingCS CodeSystem",
+  "title": "SHR RespiratoryRateSettingCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.482Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.807Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 6,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-encounter-EncounterTypeVS.json b/lib/resources/standard_health_record/CodeSystem-shr-encounter-EncounterTypeCS.json
old mode 100755
new mode 100644
similarity index 83%
rename from lib/resources/standard_health_record/CodeSystem-shr-encounter-EncounterTypeVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-encounter-EncounterTypeCS.json
index ce0ef6c..f019f3d
--- a/lib/resources/standard_health_record/CodeSystem-shr-encounter-EncounterTypeVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-encounter-EncounterTypeCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-encounter-EncounterTypeVS",
+  "id": "shr-encounter-EncounterTypeCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR EncounterTypeVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR EncounterTypeCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-encounter-EncounterTypeVS",
+  "url": "http://standardhealthrecord.org/shr/encounter/cs/EncounterTypeCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.encounter.EncounterTypeVS"
+    "value": "shr.encounter.EncounterTypeCS"
   },
-  "name": "SHR EncounterTypeVS CodeSystem",
-  "title": "SHR EncounterTypeVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR EncounterTypeCS CodeSystem",
+  "title": "SHR EncounterTypeCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.483Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.807Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 6,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-encounter-EpisodeOfCareCompletionVS.json b/lib/resources/standard_health_record/CodeSystem-shr-encounter-EpisodeOfCareCompletionCS.json
old mode 100755
new mode 100644
similarity index 83%
rename from lib/resources/standard_health_record/CodeSystem-shr-encounter-EpisodeOfCareCompletionVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-encounter-EpisodeOfCareCompletionCS.json
index dfb3be0..70a07ca
--- a/lib/resources/standard_health_record/CodeSystem-shr-encounter-EpisodeOfCareCompletionVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-encounter-EpisodeOfCareCompletionCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-encounter-EpisodeOfCareCompletionVS",
+  "id": "shr-encounter-EpisodeOfCareCompletionCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR EpisodeOfCareCompletionVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR EpisodeOfCareCompletionCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-encounter-EpisodeOfCareCompletionVS",
+  "url": "http://standardhealthrecord.org/shr/encounter/cs/EpisodeOfCareCompletionCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.encounter.EpisodeOfCareCompletionVS"
+    "value": "shr.encounter.EpisodeOfCareCompletionCS"
   },
-  "name": "SHR EpisodeOfCareCompletionVS CodeSystem",
-  "title": "SHR EpisodeOfCareCompletionVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR EpisodeOfCareCompletionCS CodeSystem",
+  "title": "SHR EpisodeOfCareCompletionCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.483Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.807Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 10,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-encounter-ReasonEncounterDidNotHappenVS.json b/lib/resources/standard_health_record/CodeSystem-shr-encounter-ReasonEncounterDidNotHappenCS.json
old mode 100755
new mode 100644
similarity index 73%
rename from lib/resources/standard_health_record/CodeSystem-shr-encounter-ReasonEncounterDidNotHappenVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-encounter-ReasonEncounterDidNotHappenCS.json
index 2ca9d9e..c063b1c
--- a/lib/resources/standard_health_record/CodeSystem-shr-encounter-ReasonEncounterDidNotHappenVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-encounter-ReasonEncounterDidNotHappenCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-encounter-ReasonEncounterDidNotHappenVS",
+  "id": "shr-encounter-ReasonEncounterDidNotHappenCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ReasonEncounterDidNotHappenVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ReasonEncounterDidNotHappenCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-encounter-ReasonEncounterDidNotHappenVS",
+  "url": "http://standardhealthrecord.org/shr/encounter/cs/ReasonEncounterDidNotHappenCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.encounter.ReasonEncounterDidNotHappenVS"
+    "value": "shr.encounter.ReasonEncounterDidNotHappenCS"
   },
-  "name": "SHR ReasonEncounterDidNotHappenVS CodeSystem",
-  "title": "SHR ReasonEncounterDidNotHappenVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR ReasonEncounterDidNotHappenCS CodeSystem",
+  "title": "SHR ReasonEncounterDidNotHappenCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.484Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.808Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 4,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-encounter-ReferralSourceTypeVS.json b/lib/resources/standard_health_record/CodeSystem-shr-encounter-ReferralSourceTypeCS.json
old mode 100755
new mode 100644
similarity index 82%
rename from lib/resources/standard_health_record/CodeSystem-shr-encounter-ReferralSourceTypeVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-encounter-ReferralSourceTypeCS.json
index a02c455..08c34b9
--- a/lib/resources/standard_health_record/CodeSystem-shr-encounter-ReferralSourceTypeVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-encounter-ReferralSourceTypeCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-encounter-ReferralSourceTypeVS",
+  "id": "shr-encounter-ReferralSourceTypeCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ReferralSourceTypeVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ReferralSourceTypeCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-encounter-ReferralSourceTypeVS",
+  "url": "http://standardhealthrecord.org/shr/encounter/cs/ReferralSourceTypeCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.encounter.ReferralSourceTypeVS"
+    "value": "shr.encounter.ReferralSourceTypeCS"
   },
-  "name": "SHR ReferralSourceTypeVS CodeSystem",
-  "title": "SHR ReferralSourceTypeVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR ReferralSourceTypeCS CodeSystem",
+  "title": "SHR ReferralSourceTypeCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.483Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.807Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 9,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-encounter-TreatmentCooperationVS.json b/lib/resources/standard_health_record/CodeSystem-shr-encounter-TreatmentCooperationCS.json
old mode 100755
new mode 100644
similarity index 75%
rename from lib/resources/standard_health_record/CodeSystem-shr-encounter-TreatmentCooperationVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-encounter-TreatmentCooperationCS.json
index a80b2b7..d7f802f
--- a/lib/resources/standard_health_record/CodeSystem-shr-encounter-TreatmentCooperationVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-encounter-TreatmentCooperationCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-encounter-TreatmentCooperationVS",
+  "id": "shr-encounter-TreatmentCooperationCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR TreatmentCooperationVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR TreatmentCooperationCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-encounter-TreatmentCooperationVS",
+  "url": "http://standardhealthrecord.org/shr/encounter/cs/TreatmentCooperationCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.encounter.TreatmentCooperationVS"
+    "value": "shr.encounter.TreatmentCooperationCS"
   },
-  "name": "SHR TreatmentCooperationVS CodeSystem",
-  "title": "SHR TreatmentCooperationVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR TreatmentCooperationCS CodeSystem",
+  "title": "SHR TreatmentCooperationCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.484Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.807Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 4,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-environment-AnimalExposureVS.json b/lib/resources/standard_health_record/CodeSystem-shr-environment-AnimalExposureCS.json
old mode 100755
new mode 100644
similarity index 80%
rename from lib/resources/standard_health_record/CodeSystem-shr-environment-AnimalExposureVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-environment-AnimalExposureCS.json
index ce0b9b8..07ed87a
--- a/lib/resources/standard_health_record/CodeSystem-shr-environment-AnimalExposureVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-environment-AnimalExposureCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-environment-AnimalExposureVS",
+  "id": "shr-environment-AnimalExposureCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR AnimalExposureVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR AnimalExposureCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-environment-AnimalExposureVS",
+  "url": "http://standardhealthrecord.org/shr/environment/cs/AnimalExposureCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.environment.AnimalExposureVS"
+    "value": "shr.environment.AnimalExposureCS"
   },
-  "name": "SHR AnimalExposureVS CodeSystem",
-  "title": "SHR AnimalExposureVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR AnimalExposureCS CodeSystem",
+  "title": "SHR AnimalExposureCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.484Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.808Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 9,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-environment-CoinhabitantVS.json b/lib/resources/standard_health_record/CodeSystem-shr-environment-CoinhabitantCS.json
old mode 100755
new mode 100644
similarity index 80%
rename from lib/resources/standard_health_record/CodeSystem-shr-environment-CoinhabitantVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-environment-CoinhabitantCS.json
index 579b0da..ffc6e0b
--- a/lib/resources/standard_health_record/CodeSystem-shr-environment-CoinhabitantVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-environment-CoinhabitantCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-environment-CoinhabitantVS",
+  "id": "shr-environment-CoinhabitantCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR CoinhabitantVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR CoinhabitantCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-environment-CoinhabitantVS",
+  "url": "http://standardhealthrecord.org/shr/environment/cs/CoinhabitantCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.environment.CoinhabitantVS"
+    "value": "shr.environment.CoinhabitantCS"
   },
-  "name": "SHR CoinhabitantVS CodeSystem",
-  "title": "SHR CoinhabitantVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR CoinhabitantCS CodeSystem",
+  "title": "SHR CoinhabitantCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.484Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.808Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 7,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-environment-HomeEnvironmentRiskVS.json b/lib/resources/standard_health_record/CodeSystem-shr-environment-HomeEnvironmentRiskCS.json
old mode 100755
new mode 100644
similarity index 92%
rename from lib/resources/standard_health_record/CodeSystem-shr-environment-HomeEnvironmentRiskVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-environment-HomeEnvironmentRiskCS.json
index a9888e7..5a4c8c8
--- a/lib/resources/standard_health_record/CodeSystem-shr-environment-HomeEnvironmentRiskVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-environment-HomeEnvironmentRiskCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-environment-HomeEnvironmentRiskVS",
+  "id": "shr-environment-HomeEnvironmentRiskCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR HomeEnvironmentRiskVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR HomeEnvironmentRiskCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-environment-HomeEnvironmentRiskVS",
+  "url": "http://standardhealthrecord.org/shr/environment/cs/HomeEnvironmentRiskCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.environment.HomeEnvironmentRiskVS"
+    "value": "shr.environment.HomeEnvironmentRiskCS"
   },
-  "name": "SHR HomeEnvironmentRiskVS CodeSystem",
-  "title": "SHR HomeEnvironmentRiskVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR HomeEnvironmentRiskCS CodeSystem",
+  "title": "SHR HomeEnvironmentRiskCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.484Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.808Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 35,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-environment-IncomeSourceVS.json b/lib/resources/standard_health_record/CodeSystem-shr-environment-IncomeSourceCS.json
old mode 100755
new mode 100644
similarity index 88%
rename from lib/resources/standard_health_record/CodeSystem-shr-environment-IncomeSourceVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-environment-IncomeSourceCS.json
index 1066377..2b57691
--- a/lib/resources/standard_health_record/CodeSystem-shr-environment-IncomeSourceVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-environment-IncomeSourceCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-environment-IncomeSourceVS",
+  "id": "shr-environment-IncomeSourceCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR IncomeSourceVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR IncomeSourceCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-environment-IncomeSourceVS",
+  "url": "http://standardhealthrecord.org/shr/environment/cs/IncomeSourceCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.environment.IncomeSourceVS"
+    "value": "shr.environment.IncomeSourceCS"
   },
-  "name": "SHR IncomeSourceVS CodeSystem",
-  "title": "SHR IncomeSourceVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR IncomeSourceCS CodeSystem",
+  "title": "SHR IncomeSourceCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.484Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.808Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 14,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-environment-NonCashBenefitVS.json b/lib/resources/standard_health_record/CodeSystem-shr-environment-NonCashBenefitCS.json
old mode 100755
new mode 100644
similarity index 87%
rename from lib/resources/standard_health_record/CodeSystem-shr-environment-NonCashBenefitVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-environment-NonCashBenefitCS.json
index 4e9ad83..9a06548
--- a/lib/resources/standard_health_record/CodeSystem-shr-environment-NonCashBenefitVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-environment-NonCashBenefitCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-environment-NonCashBenefitVS",
+  "id": "shr-environment-NonCashBenefitCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR NonCashBenefitVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR NonCashBenefitCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-environment-NonCashBenefitVS",
+  "url": "http://standardhealthrecord.org/shr/environment/cs/NonCashBenefitCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.environment.NonCashBenefitVS"
+    "value": "shr.environment.NonCashBenefitCS"
   },
-  "name": "SHR NonCashBenefitVS CodeSystem",
-  "title": "SHR NonCashBenefitVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR NonCashBenefitCS CodeSystem",
+  "title": "SHR NonCashBenefitCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.484Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.808Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 10,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-environment-ResourceStabilityVS.json b/lib/resources/standard_health_record/CodeSystem-shr-environment-ResourceStabilityCS.json
old mode 100755
new mode 100644
similarity index 80%
rename from lib/resources/standard_health_record/CodeSystem-shr-environment-ResourceStabilityVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-environment-ResourceStabilityCS.json
index b54dbb1..cd27c00
--- a/lib/resources/standard_health_record/CodeSystem-shr-environment-ResourceStabilityVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-environment-ResourceStabilityCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-environment-ResourceStabilityVS",
+  "id": "shr-environment-ResourceStabilityCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ResourceStabilityVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ResourceStabilityCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-environment-ResourceStabilityVS",
+  "url": "http://standardhealthrecord.org/shr/environment/cs/ResourceStabilityCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.environment.ResourceStabilityVS"
+    "value": "shr.environment.ResourceStabilityCS"
   },
-  "name": "SHR ResourceStabilityVS CodeSystem",
-  "title": "SHR ResourceStabilityVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR ResourceStabilityCS CodeSystem",
+  "title": "SHR ResourceStabilityCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.484Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.808Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 4,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-lab-RequestStatusVS.json b/lib/resources/standard_health_record/CodeSystem-shr-lab-RequestStatusCS.json
old mode 100755
new mode 100644
similarity index 81%
rename from lib/resources/standard_health_record/CodeSystem-shr-lab-RequestStatusVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-lab-RequestStatusCS.json
index 0ff4537..7b99189
--- a/lib/resources/standard_health_record/CodeSystem-shr-lab-RequestStatusVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-lab-RequestStatusCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-lab-RequestStatusVS",
+  "id": "shr-lab-RequestStatusCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR RequestStatusVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR RequestStatusCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-lab-RequestStatusVS",
+  "url": "http://standardhealthrecord.org/shr/lab/cs/RequestStatusCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.lab.RequestStatusVS"
+    "value": "shr.lab.RequestStatusCS"
   },
-  "name": "SHR RequestStatusVS CodeSystem",
-  "title": "SHR RequestStatusVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR RequestStatusCS CodeSystem",
+  "title": "SHR RequestStatusCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.484Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.808Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 4,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-lifehistory-EducationalAttainmentVS.json b/lib/resources/standard_health_record/CodeSystem-shr-lifehistory-EducationalAttainmentCS.json
old mode 100755
new mode 100644
similarity index 84%
rename from lib/resources/standard_health_record/CodeSystem-shr-lifehistory-EducationalAttainmentVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-lifehistory-EducationalAttainmentCS.json
index 0d90f2d..5a25ef8
--- a/lib/resources/standard_health_record/CodeSystem-shr-lifehistory-EducationalAttainmentVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-lifehistory-EducationalAttainmentCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-lifehistory-EducationalAttainmentVS",
+  "id": "shr-lifehistory-EducationalAttainmentCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR EducationalAttainmentVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR EducationalAttainmentCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-lifehistory-EducationalAttainmentVS",
+  "url": "http://standardhealthrecord.org/shr/lifehistory/cs/EducationalAttainmentCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.lifehistory.EducationalAttainmentVS"
+    "value": "shr.lifehistory.EducationalAttainmentCS"
   },
-  "name": "SHR EducationalAttainmentVS CodeSystem",
-  "title": "SHR EducationalAttainmentVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR EducationalAttainmentCS CodeSystem",
+  "title": "SHR EducationalAttainmentCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.484Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.808Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 10,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-lifehistory-EmploymentStatusVS.json b/lib/resources/standard_health_record/CodeSystem-shr-lifehistory-EmploymentStatusCS.json
old mode 100755
new mode 100644
similarity index 94%
rename from lib/resources/standard_health_record/CodeSystem-shr-lifehistory-EmploymentStatusVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-lifehistory-EmploymentStatusCS.json
index a28d6eb..26b3253
--- a/lib/resources/standard_health_record/CodeSystem-shr-lifehistory-EmploymentStatusVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-lifehistory-EmploymentStatusCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-lifehistory-EmploymentStatusVS",
+  "id": "shr-lifehistory-EmploymentStatusCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR EmploymentStatusVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR EmploymentStatusCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-lifehistory-EmploymentStatusVS",
+  "url": "http://standardhealthrecord.org/shr/lifehistory/cs/EmploymentStatusCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.lifehistory.EmploymentStatusVS"
+    "value": "shr.lifehistory.EmploymentStatusCS"
   },
-  "name": "SHR EmploymentStatusVS CodeSystem",
-  "title": "SHR EmploymentStatusVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR EmploymentStatusCS CodeSystem",
+  "title": "SHR EmploymentStatusCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.484Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.808Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 13,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-lifehistory-MilitaryServiceDischargeStatusVS.json b/lib/resources/standard_health_record/CodeSystem-shr-lifehistory-MilitaryServiceDischargeStatusCS.json
old mode 100755
new mode 100644
similarity index 74%
rename from lib/resources/standard_health_record/CodeSystem-shr-lifehistory-MilitaryServiceDischargeStatusVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-lifehistory-MilitaryServiceDischargeStatusCS.json
index 80890ff..e0dd9d4
--- a/lib/resources/standard_health_record/CodeSystem-shr-lifehistory-MilitaryServiceDischargeStatusVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-lifehistory-MilitaryServiceDischargeStatusCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-lifehistory-MilitaryServiceDischargeStatusVS",
+  "id": "shr-lifehistory-MilitaryServiceDischargeStatusCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR MilitaryServiceDischargeStatusVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR MilitaryServiceDischargeStatusCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-lifehistory-MilitaryServiceDischargeStatusVS",
+  "url": "http://standardhealthrecord.org/shr/lifehistory/cs/MilitaryServiceDischargeStatusCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.lifehistory.MilitaryServiceDischargeStatusVS"
+    "value": "shr.lifehistory.MilitaryServiceDischargeStatusCS"
   },
-  "name": "SHR MilitaryServiceDischargeStatusVS CodeSystem",
-  "title": "SHR MilitaryServiceDischargeStatusVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR MilitaryServiceDischargeStatusCS CodeSystem",
+  "title": "SHR MilitaryServiceDischargeStatusCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.484Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.808Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 5,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-lifehistory-MilitaryServiceEraVS.json b/lib/resources/standard_health_record/CodeSystem-shr-lifehistory-MilitaryServiceEraCS.json
old mode 100755
new mode 100644
similarity index 86%
rename from lib/resources/standard_health_record/CodeSystem-shr-lifehistory-MilitaryServiceEraVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-lifehistory-MilitaryServiceEraCS.json
index f23ee6d..a5b67f4
--- a/lib/resources/standard_health_record/CodeSystem-shr-lifehistory-MilitaryServiceEraVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-lifehistory-MilitaryServiceEraCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-lifehistory-MilitaryServiceEraVS",
+  "id": "shr-lifehistory-MilitaryServiceEraCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR MilitaryServiceEraVS CodeSystem</b></p>\n<p>Values were taken from Final HMIS Data Standards March 2010 (Homeless Management Information System), field 4.15E Veteran’s Information. See: https://www.onecpd.info/resources/documents/FinalHMISDataStandards_March2010.pdf.</p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR MilitaryServiceEraCS CodeSystem</b></p>\n<p>Values were taken from Final HMIS Data Standards March 2010 (Homeless Management Information System), field 4.15E Veteran’s Information. See: https://www.onecpd.info/resources/documents/FinalHMISDataStandards_March2010.pdf.</p>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-lifehistory-MilitaryServiceEraVS",
+  "url": "http://standardhealthrecord.org/shr/lifehistory/cs/MilitaryServiceEraCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.lifehistory.MilitaryServiceEraVS"
+    "value": "shr.lifehistory.MilitaryServiceEraCS"
   },
-  "name": "SHR MilitaryServiceEraVS CodeSystem",
-  "title": "SHR MilitaryServiceEraVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR MilitaryServiceEraCS CodeSystem",
+  "title": "SHR MilitaryServiceEraCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.484Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.808Z",
   "description": "Values were taken from Final HMIS Data Standards March 2010 (Homeless Management Information System), field 4.15E Veteran’s Information. See: https://www.onecpd.info/resources/documents/FinalHMISDataStandards_March2010.pdf.",
   "caseSensitive": true,
   "content": "complete",
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-lifehistory-MilitaryStatusVS.json b/lib/resources/standard_health_record/CodeSystem-shr-lifehistory-MilitaryStatusCS.json
old mode 100755
new mode 100644
similarity index 74%
rename from lib/resources/standard_health_record/CodeSystem-shr-lifehistory-MilitaryStatusVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-lifehistory-MilitaryStatusCS.json
index 4b2ce0b..701ef83
--- a/lib/resources/standard_health_record/CodeSystem-shr-lifehistory-MilitaryStatusVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-lifehistory-MilitaryStatusCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-lifehistory-MilitaryStatusVS",
+  "id": "shr-lifehistory-MilitaryStatusCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR MilitaryStatusVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR MilitaryStatusCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-lifehistory-MilitaryStatusVS",
+  "url": "http://standardhealthrecord.org/shr/lifehistory/cs/MilitaryStatusCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.lifehistory.MilitaryStatusVS"
+    "value": "shr.lifehistory.MilitaryStatusCS"
   },
-  "name": "SHR MilitaryStatusVS CodeSystem",
-  "title": "SHR MilitaryStatusVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR MilitaryStatusCS CodeSystem",
+  "title": "SHR MilitaryStatusCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.484Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.808Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 3,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-lifehistory-TeratogenVS.json b/lib/resources/standard_health_record/CodeSystem-shr-lifehistory-TeratogenCS.json
old mode 100755
new mode 100644
similarity index 95%
rename from lib/resources/standard_health_record/CodeSystem-shr-lifehistory-TeratogenVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-lifehistory-TeratogenCS.json
index 44cb37f..f348894
--- a/lib/resources/standard_health_record/CodeSystem-shr-lifehistory-TeratogenVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-lifehistory-TeratogenCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-lifehistory-TeratogenVS",
+  "id": "shr-lifehistory-TeratogenCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR TeratogenVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR TeratogenCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-lifehistory-TeratogenVS",
+  "url": "http://standardhealthrecord.org/shr/lifehistory/cs/TeratogenCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.lifehistory.TeratogenVS"
+    "value": "shr.lifehistory.TeratogenCS"
   },
-  "name": "SHR TeratogenVS CodeSystem",
-  "title": "SHR TeratogenVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR TeratogenCS CodeSystem",
+  "title": "SHR TeratogenCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.484Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.808Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 56,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-lifehistory-USMilitaryBranchVS.json b/lib/resources/standard_health_record/CodeSystem-shr-lifehistory-USMilitaryBranchCS.json
old mode 100755
new mode 100644
similarity index 79%
rename from lib/resources/standard_health_record/CodeSystem-shr-lifehistory-USMilitaryBranchVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-lifehistory-USMilitaryBranchCS.json
index 6d90a25..27fd5f2
--- a/lib/resources/standard_health_record/CodeSystem-shr-lifehistory-USMilitaryBranchVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-lifehistory-USMilitaryBranchCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-lifehistory-USMilitaryBranchVS",
+  "id": "shr-lifehistory-USMilitaryBranchCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR USMilitaryBranchVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR USMilitaryBranchCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-lifehistory-USMilitaryBranchVS",
+  "url": "http://standardhealthrecord.org/shr/lifehistory/cs/USMilitaryBranchCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.lifehistory.USMilitaryBranchVS"
+    "value": "shr.lifehistory.USMilitaryBranchCS"
   },
-  "name": "SHR USMilitaryBranchVS CodeSystem",
-  "title": "SHR USMilitaryBranchVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR USMilitaryBranchCS CodeSystem",
+  "title": "SHR USMilitaryBranchCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.484Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.808Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 7,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-medication-MedicationChangeReasonVS.json b/lib/resources/standard_health_record/CodeSystem-shr-medication-MedicationChangeReasonCS.json
old mode 100755
new mode 100644
similarity index 80%
rename from lib/resources/standard_health_record/CodeSystem-shr-medication-MedicationChangeReasonVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-medication-MedicationChangeReasonCS.json
index f293bf6..4d963c9
--- a/lib/resources/standard_health_record/CodeSystem-shr-medication-MedicationChangeReasonVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-medication-MedicationChangeReasonCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-medication-MedicationChangeReasonVS",
+  "id": "shr-medication-MedicationChangeReasonCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR MedicationChangeReasonVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR MedicationChangeReasonCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-medication-MedicationChangeReasonVS",
+  "url": "http://standardhealthrecord.org/shr/medication/cs/MedicationChangeReasonCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.medication.MedicationChangeReasonVS"
+    "value": "shr.medication.MedicationChangeReasonCS"
   },
-  "name": "SHR MedicationChangeReasonVS CodeSystem",
-  "title": "SHR MedicationChangeReasonVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR MedicationChangeReasonCS CodeSystem",
+  "title": "SHR MedicationChangeReasonCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.484Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.808Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 6,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-medication-MedicationChangeTypeVS.json b/lib/resources/standard_health_record/CodeSystem-shr-medication-MedicationChangeTypeCS.json
old mode 100755
new mode 100644
similarity index 76%
rename from lib/resources/standard_health_record/CodeSystem-shr-medication-MedicationChangeTypeVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-medication-MedicationChangeTypeCS.json
index 1325646..edb1fc2
--- a/lib/resources/standard_health_record/CodeSystem-shr-medication-MedicationChangeTypeVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-medication-MedicationChangeTypeCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-medication-MedicationChangeTypeVS",
+  "id": "shr-medication-MedicationChangeTypeCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR MedicationChangeTypeVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR MedicationChangeTypeCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-medication-MedicationChangeTypeVS",
+  "url": "http://standardhealthrecord.org/shr/medication/cs/MedicationChangeTypeCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.medication.MedicationChangeTypeVS"
+    "value": "shr.medication.MedicationChangeTypeCS"
   },
-  "name": "SHR MedicationChangeTypeVS CodeSystem",
-  "title": "SHR MedicationChangeTypeVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR MedicationChangeTypeCS CodeSystem",
+  "title": "SHR MedicationChangeTypeCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.484Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.808Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 5,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-medication-ReasonMedicationNotUsedVS.json b/lib/resources/standard_health_record/CodeSystem-shr-medication-ReasonMedicationNotUsedCS.json
old mode 100755
new mode 100644
similarity index 86%
rename from lib/resources/standard_health_record/CodeSystem-shr-medication-ReasonMedicationNotUsedVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-medication-ReasonMedicationNotUsedCS.json
index 816a58d..69e3d43
--- a/lib/resources/standard_health_record/CodeSystem-shr-medication-ReasonMedicationNotUsedVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-medication-ReasonMedicationNotUsedCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-medication-ReasonMedicationNotUsedVS",
+  "id": "shr-medication-ReasonMedicationNotUsedCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ReasonMedicationNotUsedVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ReasonMedicationNotUsedCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-medication-ReasonMedicationNotUsedVS",
+  "url": "http://standardhealthrecord.org/shr/medication/cs/ReasonMedicationNotUsedCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.medication.ReasonMedicationNotUsedVS"
+    "value": "shr.medication.ReasonMedicationNotUsedCS"
   },
-  "name": "SHR ReasonMedicationNotUsedVS CodeSystem",
-  "title": "SHR ReasonMedicationNotUsedVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR ReasonMedicationNotUsedCS CodeSystem",
+  "title": "SHR ReasonMedicationNotUsedCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.484Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.808Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 10,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-observation-ExposureReasonVS.json b/lib/resources/standard_health_record/CodeSystem-shr-observation-ExposureReasonCS.json
old mode 100755
new mode 100644
similarity index 85%
rename from lib/resources/standard_health_record/CodeSystem-shr-observation-ExposureReasonVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-observation-ExposureReasonCS.json
index 5763f1e..61e0b5c
--- a/lib/resources/standard_health_record/CodeSystem-shr-observation-ExposureReasonVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-observation-ExposureReasonCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-observation-ExposureReasonVS",
+  "id": "shr-observation-ExposureReasonCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ExposureReasonVS CodeSystem</b></p>\n<p>The reason that an exposure occurred.</p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ExposureReasonCS CodeSystem</b></p>\n<p>The reason that an exposure occurred.</p>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-observation-ExposureReasonVS",
+  "url": "http://standardhealthrecord.org/shr/observation/cs/ExposureReasonCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.observation.ExposureReasonVS"
+    "value": "shr.observation.ExposureReasonCS"
   },
-  "name": "SHR ExposureReasonVS CodeSystem",
-  "title": "SHR ExposureReasonVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR ExposureReasonCS CodeSystem",
+  "title": "SHR ExposureReasonCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.484Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.808Z",
   "description": "The reason that an exposure occurred.",
   "caseSensitive": true,
   "content": "complete",
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-observation-ObservationNotMadeReasonVS.json b/lib/resources/standard_health_record/CodeSystem-shr-observation-ObservationNotMadeReasonCS.json
old mode 100755
new mode 100644
similarity index 85%
rename from lib/resources/standard_health_record/CodeSystem-shr-observation-ObservationNotMadeReasonVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-observation-ObservationNotMadeReasonCS.json
index 9b7c5cd..cb8de6a
--- a/lib/resources/standard_health_record/CodeSystem-shr-observation-ObservationNotMadeReasonVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-observation-ObservationNotMadeReasonCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-observation-ObservationNotMadeReasonVS",
+  "id": "shr-observation-ObservationNotMadeReasonCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ObservationNotMadeReasonVS CodeSystem</b></p>\n<p>An explanation of why the observation was not made (or ordered), i.e., why test was not ordered, or why a question was not asked. Since an observation is really a type of procedure, reasons that an observation was not carried out are similar to reasons any procedure might not be carried out.</p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ObservationNotMadeReasonCS CodeSystem</b></p>\n<p>An explanation of why the observation was not made (or ordered), i.e., why test was not ordered, or why a question was not asked. Since an observation is really a type of procedure, reasons that an observation was not carried out are similar to reasons any procedure might not be carried out.</p>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-observation-ObservationNotMadeReasonVS",
+  "url": "http://standardhealthrecord.org/shr/observation/cs/ObservationNotMadeReasonCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.observation.ObservationNotMadeReasonVS"
+    "value": "shr.observation.ObservationNotMadeReasonCS"
   },
-  "name": "SHR ObservationNotMadeReasonVS CodeSystem",
-  "title": "SHR ObservationNotMadeReasonVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR ObservationNotMadeReasonCS CodeSystem",
+  "title": "SHR ObservationNotMadeReasonCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.484Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.808Z",
   "description": "An explanation of why the observation was not made (or ordered), i.e., why test was not ordered, or why a question was not asked. Since an observation is really a type of procedure, reasons that an observation was not carried out are similar to reasons any procedure might not be carried out.",
   "caseSensitive": true,
   "content": "complete",
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-problem-EvidenceQualityVS.json b/lib/resources/standard_health_record/CodeSystem-shr-problem-EvidenceQualityCS.json
old mode 100755
new mode 100644
similarity index 84%
rename from lib/resources/standard_health_record/CodeSystem-shr-problem-EvidenceQualityVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-problem-EvidenceQualityCS.json
index 0113669..574e377
--- a/lib/resources/standard_health_record/CodeSystem-shr-problem-EvidenceQualityVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-problem-EvidenceQualityCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-problem-EvidenceQualityVS",
+  "id": "shr-problem-EvidenceQualityCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR EvidenceQualityVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR EvidenceQualityCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-problem-EvidenceQualityVS",
+  "url": "http://standardhealthrecord.org/shr/problem/cs/EvidenceQualityCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.problem.EvidenceQualityVS"
+    "value": "shr.problem.EvidenceQualityCS"
   },
-  "name": "SHR EvidenceQualityVS CodeSystem",
-  "title": "SHR EvidenceQualityVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR EvidenceQualityCS CodeSystem",
+  "title": "SHR EvidenceQualityCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.484Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.808Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 3,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-problem-GradeOrStageVS.json b/lib/resources/standard_health_record/CodeSystem-shr-problem-GradeOrStageCS.json
old mode 100755
new mode 100644
similarity index 77%
rename from lib/resources/standard_health_record/CodeSystem-shr-problem-GradeOrStageVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-problem-GradeOrStageCS.json
index 9eb71a9..0818de6
--- a/lib/resources/standard_health_record/CodeSystem-shr-problem-GradeOrStageVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-problem-GradeOrStageCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-problem-GradeOrStageVS",
+  "id": "shr-problem-GradeOrStageCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR GradeOrStageVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR GradeOrStageCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-problem-GradeOrStageVS",
+  "url": "http://standardhealthrecord.org/shr/problem/cs/GradeOrStageCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.problem.GradeOrStageVS"
+    "value": "shr.problem.GradeOrStageCS"
   },
-  "name": "SHR GradeOrStageVS CodeSystem",
-  "title": "SHR GradeOrStageVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR GradeOrStageCS CodeSystem",
+  "title": "SHR GradeOrStageCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.484Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.808Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 5,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-problem-ProblemCategoryVS.json b/lib/resources/standard_health_record/CodeSystem-shr-problem-ProblemCategoryCS.json
old mode 100755
new mode 100644
similarity index 86%
rename from lib/resources/standard_health_record/CodeSystem-shr-problem-ProblemCategoryVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-problem-ProblemCategoryCS.json
index 22214d3..5ba3f21
--- a/lib/resources/standard_health_record/CodeSystem-shr-problem-ProblemCategoryVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-problem-ProblemCategoryCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-problem-ProblemCategoryVS",
+  "id": "shr-problem-ProblemCategoryCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ProblemCategoryVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ProblemCategoryCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-problem-ProblemCategoryVS",
+  "url": "http://standardhealthrecord.org/shr/problem/cs/ProblemCategoryCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.problem.ProblemCategoryVS"
+    "value": "shr.problem.ProblemCategoryCS"
   },
-  "name": "SHR ProblemCategoryVS CodeSystem",
-  "title": "SHR ProblemCategoryVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR ProblemCategoryCS CodeSystem",
+  "title": "SHR ProblemCategoryCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.484Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.808Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 6,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-sex-ContraceptiveMethodVS.json b/lib/resources/standard_health_record/CodeSystem-shr-sex-ContraceptiveMethodCS.json
old mode 100755
new mode 100644
similarity index 89%
rename from lib/resources/standard_health_record/CodeSystem-shr-sex-ContraceptiveMethodVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-sex-ContraceptiveMethodCS.json
index 2ff06e5..32f851d
--- a/lib/resources/standard_health_record/CodeSystem-shr-sex-ContraceptiveMethodVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-sex-ContraceptiveMethodCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-sex-ContraceptiveMethodVS",
+  "id": "shr-sex-ContraceptiveMethodCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ContraceptiveMethodVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ContraceptiveMethodCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-sex-ContraceptiveMethodVS",
+  "url": "http://standardhealthrecord.org/shr/sex/cs/ContraceptiveMethodCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.sex.ContraceptiveMethodVS"
+    "value": "shr.sex.ContraceptiveMethodCS"
   },
-  "name": "SHR ContraceptiveMethodVS CodeSystem",
-  "title": "SHR ContraceptiveMethodVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR ContraceptiveMethodCS CodeSystem",
+  "title": "SHR ContraceptiveMethodCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.484Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.808Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 18,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-sex-ContraceptiveMethodReasonVS.json b/lib/resources/standard_health_record/CodeSystem-shr-sex-ContraceptiveMethodReasonCS.json
old mode 100755
new mode 100644
similarity index 77%
rename from lib/resources/standard_health_record/CodeSystem-shr-sex-ContraceptiveMethodReasonVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-sex-ContraceptiveMethodReasonCS.json
index a862727..9021bd4
--- a/lib/resources/standard_health_record/CodeSystem-shr-sex-ContraceptiveMethodReasonVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-sex-ContraceptiveMethodReasonCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-sex-ContraceptiveMethodReasonVS",
+  "id": "shr-sex-ContraceptiveMethodReasonCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ContraceptiveMethodReasonVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ContraceptiveMethodReasonCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-sex-ContraceptiveMethodReasonVS",
+  "url": "http://standardhealthrecord.org/shr/sex/cs/ContraceptiveMethodReasonCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.sex.ContraceptiveMethodReasonVS"
+    "value": "shr.sex.ContraceptiveMethodReasonCS"
   },
-  "name": "SHR ContraceptiveMethodReasonVS CodeSystem",
-  "title": "SHR ContraceptiveMethodReasonVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR ContraceptiveMethodReasonCS CodeSystem",
+  "title": "SHR ContraceptiveMethodReasonCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.484Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.808Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 5,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-sex-ContraceptiveNotUsedReasonVS.json b/lib/resources/standard_health_record/CodeSystem-shr-sex-ContraceptiveNotUsedReasonCS.json
old mode 100755
new mode 100644
similarity index 85%
rename from lib/resources/standard_health_record/CodeSystem-shr-sex-ContraceptiveNotUsedReasonVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-sex-ContraceptiveNotUsedReasonCS.json
index 4931378..e749eea
--- a/lib/resources/standard_health_record/CodeSystem-shr-sex-ContraceptiveNotUsedReasonVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-sex-ContraceptiveNotUsedReasonCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-sex-ContraceptiveNotUsedReasonVS",
+  "id": "shr-sex-ContraceptiveNotUsedReasonCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ContraceptiveNotUsedReasonVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ContraceptiveNotUsedReasonCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-sex-ContraceptiveNotUsedReasonVS",
+  "url": "http://standardhealthrecord.org/shr/sex/cs/ContraceptiveNotUsedReasonCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.sex.ContraceptiveNotUsedReasonVS"
+    "value": "shr.sex.ContraceptiveNotUsedReasonCS"
   },
-  "name": "SHR ContraceptiveNotUsedReasonVS CodeSystem",
-  "title": "SHR ContraceptiveNotUsedReasonVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR ContraceptiveNotUsedReasonCS CodeSystem",
+  "title": "SHR ContraceptiveNotUsedReasonCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.484Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.808Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 10,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-sex-GenderIdentityVS.json b/lib/resources/standard_health_record/CodeSystem-shr-sex-GenderIdentityCS.json
old mode 100755
new mode 100644
similarity index 85%
rename from lib/resources/standard_health_record/CodeSystem-shr-sex-GenderIdentityVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-sex-GenderIdentityCS.json
index 18c9e61..8112a8f
--- a/lib/resources/standard_health_record/CodeSystem-shr-sex-GenderIdentityVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-sex-GenderIdentityCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-sex-GenderIdentityVS",
+  "id": "shr-sex-GenderIdentityCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR GenderIdentityVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR GenderIdentityCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-sex-GenderIdentityVS",
+  "url": "http://standardhealthrecord.org/shr/sex/cs/GenderIdentityCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.sex.GenderIdentityVS"
+    "value": "shr.sex.GenderIdentityCS"
   },
-  "name": "SHR GenderIdentityVS CodeSystem",
-  "title": "SHR GenderIdentityVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR GenderIdentityCS CodeSystem",
+  "title": "SHR GenderIdentityCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.484Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.808Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 7,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-skin-PressureUlcerAssociationVS.json b/lib/resources/standard_health_record/CodeSystem-shr-skin-PressureUlcerAssociationCS.json
old mode 100755
new mode 100644
similarity index 68%
rename from lib/resources/standard_health_record/CodeSystem-shr-skin-PressureUlcerAssociationVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-skin-PressureUlcerAssociationCS.json
index fa90089..3ec42d2
--- a/lib/resources/standard_health_record/CodeSystem-shr-skin-PressureUlcerAssociationVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-skin-PressureUlcerAssociationCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-skin-PressureUlcerAssociationVS",
+  "id": "shr-skin-PressureUlcerAssociationCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR PressureUlcerAssociationVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR PressureUlcerAssociationCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-skin-PressureUlcerAssociationVS",
+  "url": "http://standardhealthrecord.org/shr/skin/cs/PressureUlcerAssociationCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.skin.PressureUlcerAssociationVS"
+    "value": "shr.skin.PressureUlcerAssociationCS"
   },
-  "name": "SHR PressureUlcerAssociationVS CodeSystem",
-  "title": "SHR PressureUlcerAssociationVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR PressureUlcerAssociationCS CodeSystem",
+  "title": "SHR PressureUlcerAssociationCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.484Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.808Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 2,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-skin-SupportSurfaceBodyPositionVS.json b/lib/resources/standard_health_record/CodeSystem-shr-skin-SupportSurfaceBodyPositionCS.json
old mode 100755
new mode 100644
similarity index 66%
rename from lib/resources/standard_health_record/CodeSystem-shr-skin-SupportSurfaceBodyPositionVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-skin-SupportSurfaceBodyPositionCS.json
index 5ae6b68..790fd2f
--- a/lib/resources/standard_health_record/CodeSystem-shr-skin-SupportSurfaceBodyPositionVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-skin-SupportSurfaceBodyPositionCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-skin-SupportSurfaceBodyPositionVS",
+  "id": "shr-skin-SupportSurfaceBodyPositionCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR SupportSurfaceBodyPositionVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR SupportSurfaceBodyPositionCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-skin-SupportSurfaceBodyPositionVS",
+  "url": "http://standardhealthrecord.org/shr/skin/cs/SupportSurfaceBodyPositionCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.skin.SupportSurfaceBodyPositionVS"
+    "value": "shr.skin.SupportSurfaceBodyPositionCS"
   },
-  "name": "SHR SupportSurfaceBodyPositionVS CodeSystem",
-  "title": "SHR SupportSurfaceBodyPositionVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR SupportSurfaceBodyPositionCS CodeSystem",
+  "title": "SHR SupportSurfaceBodyPositionCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.484Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.808Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 2,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-skin-SupportSurfaceCategoryVS.json b/lib/resources/standard_health_record/CodeSystem-shr-skin-SupportSurfaceCategoryCS.json
old mode 100755
new mode 100644
similarity index 78%
rename from lib/resources/standard_health_record/CodeSystem-shr-skin-SupportSurfaceCategoryVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-skin-SupportSurfaceCategoryCS.json
index 626088e..a80e36a
--- a/lib/resources/standard_health_record/CodeSystem-shr-skin-SupportSurfaceCategoryVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-skin-SupportSurfaceCategoryCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-skin-SupportSurfaceCategoryVS",
+  "id": "shr-skin-SupportSurfaceCategoryCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR SupportSurfaceCategoryVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR SupportSurfaceCategoryCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-skin-SupportSurfaceCategoryVS",
+  "url": "http://standardhealthrecord.org/shr/skin/cs/SupportSurfaceCategoryCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.skin.SupportSurfaceCategoryVS"
+    "value": "shr.skin.SupportSurfaceCategoryCS"
   },
-  "name": "SHR SupportSurfaceCategoryVS CodeSystem",
-  "title": "SHR SupportSurfaceCategoryVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR SupportSurfaceCategoryCS CodeSystem",
+  "title": "SHR SupportSurfaceCategoryCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.484Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.808Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 7,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-skin-SupportSurfaceComponentVS.json b/lib/resources/standard_health_record/CodeSystem-shr-skin-SupportSurfaceComponentCS.json
old mode 100755
new mode 100644
similarity index 82%
rename from lib/resources/standard_health_record/CodeSystem-shr-skin-SupportSurfaceComponentVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-skin-SupportSurfaceComponentCS.json
index e1a895f..09312c4
--- a/lib/resources/standard_health_record/CodeSystem-shr-skin-SupportSurfaceComponentVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-skin-SupportSurfaceComponentCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-skin-SupportSurfaceComponentVS",
+  "id": "shr-skin-SupportSurfaceComponentCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR SupportSurfaceComponentVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR SupportSurfaceComponentCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-skin-SupportSurfaceComponentVS",
+  "url": "http://standardhealthrecord.org/shr/skin/cs/SupportSurfaceComponentCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.skin.SupportSurfaceComponentVS"
+    "value": "shr.skin.SupportSurfaceComponentCS"
   },
-  "name": "SHR SupportSurfaceComponentVS CodeSystem",
-  "title": "SHR SupportSurfaceComponentVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR SupportSurfaceComponentCS CodeSystem",
+  "title": "SHR SupportSurfaceComponentCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.484Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.808Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 12,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-skin-SupportSurfaceFeatureVS.json b/lib/resources/standard_health_record/CodeSystem-shr-skin-SupportSurfaceFeatureCS.json
old mode 100755
new mode 100644
similarity index 78%
rename from lib/resources/standard_health_record/CodeSystem-shr-skin-SupportSurfaceFeatureVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-skin-SupportSurfaceFeatureCS.json
index 5fa027b..0db8f47
--- a/lib/resources/standard_health_record/CodeSystem-shr-skin-SupportSurfaceFeatureVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-skin-SupportSurfaceFeatureCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-skin-SupportSurfaceFeatureVS",
+  "id": "shr-skin-SupportSurfaceFeatureCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR SupportSurfaceFeatureVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR SupportSurfaceFeatureCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-skin-SupportSurfaceFeatureVS",
+  "url": "http://standardhealthrecord.org/shr/skin/cs/SupportSurfaceFeatureCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.skin.SupportSurfaceFeatureVS"
+    "value": "shr.skin.SupportSurfaceFeatureCS"
   },
-  "name": "SHR SupportSurfaceFeatureVS CodeSystem",
-  "title": "SHR SupportSurfaceFeatureVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR SupportSurfaceFeatureCS CodeSystem",
+  "title": "SHR SupportSurfaceFeatureCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.484Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.808Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 7,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-vital-BloodPressureMethodVS.json b/lib/resources/standard_health_record/CodeSystem-shr-vital-BloodPressureMethodCS.json
old mode 100755
new mode 100644
similarity index 76%
rename from lib/resources/standard_health_record/CodeSystem-shr-vital-BloodPressureMethodVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-vital-BloodPressureMethodCS.json
index 480fd90..4fe00ea
--- a/lib/resources/standard_health_record/CodeSystem-shr-vital-BloodPressureMethodVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-vital-BloodPressureMethodCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-vital-BloodPressureMethodVS",
+  "id": "shr-vital-BloodPressureMethodCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR BloodPressureMethodVS CodeSystem</b></p>\n<p>The method used to measure blood pressure.</p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR BloodPressureMethodCS CodeSystem</b></p>\n<p>The method used to measure blood pressure.</p>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-vital-BloodPressureMethodVS",
+  "url": "http://standardhealthrecord.org/shr/vital/cs/BloodPressureMethodCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.vital.BloodPressureMethodVS"
+    "value": "shr.vital.BloodPressureMethodCS"
   },
-  "name": "SHR BloodPressureMethodVS CodeSystem",
-  "title": "SHR BloodPressureMethodVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR BloodPressureMethodCS CodeSystem",
+  "title": "SHR BloodPressureMethodCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.485Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.809Z",
   "description": "The method used to measure blood pressure.",
   "caseSensitive": true,
   "content": "complete",
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-vital-BloodPressureQualifierVS.json b/lib/resources/standard_health_record/CodeSystem-shr-vital-BloodPressureQualifierCS.json
old mode 100755
new mode 100644
similarity index 78%
rename from lib/resources/standard_health_record/CodeSystem-shr-vital-BloodPressureQualifierVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-vital-BloodPressureQualifierCS.json
index eff358b..ad1d759
--- a/lib/resources/standard_health_record/CodeSystem-shr-vital-BloodPressureQualifierVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-vital-BloodPressureQualifierCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-vital-BloodPressureQualifierVS",
+  "id": "shr-vital-BloodPressureQualifierCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR BloodPressureQualifierVS CodeSystem</b></p>\n<p>Code further describing the blood pressure measurement.</p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR BloodPressureQualifierCS CodeSystem</b></p>\n<p>Code further describing the blood pressure measurement.</p>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-vital-BloodPressureQualifierVS",
+  "url": "http://standardhealthrecord.org/shr/vital/cs/BloodPressureQualifierCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.vital.BloodPressureQualifierVS"
+    "value": "shr.vital.BloodPressureQualifierCS"
   },
-  "name": "SHR BloodPressureQualifierVS CodeSystem",
-  "title": "SHR BloodPressureQualifierVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR BloodPressureQualifierCS CodeSystem",
+  "title": "SHR BloodPressureQualifierCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.485Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.809Z",
   "description": "Code further describing the blood pressure measurement.",
   "caseSensitive": true,
   "content": "complete",
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-vital-BodyHeightQualifierVS.json b/lib/resources/standard_health_record/CodeSystem-shr-vital-BodyHeightQualifierCS.json
old mode 100755
new mode 100644
similarity index 67%
rename from lib/resources/standard_health_record/CodeSystem-shr-vital-BodyHeightQualifierVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-vital-BodyHeightQualifierCS.json
index 738f7fc..a184150
--- a/lib/resources/standard_health_record/CodeSystem-shr-vital-BodyHeightQualifierVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-vital-BodyHeightQualifierCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-vital-BodyHeightQualifierVS",
+  "id": "shr-vital-BodyHeightQualifierCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR BodyHeightQualifierVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR BodyHeightQualifierCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-vital-BodyHeightQualifierVS",
+  "url": "http://standardhealthrecord.org/shr/vital/cs/BodyHeightQualifierCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.vital.BodyHeightQualifierVS"
+    "value": "shr.vital.BodyHeightQualifierCS"
   },
-  "name": "SHR BodyHeightQualifierVS CodeSystem",
-  "title": "SHR BodyHeightQualifierVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR BodyHeightQualifierCS CodeSystem",
+  "title": "SHR BodyHeightQualifierCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.485Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.808Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 1,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-vital-BodyTemperatureQualifierVS.json b/lib/resources/standard_health_record/CodeSystem-shr-vital-BodyTemperatureQualifierCS.json
old mode 100755
new mode 100644
similarity index 66%
rename from lib/resources/standard_health_record/CodeSystem-shr-vital-BodyTemperatureQualifierVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-vital-BodyTemperatureQualifierCS.json
index a94942b..77c6b9e
--- a/lib/resources/standard_health_record/CodeSystem-shr-vital-BodyTemperatureQualifierVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-vital-BodyTemperatureQualifierCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-vital-BodyTemperatureQualifierVS",
+  "id": "shr-vital-BodyTemperatureQualifierCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR BodyTemperatureQualifierVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR BodyTemperatureQualifierCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-vital-BodyTemperatureQualifierVS",
+  "url": "http://standardhealthrecord.org/shr/vital/cs/BodyTemperatureQualifierCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.vital.BodyTemperatureQualifierVS"
+    "value": "shr.vital.BodyTemperatureQualifierCS"
   },
-  "name": "SHR BodyTemperatureQualifierVS CodeSystem",
-  "title": "SHR BodyTemperatureQualifierVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR BodyTemperatureQualifierCS CodeSystem",
+  "title": "SHR BodyTemperatureQualifierCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.485Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.808Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 1,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-vital-BodyWeightQualifierVS.json b/lib/resources/standard_health_record/CodeSystem-shr-vital-BodyWeightQualifierCS.json
old mode 100755
new mode 100644
similarity index 84%
rename from lib/resources/standard_health_record/CodeSystem-shr-vital-BodyWeightQualifierVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-vital-BodyWeightQualifierCS.json
index 11071dc..214b8f9
--- a/lib/resources/standard_health_record/CodeSystem-shr-vital-BodyWeightQualifierVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-vital-BodyWeightQualifierCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-vital-BodyWeightQualifierVS",
+  "id": "shr-vital-BodyWeightQualifierCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR BodyWeightQualifierVS CodeSystem</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR BodyWeightQualifierCS CodeSystem</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-vital-BodyWeightQualifierVS",
+  "url": "http://standardhealthrecord.org/shr/vital/cs/BodyWeightQualifierCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.vital.BodyWeightQualifierVS"
+    "value": "shr.vital.BodyWeightQualifierCS"
   },
-  "name": "SHR BodyWeightQualifierVS CodeSystem",
-  "title": "SHR BodyWeightQualifierVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR BodyWeightQualifierCS CodeSystem",
+  "title": "SHR BodyWeightQualifierCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.485Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.809Z",
   "caseSensitive": true,
   "content": "complete",
   "count": 14,
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-vital-HeartRateMethodVS.json b/lib/resources/standard_health_record/CodeSystem-shr-vital-HeartRateMethodCS.json
old mode 100755
new mode 100644
similarity index 80%
rename from lib/resources/standard_health_record/CodeSystem-shr-vital-HeartRateMethodVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-vital-HeartRateMethodCS.json
index 40500f1..d194f50
--- a/lib/resources/standard_health_record/CodeSystem-shr-vital-HeartRateMethodVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-vital-HeartRateMethodCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-vital-HeartRateMethodVS",
+  "id": "shr-vital-HeartRateMethodCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR HeartRateMethodVS CodeSystem</b></p>\n<p>Method of measuring heart rate.</p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR HeartRateMethodCS CodeSystem</b></p>\n<p>Method of measuring heart rate.</p>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-vital-HeartRateMethodVS",
+  "url": "http://standardhealthrecord.org/shr/vital/cs/HeartRateMethodCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.vital.HeartRateMethodVS"
+    "value": "shr.vital.HeartRateMethodCS"
   },
-  "name": "SHR HeartRateMethodVS CodeSystem",
-  "title": "SHR HeartRateMethodVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR HeartRateMethodCS CodeSystem",
+  "title": "SHR HeartRateMethodCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.484Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.808Z",
   "description": "Method of measuring heart rate.",
   "caseSensitive": true,
   "content": "complete",
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-vital-HeartRateQualifierVS.json b/lib/resources/standard_health_record/CodeSystem-shr-vital-HeartRateQualifierCS.json
old mode 100755
new mode 100644
similarity index 78%
rename from lib/resources/standard_health_record/CodeSystem-shr-vital-HeartRateQualifierVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-vital-HeartRateQualifierCS.json
index e437191..f2a484c
--- a/lib/resources/standard_health_record/CodeSystem-shr-vital-HeartRateQualifierVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-vital-HeartRateQualifierCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-vital-HeartRateQualifierVS",
+  "id": "shr-vital-HeartRateQualifierCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR HeartRateQualifierVS CodeSystem</b></p>\n<p>Details of a heart rate measurement.</p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR HeartRateQualifierCS CodeSystem</b></p>\n<p>Details of a heart rate measurement.</p>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-vital-HeartRateQualifierVS",
+  "url": "http://standardhealthrecord.org/shr/vital/cs/HeartRateQualifierCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.vital.HeartRateQualifierVS"
+    "value": "shr.vital.HeartRateQualifierCS"
   },
-  "name": "SHR HeartRateQualifierVS CodeSystem",
-  "title": "SHR HeartRateQualifierVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR HeartRateQualifierCS CodeSystem",
+  "title": "SHR HeartRateQualifierCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.484Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.808Z",
   "description": "Details of a heart rate measurement.",
   "caseSensitive": true,
   "content": "complete",
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-vital-RespiratoryRateMethodVS.json b/lib/resources/standard_health_record/CodeSystem-shr-vital-RespiratoryRateMethodCS.json
old mode 100755
new mode 100644
similarity index 78%
rename from lib/resources/standard_health_record/CodeSystem-shr-vital-RespiratoryRateMethodVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-vital-RespiratoryRateMethodCS.json
index 33dd8b3..a304074
--- a/lib/resources/standard_health_record/CodeSystem-shr-vital-RespiratoryRateMethodVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-vital-RespiratoryRateMethodCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-vital-RespiratoryRateMethodVS",
+  "id": "shr-vital-RespiratoryRateMethodCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR RespiratoryRateMethodVS CodeSystem</b></p>\n<p>Methods of measuring respiratory rate.</p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR RespiratoryRateMethodCS CodeSystem</b></p>\n<p>Methods of measuring respiratory rate.</p>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-vital-RespiratoryRateMethodVS",
+  "url": "http://standardhealthrecord.org/shr/vital/cs/RespiratoryRateMethodCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.vital.RespiratoryRateMethodVS"
+    "value": "shr.vital.RespiratoryRateMethodCS"
   },
-  "name": "SHR RespiratoryRateMethodVS CodeSystem",
-  "title": "SHR RespiratoryRateMethodVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR RespiratoryRateMethodCS CodeSystem",
+  "title": "SHR RespiratoryRateMethodCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.484Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.808Z",
   "description": "Methods of measuring respiratory rate.",
   "caseSensitive": true,
   "content": "complete",
diff --git a/lib/resources/standard_health_record/CodeSystem-shr-vital-RespiratoryRateQualifierVS.json b/lib/resources/standard_health_record/CodeSystem-shr-vital-RespiratoryRateQualifierCS.json
old mode 100755
new mode 100644
similarity index 86%
rename from lib/resources/standard_health_record/CodeSystem-shr-vital-RespiratoryRateQualifierVS.json
rename to lib/resources/standard_health_record/CodeSystem-shr-vital-RespiratoryRateQualifierCS.json
index b2aff46..2833549
--- a/lib/resources/standard_health_record/CodeSystem-shr-vital-RespiratoryRateQualifierVS.json
+++ b/lib/resources/standard_health_record/CodeSystem-shr-vital-RespiratoryRateQualifierCS.json
@@ -1,6 +1,6 @@
 {
   "resourceType": "CodeSystem",
-  "id": "shr-vital-RespiratoryRateQualifierVS",
+  "id": "shr-vital-RespiratoryRateQualifierCS",
   "meta": {
     "profile": [
       "http://hl7.org/fhir/StructureDefinition/codesystem-shareable-definition"
@@ -8,16 +8,18 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR RespiratoryRateQualifierVS CodeSystem</b></p>\n<p>Details of a respiratory rate measurement.</p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR RespiratoryRateQualifierCS CodeSystem</b></p>\n<p>Details of a respiratory rate measurement.</p>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/CodeSystem/shr-vital-RespiratoryRateQualifierVS",
+  "url": "http://standardhealthrecord.org/shr/vital/cs/RespiratoryRateQualifierCS",
   "identifier": {
     "system": "http://standardhealthrecord.org",
-    "value": "shr.vital.RespiratoryRateQualifierVS"
+    "value": "shr.vital.RespiratoryRateQualifierCS"
   },
-  "name": "SHR RespiratoryRateQualifierVS CodeSystem",
-  "title": "SHR RespiratoryRateQualifierVS CodeSystem",
+  "version": "0.0.1",
+  "name": "SHR RespiratoryRateQualifierCS CodeSystem",
+  "title": "SHR RespiratoryRateQualifierCS CodeSystem",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.484Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -29,7 +31,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.808Z",
   "description": "Details of a respiratory rate measurement.",
   "caseSensitive": true,
   "content": "complete",
diff --git a/lib/resources/standard_health_record/ImplementationGuide.json b/lib/resources/standard_health_record/ImplementationGuide-1.json
old mode 100755
new mode 100644
similarity index 96%
rename from lib/resources/standard_health_record/ImplementationGuide.json
rename to lib/resources/standard_health_record/ImplementationGuide-1.json
index 9fde6bc..ef17759
--- a/lib/resources/standard_health_record/ImplementationGuide.json
+++ b/lib/resources/standard_health_record/ImplementationGuide-1.json
@@ -4,6 +4,7 @@
   "url": "http://standardhealthrecord.org/fhir/ImplementationGuide/1",
   "name": "Standard Health Record FHIR Profiles",
   "status": "draft",
+  "fhirVersion": "3.0.0",
   "package": [
     {
       "name": "Profiles in this Implementation Guide",
@@ -1347,6 +1348,19 @@
             "display": "SHR Travel Profile"
           }
         },
+        {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
+              "valueUri": "StructureDefinition-shr-medication-MaximumDosePerTimePeriod.html"
+            }
+          ],
+          "example": false,
+          "sourceReference": {
+            "reference": "StructureDefinition/shr-medication-MaximumDosePerTimePeriod",
+            "display": "SHR MaximumDosePerTimePeriod Profile"
+          }
+        },
         {
           "extension": [
             {
@@ -1919,6 +1933,19 @@
             "display": "SHR VitalSign Profile"
           }
         },
+        {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
+              "valueUri": "StructureDefinition-shr-actor-Affiliation-extension.html"
+            }
+          ],
+          "example": false,
+          "sourceReference": {
+            "reference": "StructureDefinition/shr-actor-Affiliation-extension",
+            "display": "SHR Affiliation Extension"
+          }
+        },
         {
           "extension": [
             {
@@ -2010,6 +2037,19 @@
             "display": "SHR LanguageUsed Extension"
           }
         },
+        {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
+              "valueUri": "StructureDefinition-shr-actor-MedicalSpecialty-extension.html"
+            }
+          ],
+          "example": false,
+          "sourceReference": {
+            "reference": "StructureDefinition/shr-actor-MedicalSpecialty-extension",
+            "display": "SHR MedicalSpecialty Extension"
+          }
+        },
         {
           "extension": [
             {
@@ -2270,32 +2310,6 @@
             "display": "SHR PerformerInstructions Extension"
           }
         },
-        {
-          "extension": [
-            {
-              "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "StructureDefinition-shr-base-PriorityOfRequest-extension.html"
-            }
-          ],
-          "example": false,
-          "sourceReference": {
-            "reference": "StructureDefinition/shr-base-PriorityOfRequest-extension",
-            "display": "SHR PriorityOfRequest Extension"
-          }
-        },
-        {
-          "extension": [
-            {
-              "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "StructureDefinition-shr-base-RequestNotToPerformActionModifier-extension.html"
-            }
-          ],
-          "example": false,
-          "sourceReference": {
-            "reference": "StructureDefinition/shr-base-RequestNotToPerformActionModifier-extension",
-            "display": "SHR RequestNotToPerformActionModifier Extension"
-          }
-        },
         {
           "extension": [
             {
@@ -3700,19 +3714,6 @@
             "display": "SHR Test Extension"
           }
         },
-        {
-          "extension": [
-            {
-              "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "StructureDefinition-shr-lab-TestRequest-extension.html"
-            }
-          ],
-          "example": false,
-          "sourceReference": {
-            "reference": "StructureDefinition/shr-lab-TestRequest-extension",
-            "display": "SHR TestRequest Extension"
-          }
-        },
         {
           "extension": [
             {
@@ -3882,19 +3883,6 @@
             "display": "SHR NonAdherenceReason Extension"
           }
         },
-        {
-          "extension": [
-            {
-              "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "StructureDefinition-shr-medication-OverTheCounter-extension.html"
-            }
-          ],
-          "example": false,
-          "sourceReference": {
-            "reference": "StructureDefinition/shr-medication-OverTheCounter-extension",
-            "display": "SHR OverTheCounter Extension"
-          }
-        },
         {
           "extension": [
             {
@@ -4636,6 +4624,19 @@
             "display": "SHR LanguageQualifierVS ValueSet"
           }
         },
+        {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
+              "valueUri": "ValueSet-shr-adverse-MedDRAVS.html"
+            }
+          ],
+          "example": false,
+          "sourceReference": {
+            "reference": "ValueSet/shr-adverse-MedDRAVS",
+            "display": "SHR MedDRAVS ValueSet"
+          }
+        },
         {
           "extension": [
             {
@@ -5624,6 +5625,19 @@
             "display": "SHR MedicationNonAdherenceReasonVS ValueSet"
           }
         },
+        {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
+              "valueUri": "ValueSet-shr-medication-MedicationVS.html"
+            }
+          ],
+          "example": false,
+          "sourceReference": {
+            "reference": "ValueSet/shr-medication-MedicationVS",
+            "display": "SHR MedicationVS ValueSet"
+          }
+        },
         {
           "extension": [
             {
@@ -5676,6 +5690,19 @@
             "display": "SHR ObservationNotMadeReasonVS ValueSet"
           }
         },
+        {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
+              "valueUri": "ValueSet-shr-problem-DSMVS.html"
+            }
+          ],
+          "example": false,
+          "sourceReference": {
+            "reference": "ValueSet/shr-problem-DSMVS",
+            "display": "SHR DSMVS ValueSet"
+          }
+        },
         {
           "extension": [
             {
@@ -6096,949 +6123,949 @@
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "CodeSystem-shr-actor-LanguageQualifierVS.html"
+              "valueUri": "CodeSystem-shr-actor-LanguageQualifierCS.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "CodeSystem/shr-actor-LanguageQualifierVS",
-            "display": "SHR LanguageQualifierVS CodeSystem"
+            "reference": "CodeSystem/shr-actor-LanguageQualifierCS",
+            "display": "SHR LanguageQualifierCS CodeSystem"
           }
         },
         {
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "CodeSystem-shr-base-GenericAnswersVS.html"
+              "valueUri": "CodeSystem-shr-base-GenericAnswersCS.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "CodeSystem/shr-base-GenericAnswersVS",
-            "display": "SHR GenericAnswersVS CodeSystem"
+            "reference": "CodeSystem/shr-base-GenericAnswersCS",
+            "display": "SHR GenericAnswersCS CodeSystem"
           }
         },
         {
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "CodeSystem-shr-base-MissingValueReasonVS.html"
+              "valueUri": "CodeSystem-shr-base-MissingValueReasonCS.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "CodeSystem/shr-base-MissingValueReasonVS",
-            "display": "SHR MissingValueReasonVS CodeSystem"
+            "reference": "CodeSystem/shr-base-MissingValueReasonCS",
+            "display": "SHR MissingValueReasonCS CodeSystem"
           }
         },
         {
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "CodeSystem-shr-behavior-AlcoholUseScreeningToolVS.html"
+              "valueUri": "CodeSystem-shr-behavior-AlcoholUseScreeningToolCS.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "CodeSystem/shr-behavior-AlcoholUseScreeningToolVS",
-            "display": "SHR AlcoholUseScreeningToolVS CodeSystem"
+            "reference": "CodeSystem/shr-behavior-AlcoholUseScreeningToolCS",
+            "display": "SHR AlcoholUseScreeningToolCS CodeSystem"
           }
         },
         {
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "CodeSystem-shr-behavior-DietNutritionConcernVS.html"
+              "valueUri": "CodeSystem-shr-behavior-DietNutritionConcernCS.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "CodeSystem/shr-behavior-DietNutritionConcernVS",
-            "display": "SHR DietNutritionConcernVS CodeSystem"
+            "reference": "CodeSystem/shr-behavior-DietNutritionConcernCS",
+            "display": "SHR DietNutritionConcernCS CodeSystem"
           }
         },
         {
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "CodeSystem-shr-behavior-PhysicalActivityLimitationVS.html"
+              "valueUri": "CodeSystem-shr-behavior-PhysicalActivityLimitationCS.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "CodeSystem/shr-behavior-PhysicalActivityLimitationVS",
-            "display": "SHR PhysicalActivityLimitationVS CodeSystem"
+            "reference": "CodeSystem/shr-behavior-PhysicalActivityLimitationCS",
+            "display": "SHR PhysicalActivityLimitationCS CodeSystem"
           }
         },
         {
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "CodeSystem-shr-behavior-ReligiousPracticeStatusVS.html"
+              "valueUri": "CodeSystem-shr-behavior-ReligiousPracticeStatusCS.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "CodeSystem/shr-behavior-ReligiousPracticeStatusVS",
-            "display": "SHR ReligiousPracticeStatusVS CodeSystem"
+            "reference": "CodeSystem/shr-behavior-ReligiousPracticeStatusCS",
+            "display": "SHR ReligiousPracticeStatusCS CodeSystem"
           }
         },
         {
           "extension": [
             {
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             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "CodeSystem-shr-medication-MedicationChangeTypeVS.html"
+              "valueUri": "CodeSystem-shr-medication-MedicationChangeTypeCS.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "CodeSystem/shr-medication-MedicationChangeTypeVS",
-            "display": "SHR MedicationChangeTypeVS CodeSystem"
+            "reference": "CodeSystem/shr-medication-MedicationChangeTypeCS",
+            "display": "SHR MedicationChangeTypeCS CodeSystem"
           }
         },
         {
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "CodeSystem-shr-medication-ReasonMedicationNotUsedVS.html"
+              "valueUri": "CodeSystem-shr-medication-ReasonMedicationNotUsedCS.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "CodeSystem/shr-medication-ReasonMedicationNotUsedVS",
-            "display": "SHR ReasonMedicationNotUsedVS CodeSystem"
+            "reference": "CodeSystem/shr-medication-ReasonMedicationNotUsedCS",
+            "display": "SHR ReasonMedicationNotUsedCS CodeSystem"
           }
         },
         {
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "CodeSystem-shr-observation-ExposureReasonVS.html"
+              "valueUri": "CodeSystem-shr-observation-ExposureReasonCS.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "CodeSystem/shr-observation-ExposureReasonVS",
-            "display": "SHR ExposureReasonVS CodeSystem"
+            "reference": "CodeSystem/shr-observation-ExposureReasonCS",
+            "display": "SHR ExposureReasonCS CodeSystem"
           }
         },
         {
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "CodeSystem-shr-observation-ObservationNotMadeReasonVS.html"
+              "valueUri": "CodeSystem-shr-observation-ObservationNotMadeReasonCS.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "CodeSystem/shr-observation-ObservationNotMadeReasonVS",
-            "display": "SHR ObservationNotMadeReasonVS CodeSystem"
+            "reference": "CodeSystem/shr-observation-ObservationNotMadeReasonCS",
+            "display": "SHR ObservationNotMadeReasonCS CodeSystem"
           }
         },
         {
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "CodeSystem-shr-problem-EvidenceQualityVS.html"
+              "valueUri": "CodeSystem-shr-problem-EvidenceQualityCS.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "CodeSystem/shr-problem-EvidenceQualityVS",
-            "display": "SHR EvidenceQualityVS CodeSystem"
+            "reference": "CodeSystem/shr-problem-EvidenceQualityCS",
+            "display": "SHR EvidenceQualityCS CodeSystem"
           }
         },
         {
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "CodeSystem-shr-problem-GradeOrStageVS.html"
+              "valueUri": "CodeSystem-shr-problem-GradeOrStageCS.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "CodeSystem/shr-problem-GradeOrStageVS",
-            "display": "SHR GradeOrStageVS CodeSystem"
+            "reference": "CodeSystem/shr-problem-GradeOrStageCS",
+            "display": "SHR GradeOrStageCS CodeSystem"
           }
         },
         {
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "CodeSystem-shr-problem-ProblemCategoryVS.html"
+              "valueUri": "CodeSystem-shr-problem-ProblemCategoryCS.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "CodeSystem/shr-problem-ProblemCategoryVS",
-            "display": "SHR ProblemCategoryVS CodeSystem"
+            "reference": "CodeSystem/shr-problem-ProblemCategoryCS",
+            "display": "SHR ProblemCategoryCS CodeSystem"
           }
         },
         {
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "CodeSystem-shr-sex-ContraceptiveMethodReasonVS.html"
+              "valueUri": "CodeSystem-shr-sex-ContraceptiveMethodCS.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "CodeSystem/shr-sex-ContraceptiveMethodReasonVS",
-            "display": "SHR ContraceptiveMethodReasonVS CodeSystem"
+            "reference": "CodeSystem/shr-sex-ContraceptiveMethodCS",
+            "display": "SHR ContraceptiveMethodCS CodeSystem"
           }
         },
         {
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "CodeSystem-shr-sex-ContraceptiveMethodVS.html"
+              "valueUri": "CodeSystem-shr-sex-ContraceptiveMethodReasonCS.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "CodeSystem/shr-sex-ContraceptiveMethodVS",
-            "display": "SHR ContraceptiveMethodVS CodeSystem"
+            "reference": "CodeSystem/shr-sex-ContraceptiveMethodReasonCS",
+            "display": "SHR ContraceptiveMethodReasonCS CodeSystem"
           }
         },
         {
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "CodeSystem-shr-sex-ContraceptiveNotUsedReasonVS.html"
+              "valueUri": "CodeSystem-shr-sex-ContraceptiveNotUsedReasonCS.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "CodeSystem/shr-sex-ContraceptiveNotUsedReasonVS",
-            "display": "SHR ContraceptiveNotUsedReasonVS CodeSystem"
+            "reference": "CodeSystem/shr-sex-ContraceptiveNotUsedReasonCS",
+            "display": "SHR ContraceptiveNotUsedReasonCS CodeSystem"
           }
         },
         {
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "CodeSystem-shr-sex-GenderIdentityVS.html"
+              "valueUri": "CodeSystem-shr-sex-GenderIdentityCS.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "CodeSystem/shr-sex-GenderIdentityVS",
-            "display": "SHR GenderIdentityVS CodeSystem"
+            "reference": "CodeSystem/shr-sex-GenderIdentityCS",
+            "display": "SHR GenderIdentityCS CodeSystem"
           }
         },
         {
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "CodeSystem-shr-skin-PressureUlcerAssociationVS.html"
+              "valueUri": "CodeSystem-shr-skin-PressureUlcerAssociationCS.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "CodeSystem/shr-skin-PressureUlcerAssociationVS",
-            "display": "SHR PressureUlcerAssociationVS CodeSystem"
+            "reference": "CodeSystem/shr-skin-PressureUlcerAssociationCS",
+            "display": "SHR PressureUlcerAssociationCS CodeSystem"
           }
         },
         {
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "CodeSystem-shr-skin-SupportSurfaceBodyPositionVS.html"
+              "valueUri": "CodeSystem-shr-skin-SupportSurfaceBodyPositionCS.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "CodeSystem/shr-skin-SupportSurfaceBodyPositionVS",
-            "display": "SHR SupportSurfaceBodyPositionVS CodeSystem"
+            "reference": "CodeSystem/shr-skin-SupportSurfaceBodyPositionCS",
+            "display": "SHR SupportSurfaceBodyPositionCS CodeSystem"
           }
         },
         {
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "CodeSystem-shr-skin-SupportSurfaceCategoryVS.html"
+              "valueUri": "CodeSystem-shr-skin-SupportSurfaceCategoryCS.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "CodeSystem/shr-skin-SupportSurfaceCategoryVS",
-            "display": "SHR SupportSurfaceCategoryVS CodeSystem"
+            "reference": "CodeSystem/shr-skin-SupportSurfaceCategoryCS",
+            "display": "SHR SupportSurfaceCategoryCS CodeSystem"
           }
         },
         {
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "CodeSystem-shr-skin-SupportSurfaceComponentVS.html"
+              "valueUri": "CodeSystem-shr-skin-SupportSurfaceComponentCS.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "CodeSystem/shr-skin-SupportSurfaceComponentVS",
-            "display": "SHR SupportSurfaceComponentVS CodeSystem"
+            "reference": "CodeSystem/shr-skin-SupportSurfaceComponentCS",
+            "display": "SHR SupportSurfaceComponentCS CodeSystem"
           }
         },
         {
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "CodeSystem-shr-skin-SupportSurfaceFeatureVS.html"
+              "valueUri": "CodeSystem-shr-skin-SupportSurfaceFeatureCS.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "CodeSystem/shr-skin-SupportSurfaceFeatureVS",
-            "display": "SHR SupportSurfaceFeatureVS CodeSystem"
+            "reference": "CodeSystem/shr-skin-SupportSurfaceFeatureCS",
+            "display": "SHR SupportSurfaceFeatureCS CodeSystem"
           }
         },
         {
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "CodeSystem-shr-vital-BloodPressureMethodVS.html"
+              "valueUri": "CodeSystem-shr-vital-BloodPressureMethodCS.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "CodeSystem/shr-vital-BloodPressureMethodVS",
-            "display": "SHR BloodPressureMethodVS CodeSystem"
+            "reference": "CodeSystem/shr-vital-BloodPressureMethodCS",
+            "display": "SHR BloodPressureMethodCS CodeSystem"
           }
         },
         {
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "CodeSystem-shr-vital-BloodPressureQualifierVS.html"
+              "valueUri": "CodeSystem-shr-vital-BloodPressureQualifierCS.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "CodeSystem/shr-vital-BloodPressureQualifierVS",
-            "display": "SHR BloodPressureQualifierVS CodeSystem"
+            "reference": "CodeSystem/shr-vital-BloodPressureQualifierCS",
+            "display": "SHR BloodPressureQualifierCS CodeSystem"
           }
         },
         {
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "CodeSystem-shr-vital-BodyHeightQualifierVS.html"
+              "valueUri": "CodeSystem-shr-vital-BodyHeightQualifierCS.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "CodeSystem/shr-vital-BodyHeightQualifierVS",
-            "display": "SHR BodyHeightQualifierVS CodeSystem"
+            "reference": "CodeSystem/shr-vital-BodyHeightQualifierCS",
+            "display": "SHR BodyHeightQualifierCS CodeSystem"
           }
         },
         {
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "CodeSystem-shr-vital-BodyTemperatureQualifierVS.html"
+              "valueUri": "CodeSystem-shr-vital-BodyTemperatureQualifierCS.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "CodeSystem/shr-vital-BodyTemperatureQualifierVS",
-            "display": "SHR BodyTemperatureQualifierVS CodeSystem"
+            "reference": "CodeSystem/shr-vital-BodyTemperatureQualifierCS",
+            "display": "SHR BodyTemperatureQualifierCS CodeSystem"
           }
         },
         {
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "CodeSystem-shr-vital-BodyWeightQualifierVS.html"
+              "valueUri": "CodeSystem-shr-vital-BodyWeightQualifierCS.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "CodeSystem/shr-vital-BodyWeightQualifierVS",
-            "display": "SHR BodyWeightQualifierVS CodeSystem"
+            "reference": "CodeSystem/shr-vital-BodyWeightQualifierCS",
+            "display": "SHR BodyWeightQualifierCS CodeSystem"
           }
         },
         {
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "CodeSystem-shr-vital-HeartRateMethodVS.html"
+              "valueUri": "CodeSystem-shr-vital-HeartRateMethodCS.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "CodeSystem/shr-vital-HeartRateMethodVS",
-            "display": "SHR HeartRateMethodVS CodeSystem"
+            "reference": "CodeSystem/shr-vital-HeartRateMethodCS",
+            "display": "SHR HeartRateMethodCS CodeSystem"
           }
         },
         {
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "CodeSystem-shr-vital-HeartRateQualifierVS.html"
+              "valueUri": "CodeSystem-shr-vital-HeartRateQualifierCS.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "CodeSystem/shr-vital-HeartRateQualifierVS",
-            "display": "SHR HeartRateQualifierVS CodeSystem"
+            "reference": "CodeSystem/shr-vital-HeartRateQualifierCS",
+            "display": "SHR HeartRateQualifierCS CodeSystem"
           }
         },
         {
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "CodeSystem-shr-vital-RespiratoryRateMethodVS.html"
+              "valueUri": "CodeSystem-shr-vital-RespiratoryRateMethodCS.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "CodeSystem/shr-vital-RespiratoryRateMethodVS",
-            "display": "SHR RespiratoryRateMethodVS CodeSystem"
+            "reference": "CodeSystem/shr-vital-RespiratoryRateMethodCS",
+            "display": "SHR RespiratoryRateMethodCS CodeSystem"
           }
         },
         {
           "extension": [
             {
               "url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
-              "valueUri": "CodeSystem-shr-vital-RespiratoryRateQualifierVS.html"
+              "valueUri": "CodeSystem-shr-vital-RespiratoryRateQualifierCS.html"
             }
           ],
           "example": false,
           "sourceReference": {
-            "reference": "CodeSystem/shr-vital-RespiratoryRateQualifierVS",
-            "display": "SHR RespiratoryRateQualifierVS CodeSystem"
+            "reference": "CodeSystem/shr-vital-RespiratoryRateQualifierCS",
+            "display": "SHR RespiratoryRateQualifierCS CodeSystem"
           }
         }
       ]
diff --git a/lib/resources/standard_health_record/StructureDefinition-primitive-base64Binary-extension.json b/lib/resources/standard_health_record/StructureDefinition-primitive-base64Binary-extension.json
old mode 100755
new mode 100644
index 784c7c2..2d1cca1
--- a/lib/resources/standard_health_record/StructureDefinition-primitive-base64Binary-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-primitive-base64Binary-extension.json
@@ -3,18 +3,19 @@
   "id": "primitive-base64Binary-extension",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR base64Binary Extension</b></p>\n  <p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR base64Binary Extension</b></p>\n  <p/>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/primitive-base64Binary-extension",
   "identifier": [
     {
-      "system": "http://standardhealthrecord.org",
-      "value": ""
+      "system": "http://standardhealthrecord.org"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR base64Binary Extension",
   "title": "SHR base64Binary Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.498Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.820Z",
   "description": "The base64Binary that represents the value of the SHR element to which it is applied.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +128,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-primitive-boolean-extension.json b/lib/resources/standard_health_record/StructureDefinition-primitive-boolean-extension.json
old mode 100755
new mode 100644
index 3e6574a..cc18c2b
--- a/lib/resources/standard_health_record/StructureDefinition-primitive-boolean-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-primitive-boolean-extension.json
@@ -3,18 +3,19 @@
   "id": "primitive-boolean-extension",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR boolean Extension</b></p>\n  <p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR boolean Extension</b></p>\n  <p/>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/primitive-boolean-extension",
   "identifier": [
     {
-      "system": "http://standardhealthrecord.org",
-      "value": ""
+      "system": "http://standardhealthrecord.org"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR boolean Extension",
   "title": "SHR boolean Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.494Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.817Z",
   "description": "The boolean that represents the value of the SHR element to which it is applied.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +128,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-primitive-code-extension.json b/lib/resources/standard_health_record/StructureDefinition-primitive-code-extension.json
old mode 100755
new mode 100644
index 6158195..0b5f56d
--- a/lib/resources/standard_health_record/StructureDefinition-primitive-code-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-primitive-code-extension.json
@@ -3,18 +3,19 @@
   "id": "primitive-code-extension",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR code Extension</b></p>\n  <p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR code Extension</b></p>\n  <p/>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/primitive-code-extension",
   "identifier": [
     {
-      "system": "http://standardhealthrecord.org",
-      "value": ""
+      "system": "http://standardhealthrecord.org"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR code Extension",
   "title": "SHR code Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.497Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.819Z",
   "description": "The code that represents the value of the SHR element to which it is applied.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +128,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-primitive-date-extension.json b/lib/resources/standard_health_record/StructureDefinition-primitive-date-extension.json
old mode 100755
new mode 100644
index 9714625..1d9b429
--- a/lib/resources/standard_health_record/StructureDefinition-primitive-date-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-primitive-date-extension.json
@@ -3,18 +3,19 @@
   "id": "primitive-date-extension",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR date Extension</b></p>\n  <p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR date Extension</b></p>\n  <p/>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/primitive-date-extension",
   "identifier": [
     {
-      "system": "http://standardhealthrecord.org",
-      "value": ""
+      "system": "http://standardhealthrecord.org"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR date Extension",
   "title": "SHR date Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.498Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.820Z",
   "description": "The date that represents the value of the SHR element to which it is applied.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +128,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-primitive-dateTime-extension.json b/lib/resources/standard_health_record/StructureDefinition-primitive-dateTime-extension.json
old mode 100755
new mode 100644
index 3f0d894..8d2d78b
--- a/lib/resources/standard_health_record/StructureDefinition-primitive-dateTime-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-primitive-dateTime-extension.json
@@ -3,18 +3,19 @@
   "id": "primitive-dateTime-extension",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR dateTime Extension</b></p>\n  <p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR dateTime Extension</b></p>\n  <p/>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/primitive-dateTime-extension",
   "identifier": [
     {
-      "system": "http://standardhealthrecord.org",
-      "value": ""
+      "system": "http://standardhealthrecord.org"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR dateTime Extension",
   "title": "SHR dateTime Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.498Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.820Z",
   "description": "The dateTime that represents the value of the SHR element to which it is applied.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +128,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-primitive-decimal-extension.json b/lib/resources/standard_health_record/StructureDefinition-primitive-decimal-extension.json
old mode 100755
new mode 100644
index e92ec38..f00585d
--- a/lib/resources/standard_health_record/StructureDefinition-primitive-decimal-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-primitive-decimal-extension.json
@@ -3,18 +3,19 @@
   "id": "primitive-decimal-extension",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR decimal Extension</b></p>\n  <p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR decimal Extension</b></p>\n  <p/>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/primitive-decimal-extension",
   "identifier": [
     {
-      "system": "http://standardhealthrecord.org",
-      "value": ""
+      "system": "http://standardhealthrecord.org"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR decimal Extension",
   "title": "SHR decimal Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.497Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.819Z",
   "description": "The decimal that represents the value of the SHR element to which it is applied.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +128,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-primitive-id-extension.json b/lib/resources/standard_health_record/StructureDefinition-primitive-id-extension.json
old mode 100755
new mode 100644
index 752d482..d34ae67
--- a/lib/resources/standard_health_record/StructureDefinition-primitive-id-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-primitive-id-extension.json
@@ -3,18 +3,19 @@
   "id": "primitive-id-extension",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR id Extension</b></p>\n  <p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR id Extension</b></p>\n  <p/>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/primitive-id-extension",
   "identifier": [
     {
-      "system": "http://standardhealthrecord.org",
-      "value": ""
+      "system": "http://standardhealthrecord.org"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR id Extension",
   "title": "SHR id Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.497Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.819Z",
   "description": "The id that represents the value of the SHR element to which it is applied.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +128,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-primitive-instant-extension.json b/lib/resources/standard_health_record/StructureDefinition-primitive-instant-extension.json
old mode 100755
new mode 100644
index eaa2c27..77c1db6
--- a/lib/resources/standard_health_record/StructureDefinition-primitive-instant-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-primitive-instant-extension.json
@@ -3,18 +3,19 @@
   "id": "primitive-instant-extension",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR instant Extension</b></p>\n  <p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR instant Extension</b></p>\n  <p/>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/primitive-instant-extension",
   "identifier": [
     {
-      "system": "http://standardhealthrecord.org",
-      "value": ""
+      "system": "http://standardhealthrecord.org"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR instant Extension",
   "title": "SHR instant Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.498Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.820Z",
   "description": "The instant that represents the value of the SHR element to which it is applied.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +128,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-primitive-integer-extension.json b/lib/resources/standard_health_record/StructureDefinition-primitive-integer-extension.json
old mode 100755
new mode 100644
index 57eb03d..585ee92
--- a/lib/resources/standard_health_record/StructureDefinition-primitive-integer-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-primitive-integer-extension.json
@@ -3,18 +3,19 @@
   "id": "primitive-integer-extension",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR integer Extension</b></p>\n  <p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR integer Extension</b></p>\n  <p/>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/primitive-integer-extension",
   "identifier": [
     {
-      "system": "http://standardhealthrecord.org",
-      "value": ""
+      "system": "http://standardhealthrecord.org"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR integer Extension",
   "title": "SHR integer Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.496Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.819Z",
   "description": "The integer that represents the value of the SHR element to which it is applied.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +128,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-primitive-markdown-extension.json b/lib/resources/standard_health_record/StructureDefinition-primitive-markdown-extension.json
old mode 100755
new mode 100644
index 88ba08e..1aae152
--- a/lib/resources/standard_health_record/StructureDefinition-primitive-markdown-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-primitive-markdown-extension.json
@@ -3,18 +3,19 @@
   "id": "primitive-markdown-extension",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR markdown Extension</b></p>\n  <p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR markdown Extension</b></p>\n  <p/>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/primitive-markdown-extension",
   "identifier": [
     {
-      "system": "http://standardhealthrecord.org",
-      "value": ""
+      "system": "http://standardhealthrecord.org"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR markdown Extension",
   "title": "SHR markdown Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.497Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.819Z",
   "description": "The markdown that represents the value of the SHR element to which it is applied.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +128,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-primitive-oid-extension.json b/lib/resources/standard_health_record/StructureDefinition-primitive-oid-extension.json
old mode 100755
new mode 100644
index 27dcc73..1f22742
--- a/lib/resources/standard_health_record/StructureDefinition-primitive-oid-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-primitive-oid-extension.json
@@ -3,18 +3,19 @@
   "id": "primitive-oid-extension",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR oid Extension</b></p>\n  <p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR oid Extension</b></p>\n  <p/>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/primitive-oid-extension",
   "identifier": [
     {
-      "system": "http://standardhealthrecord.org",
-      "value": ""
+      "system": "http://standardhealthrecord.org"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR oid Extension",
   "title": "SHR oid Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.497Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.819Z",
   "description": "The oid that represents the value of the SHR element to which it is applied.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +128,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-primitive-positiveInt-extension.json b/lib/resources/standard_health_record/StructureDefinition-primitive-positiveInt-extension.json
old mode 100755
new mode 100644
index 6f562f3..27f1d01
--- a/lib/resources/standard_health_record/StructureDefinition-primitive-positiveInt-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-primitive-positiveInt-extension.json
@@ -3,18 +3,19 @@
   "id": "primitive-positiveInt-extension",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR positiveInt Extension</b></p>\n  <p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR positiveInt Extension</b></p>\n  <p/>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/primitive-positiveInt-extension",
   "identifier": [
     {
-      "system": "http://standardhealthrecord.org",
-      "value": ""
+      "system": "http://standardhealthrecord.org"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR positiveInt Extension",
   "title": "SHR positiveInt Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.497Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.819Z",
   "description": "The positiveInt that represents the value of the SHR element to which it is applied.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +128,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-primitive-string-extension.json b/lib/resources/standard_health_record/StructureDefinition-primitive-string-extension.json
old mode 100755
new mode 100644
index 9e4b42a..71df9b4
--- a/lib/resources/standard_health_record/StructureDefinition-primitive-string-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-primitive-string-extension.json
@@ -3,18 +3,19 @@
   "id": "primitive-string-extension",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR string Extension</b></p>\n  <p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR string Extension</b></p>\n  <p/>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/primitive-string-extension",
   "identifier": [
     {
-      "system": "http://standardhealthrecord.org",
-      "value": ""
+      "system": "http://standardhealthrecord.org"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR string Extension",
   "title": "SHR string Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.497Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.819Z",
   "description": "The string that represents the value of the SHR element to which it is applied.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +128,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-primitive-time-extension.json b/lib/resources/standard_health_record/StructureDefinition-primitive-time-extension.json
old mode 100755
new mode 100644
index f1abd4a..819e48a
--- a/lib/resources/standard_health_record/StructureDefinition-primitive-time-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-primitive-time-extension.json
@@ -3,18 +3,19 @@
   "id": "primitive-time-extension",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR time Extension</b></p>\n  <p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR time Extension</b></p>\n  <p/>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/primitive-time-extension",
   "identifier": [
     {
-      "system": "http://standardhealthrecord.org",
-      "value": ""
+      "system": "http://standardhealthrecord.org"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR time Extension",
   "title": "SHR time Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.498Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.820Z",
   "description": "The time that represents the value of the SHR element to which it is applied.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +128,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-primitive-unsignedInt-extension.json b/lib/resources/standard_health_record/StructureDefinition-primitive-unsignedInt-extension.json
old mode 100755
new mode 100644
index 7d6b9ec..0416c8f
--- a/lib/resources/standard_health_record/StructureDefinition-primitive-unsignedInt-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-primitive-unsignedInt-extension.json
@@ -3,18 +3,19 @@
   "id": "primitive-unsignedInt-extension",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR unsignedInt Extension</b></p>\n  <p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR unsignedInt Extension</b></p>\n  <p/>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/primitive-unsignedInt-extension",
   "identifier": [
     {
-      "system": "http://standardhealthrecord.org",
-      "value": ""
+      "system": "http://standardhealthrecord.org"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR unsignedInt Extension",
   "title": "SHR unsignedInt Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.497Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.819Z",
   "description": "The unsignedInt that represents the value of the SHR element to which it is applied.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +128,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-primitive-uri-extension.json b/lib/resources/standard_health_record/StructureDefinition-primitive-uri-extension.json
old mode 100755
new mode 100644
index 534e0d9..95a098a
--- a/lib/resources/standard_health_record/StructureDefinition-primitive-uri-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-primitive-uri-extension.json
@@ -3,18 +3,19 @@
   "id": "primitive-uri-extension",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR uri Extension</b></p>\n  <p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR uri Extension</b></p>\n  <p/>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/primitive-uri-extension",
   "identifier": [
     {
-      "system": "http://standardhealthrecord.org",
-      "value": ""
+      "system": "http://standardhealthrecord.org"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR uri Extension",
   "title": "SHR uri Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.497Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.819Z",
   "description": "The uri that represents the value of the SHR element to which it is applied.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +128,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-primitive-xhtml-extension.json b/lib/resources/standard_health_record/StructureDefinition-primitive-xhtml-extension.json
old mode 100755
new mode 100644
index 1e04b57..353ea36
--- a/lib/resources/standard_health_record/StructureDefinition-primitive-xhtml-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-primitive-xhtml-extension.json
@@ -3,18 +3,19 @@
   "id": "primitive-xhtml-extension",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR xhtml Extension</b></p>\n  <p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR xhtml Extension</b></p>\n  <p/>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/primitive-xhtml-extension",
   "identifier": [
     {
-      "system": "http://standardhealthrecord.org",
-      "value": ""
+      "system": "http://standardhealthrecord.org"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR xhtml Extension",
   "title": "SHR xhtml Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.498Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.820Z",
   "description": "The xhtml that represents the value of the SHR element to which it is applied.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +128,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-lab-TestRequest-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-actor-Affiliation-extension.json
old mode 100755
new mode 100644
similarity index 74%
rename from lib/resources/standard_health_record/StructureDefinition-shr-lab-TestRequest-extension.json
rename to lib/resources/standard_health_record/StructureDefinition-shr-actor-Affiliation-extension.json
index a3556ae..58b70ec
--- a/lib/resources/standard_health_record/StructureDefinition-shr-lab-TestRequest-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-actor-Affiliation-extension.json
@@ -1,20 +1,22 @@
 {
   "resourceType": "StructureDefinition",
-  "id": "shr-lab-TestRequest-extension",
+  "id": "shr-actor-Affiliation-extension",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR TestRequest Extension</b></p>\n  <p>A record of a request (order) for a test to be performed.</p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR Affiliation Extension</b></p>\n  <p>Membership, association, or connection to an organization.</p>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest-extension",
+  "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-actor-Affiliation-extension",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
-      "value": "shr.lab.TestRequest"
+      "value": "shr.actor.Affiliation"
     }
   ],
-  "name": "SHR TestRequest Extension",
-  "title": "SHR TestRequest Extension",
+  "version": "0.0.1",
+  "name": "SHR Affiliation Extension",
+  "title": "SHR Affiliation Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.526Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.374Z",
-  "description": "A record of a request (order) for a test to be performed.",
-  "fhirVersion": "1.8.0",
+  "description": "Membership, association, or connection to an organization.",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -41,10 +42,10 @@
   "snapshot": {
     "element": [
       {
-        "id": "Extension:testrequest",
+        "id": "Extension:affiliation",
         "path": "Extension",
-        "short": "SHR TestRequest Extension",
-        "definition": "A record of a request (order) for a test to be performed.",
+        "short": "SHR Affiliation Extension",
+        "definition": "Membership, association, or connection to an organization.",
         "min": 0,
         "max": "*",
         "base": {
@@ -75,7 +76,7 @@
         ]
       },
       {
-        "id": "Extension:testrequest.id",
+        "id": "Extension:affiliation.id",
         "path": "Extension.id",
         "representation": [
           "xmlAttr"
@@ -102,7 +103,7 @@
         ]
       },
       {
-        "id": "Extension:testrequest.extension:extension",
+        "id": "Extension:affiliation.extension:extension",
         "path": "Extension.extension",
         "sliceName": "extension",
         "short": "Extension",
@@ -121,14 +122,13 @@
         ]
       },
       {
-        "id": "Extension:testrequest.url",
+        "id": "Extension:affiliation.url",
         "path": "Extension.url",
         "representation": [
           "xmlAttr"
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -141,7 +141,7 @@
             "code": "uri"
           }
         ],
-        "fixedUri": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest-extension",
+        "fixedUri": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-actor-Affiliation-extension",
         "mapping": [
           {
             "identity": "rim",
@@ -150,7 +150,7 @@
         ]
       },
       {
-        "id": "Extension:testrequest.valueReference",
+        "id": "Extension:affiliation.valueReference",
         "path": "Extension.valueReference",
         "short": "Value of extension",
         "definition": "Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).",
@@ -164,7 +164,7 @@
         "type": [
           {
             "code": "Reference",
-            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest"
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-actor-Organization"
           }
         ],
         "mapping": [
@@ -179,37 +179,37 @@
   "differential": {
     "element": [
       {
-        "id": "Extension:testrequest",
+        "id": "Extension:affiliation",
         "path": "Extension",
-        "short": "SHR TestRequest Extension",
-        "definition": "A record of a request (order) for a test to be performed.",
+        "short": "SHR Affiliation Extension",
+        "definition": "Membership, association, or connection to an organization.",
         "min": 0,
         "max": "*"
       },
       {
-        "id": "Extension:testrequest.extension:extension",
+        "id": "Extension:affiliation.extension:extension",
         "path": "Extension.extension",
         "sliceName": "extension",
         "max": "0"
       },
       {
-        "id": "Extension:testrequest.url",
+        "id": "Extension:affiliation.url",
         "path": "Extension.url",
         "type": [
           {
             "code": "uri"
           }
         ],
-        "fixedUri": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest-extension"
+        "fixedUri": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-actor-Affiliation-extension"
       },
       {
-        "id": "Extension:testrequest.valueReference",
+        "id": "Extension:affiliation.valueReference",
         "path": "Extension.valueReference",
         "min": 1,
         "type": [
           {
             "code": "Reference",
-            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest"
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-actor-Organization"
           }
         ]
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-actor-AgeAtDeath-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-actor-AgeAtDeath-extension.json
old mode 100755
new mode 100644
index 44032c3..4aafc9b
--- a/lib/resources/standard_health_record/StructureDefinition-shr-actor-AgeAtDeath-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-actor-AgeAtDeath-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.actor.AgeAtDeath"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR AgeAtDeath Extension",
   "title": "SHR AgeAtDeath Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.517Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.832Z",
   "description": "The age, age range, or age group when the cessation of life happens.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -107,7 +108,10 @@
         "slicing": {
           "id": "5",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -161,7 +165,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-actor-Anonymized-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-actor-Anonymized-extension.json
old mode 100755
new mode 100644
index b944c96..2aa17b8
--- a/lib/resources/standard_health_record/StructureDefinition-shr-actor-Anonymized-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-actor-Anonymized-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.actor.Anonymized"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Anonymized Extension",
   "title": "SHR Anonymized Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.513Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.829Z",
   "description": "Flag indicating if personally identifiable information has been withheld.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-actor-DateOfDeath-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-actor-DateOfDeath-extension.json
old mode 100755
new mode 100644
index 9f85c5a..3403157
--- a/lib/resources/standard_health_record/StructureDefinition-shr-actor-DateOfDeath-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-actor-DateOfDeath-extension.json
@@ -3,7 +3,7 @@
   "id": "shr-actor-DateOfDeath-extension",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR DateOfDeath Extension</b></p>\n  <p>The calendar date of subject&#039;s death.</p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR DateOfDeath Extension</b></p>\n  <p>The calendar date of subject's death.</p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-actor-DateOfDeath-extension",
   "identifier": [
@@ -12,9 +12,11 @@
       "value": "shr.actor.DateOfDeath"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR DateOfDeath Extension",
   "title": "SHR DateOfDeath Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.516Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.831Z",
   "description": "The calendar date of subject's death.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -107,7 +108,10 @@
         "slicing": {
           "id": "3",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -161,7 +165,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-actor-Deceased-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-actor-Deceased-extension.json
old mode 100755
new mode 100644
index 5c697de..d3d7450
--- a/lib/resources/standard_health_record/StructureDefinition-shr-actor-Deceased-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-actor-Deceased-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.actor.Deceased"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Deceased Extension",
   "title": "SHR Deceased Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.515Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.831Z",
   "description": "An indication that the person is no longer living, given by a date, time of death, or a boolean value which, when true, indicates the person is deceased.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -107,7 +108,10 @@
         "slicing": {
           "id": "2",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -213,7 +217,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-actor-EmergencyContact.json b/lib/resources/standard_health_record/StructureDefinition-shr-actor-EmergencyContact.json
old mode 100755
new mode 100644
index 5a15bc3..3519804
--- a/lib/resources/standard_health_record/StructureDefinition-shr-actor-EmergencyContact.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-actor-EmergencyContact.json
@@ -3,7 +3,7 @@
   "id": "shr-actor-EmergencyContact",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR EmergencyContact Profile</b></p>\n  <p>A personal contact specifically designated to be used for emergencies.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.actor.EmergencyContact maps to CareTeam:\n  participant is 1..1\n  Provider maps to participant.member\n  HealthcareRole maps to participant.role\n  GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to participant.period\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR EmergencyContact Profile</b></p>\n  <p>A personal contact specifically designated to be used for emergencies.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.actor.EmergencyContact maps to CareTeam:\n  constrain participant to 1..1\n  Provider maps to participant.member\n  HealthcareRole maps to participant.role\n  GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to participant.period\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-actor-EmergencyContact",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.actor.EmergencyContact"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR EmergencyContact Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.552Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.846Z",
   "description": "A personal contact specifically designated to be used for emergencies.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "w5",
@@ -109,7 +110,7 @@
         "path": "CareTeam.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -148,7 +149,7 @@
         "path": "CareTeam.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -169,7 +170,7 @@
         "path": "CareTeam.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -189,6 +190,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -203,7 +212,7 @@
         "path": "CareTeam.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -237,7 +246,7 @@
         "path": "CareTeam.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -268,14 +277,17 @@
         "slicing": {
           "id": "13",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -304,6 +316,7 @@
         "path": "CareTeam.extension",
         "sliceName": "priority",
         "definition": "An ordinal numbered priority where 1=highest priority, 2=second highest priority, etc.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -337,14 +350,17 @@
         "slicing": {
           "id": "14",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -374,6 +390,7 @@
         "path": "CareTeam.modifierExtension",
         "sliceName": "nonoccurrencemodifier",
         "definition": "When true, indicates either that the event or action documented in the entry did not occur, or the the thing documented is absent or does not exist.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -424,17 +441,31 @@
       {
         "id": "CareTeam:shr-actor-EmergencyContact.status",
         "path": "CareTeam.status",
-        "short": "active | suspended | inactive | entered in error",
-        "definition": "Indicates whether the care team is currently active, suspended, inactive, or entered in error.",
+        "short": "proposed | active | suspended | inactive | entered-in-error",
+        "definition": "Indicates the current state of the care team.",
+        "comment": "This element is labeled as a modifier because the status contains the code entered-in-error that marks the care team as not currently valid.",
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "CodeableConcept"
+            "code": "code"
           }
         ],
         "isModifier": true,
         "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "CareTeamStatus"
+            }
+          ],
+          "strength": "required",
+          "description": "Indicates the status of the care team.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/care-team-status"
+          }
+        },
         "mapping": [
           {
             "identity": "w5",
@@ -447,7 +478,7 @@
         "path": "CareTeam.category",
         "short": "Type of team",
         "definition": "Identifies what kind of team.  This is to support differentiation between multiple co-existing teams, such as care plan team, episode of care team, longitudinal care team.",
-        "comments": "There may be multiple axis of categorization and one team may serve multiple purposes.",
+        "comment": "There may be multiple axis of categorization and one team may serve multiple purposes.",
         "requirements": "Used for filtering what teams(s) are retrieved and displayed to different types of users.",
         "min": 0,
         "max": "*",
@@ -457,6 +488,19 @@
           }
         ],
         "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "CareTeamCategory"
+            }
+          ],
+          "strength": "example",
+          "description": "Indicates the type of care team.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/care-team-category"
+          }
+        },
         "mapping": [
           {
             "identity": "w5",
@@ -469,7 +513,7 @@
         "path": "CareTeam.name",
         "short": "Name of the team, such as crisis assessment team",
         "definition": "A label for human use intended to distinguish like teams.  E.g. the \"red\" vs. \"green\" trauma teams.",
-        "comments": "The meaning/purpose of the team is conveyed in CareTeam.category.  This element may also convey semantics of the team (e.g. \"Red trauma team\"), but it's primary purpose is to distinguish between identical teams in a human-friendly way.  (\"Team 18735\" isn't as friendly . ).",
+        "comment": "The meaning/purpose of the team is conveyed in CareTeam.category.  This element may also convey semantics of the team (e.g. \"Red trauma team\"), but its primary purpose is to distinguish between identical teams in a human-friendly way.  (\"Team 18735\" isn't as friendly . ).",
         "min": 0,
         "max": "1",
         "type": [
@@ -485,6 +529,9 @@
         "short": "Who care team is for",
         "definition": "Identifies the patient or group whose intended care is handled by the team.",
         "requirements": "Allows the team to care for a group (e.g. marriage) therapy.",
+        "alias": [
+          "patient"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -505,6 +552,34 @@
           }
         ]
       },
+      {
+        "id": "CareTeam:shr-actor-EmergencyContact.context",
+        "path": "CareTeam.context",
+        "short": "Encounter or episode associated with CareTeam",
+        "definition": "The encounter or episode of care that establishes the context for this care team.",
+        "alias": [
+          "encounter"
+        ],
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "w5",
+            "map": "context"
+          }
+        ]
+      },
       {
         "id": "CareTeam:shr-actor-EmergencyContact.period",
         "path": "CareTeam.period",
@@ -538,6 +613,9 @@
             "code": "BackboneElement"
           }
         ],
+        "condition": [
+          "ctm-1"
+        ],
         "constraint": [
           {
             "key": "ele-1",
@@ -546,6 +624,13 @@
             "expression": "children().count() > id.count()",
             "xpath": "@value|f:*|h:div",
             "source": "Element"
+          },
+          {
+            "key": "ctm-1",
+            "severity": "error",
+            "human": "CareTeam.participant.onBehalfOf can only be populated when CareTeam.participant.member is a Practitioner",
+            "expression": "onBehalfOf.exists() implies (member.resolve() is Practitioner)",
+            "xpath": "contains(f:member, '/Practitioner') or not(exists(f:onBehalfOf))"
           }
         ],
         "mapping": [
@@ -555,7 +640,7 @@
           },
           {
             "identity": "rim",
-            "map": ".participation[typeCode=PFM]"
+            "map": ".participation[typeCode=PRF]"
           }
         ]
       },
@@ -591,7 +676,7 @@
         "path": "CareTeam.participant.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -620,7 +705,7 @@
         "path": "CareTeam.participant.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -652,7 +737,7 @@
         "path": "CareTeam.participant.role",
         "short": "Type of involvement",
         "definition": "Indicates specific responsibility of an individual within the care team, such as \"Primary care physician\", \"Trained social worker counselor\", \"Caregiver\", etc.",
-        "comments": "Roles may sometimes be inferred by type of Practitioner.  These are relationships that hold only within the context of the care team.  General relationships should be handled as properties of the Patient resource directly.",
+        "comment": "Roles may sometimes be inferred by type of Practitioner.  These are relationships that hold only within the context of the care team.  General relationships should be handled as properties of the Patient resource directly.",
         "min": 1,
         "max": "1",
         "type": [
@@ -673,7 +758,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-actor-HealthcareRoleVS"
+            "reference": "http://standardhealthrecord.org/shr/actor/vs/HealthcareRoleVS"
           }
         },
         "mapping": [
@@ -692,7 +777,7 @@
         "path": "CareTeam.participant.member",
         "short": "Who is involved",
         "definition": "The specific person or organization who is participating/expected to participate in the care team.",
-        "comments": "Patient only needs to be listed if they have a role other than \"subject of care\".\n\nMember is optional because some participants may be known only by their role, particularly in draft plans.",
+        "comment": "Patient only needs to be listed if they have a role other than \"subject of care\".\n\nMember is optional because some participants may be known only by their role, particularly in draft plans.",
         "min": 1,
         "max": "1",
         "type": [
@@ -711,6 +796,10 @@
           {
             "code": "Reference",
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CareTeam"
           }
         ],
         "isSummary": true,
@@ -729,6 +818,22 @@
           }
         ]
       },
+      {
+        "id": "CareTeam:shr-actor-EmergencyContact.participant.onBehalfOf",
+        "path": "CareTeam.participant.onBehalfOf",
+        "short": "Organization of the practitioner",
+        "definition": "The organization of the practitioner.",
+        "requirements": "Practitioners can be associated with multiple organizations.  This element indicates which organization they were acting on behalf of.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
+          }
+        ],
+        "isSummary": true
+      },
       {
         "id": "CareTeam:shr-actor-EmergencyContact.participant.period",
         "path": "CareTeam.participant.period",
@@ -743,6 +848,58 @@
           }
         ]
       },
+      {
+        "id": "CareTeam:shr-actor-EmergencyContact.reasonCode",
+        "path": "CareTeam.reasonCode",
+        "short": "Why the care team exists",
+        "definition": "Describes why the care team exists.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "CareTeamReason"
+            }
+          ],
+          "strength": "example",
+          "description": "Indicates the reason for the care team.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/clinical-findings"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "w5",
+            "map": "why"
+          }
+        ]
+      },
+      {
+        "id": "CareTeam:shr-actor-EmergencyContact.reasonReference",
+        "path": "CareTeam.reasonReference",
+        "short": "Why the care team exists",
+        "definition": "Condition(s) that this care team addresses.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Condition"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "w5",
+            "map": "why"
+          }
+        ]
+      },
       {
         "id": "CareTeam:shr-actor-EmergencyContact.managingOrganization",
         "path": "CareTeam.managingOrganization",
@@ -758,6 +915,19 @@
           }
         ],
         "isSummary": true
+      },
+      {
+        "id": "CareTeam:shr-actor-EmergencyContact.note",
+        "path": "CareTeam.note",
+        "short": "Comments made about the CareTeam",
+        "definition": "Comments made about the CareTeam.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Annotation"
+          }
+        ]
       }
     ]
   },
@@ -829,7 +999,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-actor-HealthcareRoleVS"
+            "reference": "http://standardhealthrecord.org/shr/actor/vs/HealthcareRoleVS"
           }
         }
       },
@@ -854,6 +1024,10 @@
           {
             "code": "Reference",
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CareTeam"
           }
         ]
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-actor-FictionalPerson-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-actor-FictionalPerson-extension.json
old mode 100755
new mode 100644
index a4ed0d4..bda6515
--- a/lib/resources/standard_health_record/StructureDefinition-shr-actor-FictionalPerson-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-actor-FictionalPerson-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.actor.FictionalPerson"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR FictionalPerson Extension",
   "title": "SHR FictionalPerson Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.513Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.829Z",
   "description": "Flag indicating if this record represents a fictional (synthetic, not real) person.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-actor-LanguageQualifier-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-actor-LanguageQualifier-extension.json
old mode 100755
new mode 100644
index 3d4d53c..ed07397
--- a/lib/resources/standard_health_record/StructureDefinition-shr-actor-LanguageQualifier-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-actor-LanguageQualifier-extension.json
@@ -3,7 +3,7 @@
   "id": "shr-actor-LanguageQualifier-extension",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR LanguageQualifier Extension</b></p>\n  <p>Additional information about a person&#039;s use of language.</p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR LanguageQualifier Extension</b></p>\n  <p>Additional information about a person's use of language.</p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-actor-LanguageQualifier-extension",
   "identifier": [
@@ -12,9 +12,11 @@
       "value": "shr.actor.LanguageQualifier"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR LanguageQualifier Extension",
   "title": "SHR LanguageQualifier Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.515Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.831Z",
   "description": "Additional information about a person's use of language.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -170,7 +170,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-actor-LanguageQualifierVS"
+            "reference": "http://standardhealthrecord.org/shr/actor/vs/LanguageQualifierVS"
           }
         },
         "mapping": [
@@ -221,7 +221,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-actor-LanguageQualifierVS"
+            "reference": "http://standardhealthrecord.org/shr/actor/vs/LanguageQualifierVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-actor-LanguageUsed-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-actor-LanguageUsed-extension.json
old mode 100755
new mode 100644
index b3d8abb..2aef948
--- a/lib/resources/standard_health_record/StructureDefinition-shr-actor-LanguageUsed-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-actor-LanguageUsed-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.actor.LanguageUsed"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR LanguageUsed Extension",
   "title": "SHR LanguageUsed Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.514Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.830Z",
   "description": "Language used for communication by a human, either the subject of record, parent, or other involved person.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -107,7 +108,10 @@
         "slicing": {
           "id": "1",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -239,7 +243,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-base-PriorityOfRequest-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-actor-MedicalSpecialty-extension.json
old mode 100755
new mode 100644
similarity index 69%
rename from lib/resources/standard_health_record/StructureDefinition-shr-base-PriorityOfRequest-extension.json
rename to lib/resources/standard_health_record/StructureDefinition-shr-actor-MedicalSpecialty-extension.json
index de2541a..372186a
--- a/lib/resources/standard_health_record/StructureDefinition-shr-base-PriorityOfRequest-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-actor-MedicalSpecialty-extension.json
@@ -1,20 +1,22 @@
 {
   "resourceType": "StructureDefinition",
-  "id": "shr-base-PriorityOfRequest-extension",
+  "id": "shr-actor-MedicalSpecialty-extension",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR PriorityOfRequest Extension</b></p>\n  <p>Urgency level for which results must be reported to the requestor or responsible individual.</p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR MedicalSpecialty Extension</b></p>\n  <p>A branch of medicine practiced by the provider.</p>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-PriorityOfRequest-extension",
+  "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-actor-MedicalSpecialty-extension",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
-      "value": "shr.base.PriorityOfRequest"
+      "value": "shr.actor.MedicalSpecialty"
     }
   ],
-  "name": "SHR PriorityOfRequest Extension",
-  "title": "SHR PriorityOfRequest Extension",
+  "version": "0.0.1",
+  "name": "SHR MedicalSpecialty Extension",
+  "title": "SHR MedicalSpecialty Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.526Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.282Z",
-  "description": "Urgency level for which results must be reported to the requestor or responsible individual.",
-  "fhirVersion": "1.8.0",
+  "description": "A branch of medicine practiced by the provider.",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -41,10 +42,10 @@
   "snapshot": {
     "element": [
       {
-        "id": "Extension:priorityofrequest",
+        "id": "Extension:medicalspecialty",
         "path": "Extension",
-        "short": "SHR PriorityOfRequest Extension",
-        "definition": "Urgency level for which results must be reported to the requestor or responsible individual.",
+        "short": "SHR MedicalSpecialty Extension",
+        "definition": "A branch of medicine practiced by the provider.",
         "min": 0,
         "max": "*",
         "base": {
@@ -75,7 +76,7 @@
         ]
       },
       {
-        "id": "Extension:priorityofrequest.id",
+        "id": "Extension:medicalspecialty.id",
         "path": "Extension.id",
         "representation": [
           "xmlAttr"
@@ -102,7 +103,7 @@
         ]
       },
       {
-        "id": "Extension:priorityofrequest.extension:extension",
+        "id": "Extension:medicalspecialty.extension:extension",
         "path": "Extension.extension",
         "sliceName": "extension",
         "short": "Extension",
@@ -121,14 +122,13 @@
         ]
       },
       {
-        "id": "Extension:priorityofrequest.url",
+        "id": "Extension:medicalspecialty.url",
         "path": "Extension.url",
         "representation": [
           "xmlAttr"
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -141,7 +141,7 @@
             "code": "uri"
           }
         ],
-        "fixedUri": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-PriorityOfRequest-extension",
+        "fixedUri": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-actor-MedicalSpecialty-extension",
         "mapping": [
           {
             "identity": "rim",
@@ -150,8 +150,8 @@
         ]
       },
       {
-        "id": "Extension:priorityofrequest.valueCode",
-        "path": "Extension.valueCode",
+        "id": "Extension:medicalspecialty.valueCodeableConcept",
+        "path": "Extension.valueCodeableConcept",
         "short": "Value of extension",
         "definition": "Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).",
         "min": 1,
@@ -163,13 +163,14 @@
         },
         "type": [
           {
-            "code": "code"
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
           }
         ],
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/procedure-request-priority"
+            "reference": "http://hl7.org/fhir/ValueSet/c80-practice-codes"
           }
         },
         "mapping": [
@@ -184,42 +185,43 @@
   "differential": {
     "element": [
       {
-        "id": "Extension:priorityofrequest",
+        "id": "Extension:medicalspecialty",
         "path": "Extension",
-        "short": "SHR PriorityOfRequest Extension",
-        "definition": "Urgency level for which results must be reported to the requestor or responsible individual.",
+        "short": "SHR MedicalSpecialty Extension",
+        "definition": "A branch of medicine practiced by the provider.",
         "min": 0,
         "max": "*"
       },
       {
-        "id": "Extension:priorityofrequest.extension:extension",
+        "id": "Extension:medicalspecialty.extension:extension",
         "path": "Extension.extension",
         "sliceName": "extension",
         "max": "0"
       },
       {
-        "id": "Extension:priorityofrequest.url",
+        "id": "Extension:medicalspecialty.url",
         "path": "Extension.url",
         "type": [
           {
             "code": "uri"
           }
         ],
-        "fixedUri": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-PriorityOfRequest-extension"
+        "fixedUri": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-actor-MedicalSpecialty-extension"
       },
       {
-        "id": "Extension:priorityofrequest.valueCode",
-        "path": "Extension.valueCode",
+        "id": "Extension:medicalspecialty.valueCodeableConcept",
+        "path": "Extension.valueCodeableConcept",
         "min": 1,
         "type": [
           {
-            "code": "code"
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
           }
         ],
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/procedure-request-priority"
+            "reference": "http://hl7.org/fhir/ValueSet/c80-practice-codes"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-actor-NoPrimaryCareProvider.json b/lib/resources/standard_health_record/StructureDefinition-shr-actor-NoPrimaryCareProvider.json
old mode 100755
new mode 100644
index 346e562..365dbd8
--- a/lib/resources/standard_health_record/StructureDefinition-shr-actor-NoPrimaryCareProvider.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-actor-NoPrimaryCareProvider.json
@@ -3,7 +3,7 @@
   "id": "shr-actor-NoPrimaryCareProvider",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR NoPrimaryCareProvider Profile</b></p>\n  <p>The medical professional responsible for first-line care of an individual.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.actor.NoPrimaryCareProvider maps to CareTeam:\n  participant is 1..1\n  Provider maps to participant.member\n  HealthcareRole maps to participant.role\n  GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to participant.period\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR NoPrimaryCareProvider Profile</b></p>\n  <p>The medical professional responsible for first-line care of an individual.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.actor.NoPrimaryCareProvider maps to CareTeam:\n  constrain participant to 1..1\n  Provider maps to participant.member\n  HealthcareRole maps to participant.role\n  GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to participant.period\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-actor-NoPrimaryCareProvider",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.actor.NoPrimaryCareProvider"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR NoPrimaryCareProvider Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.564Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.852Z",
   "description": "The medical professional responsible for first-line care of an individual.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "w5",
@@ -109,7 +110,7 @@
         "path": "CareTeam.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -148,7 +149,7 @@
         "path": "CareTeam.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -169,7 +170,7 @@
         "path": "CareTeam.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -189,6 +190,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -203,7 +212,7 @@
         "path": "CareTeam.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -237,7 +246,7 @@
         "path": "CareTeam.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -268,14 +277,17 @@
         "slicing": {
           "id": "16",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -304,6 +316,7 @@
         "path": "CareTeam.extension",
         "sliceName": "priority",
         "definition": "An ordinal numbered priority where 1=highest priority, 2=second highest priority, etc.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -337,14 +350,17 @@
         "slicing": {
           "id": "17",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -374,6 +390,7 @@
         "path": "CareTeam.modifierExtension",
         "sliceName": "nonoccurrencemodifier",
         "definition": "When true, indicates either that the event or action documented in the entry did not occur, or the the thing documented is absent or does not exist.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -434,7 +451,10 @@
         "slicing": {
           "id": "10",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -534,7 +554,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -614,7 +633,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -793,17 +811,31 @@
       {
         "id": "CareTeam:shr-actor-NoPrimaryCareProvider.status",
         "path": "CareTeam.status",
-        "short": "active | suspended | inactive | entered in error",
-        "definition": "Indicates whether the care team is currently active, suspended, inactive, or entered in error.",
+        "short": "proposed | active | suspended | inactive | entered-in-error",
+        "definition": "Indicates the current state of the care team.",
+        "comment": "This element is labeled as a modifier because the status contains the code entered-in-error that marks the care team as not currently valid.",
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "CodeableConcept"
+            "code": "code"
           }
         ],
         "isModifier": true,
         "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "CareTeamStatus"
+            }
+          ],
+          "strength": "required",
+          "description": "Indicates the status of the care team.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/care-team-status"
+          }
+        },
         "mapping": [
           {
             "identity": "w5",
@@ -816,7 +848,7 @@
         "path": "CareTeam.category",
         "short": "Type of team",
         "definition": "Identifies what kind of team.  This is to support differentiation between multiple co-existing teams, such as care plan team, episode of care team, longitudinal care team.",
-        "comments": "There may be multiple axis of categorization and one team may serve multiple purposes.",
+        "comment": "There may be multiple axis of categorization and one team may serve multiple purposes.",
         "requirements": "Used for filtering what teams(s) are retrieved and displayed to different types of users.",
         "min": 0,
         "max": "*",
@@ -826,6 +858,19 @@
           }
         ],
         "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "CareTeamCategory"
+            }
+          ],
+          "strength": "example",
+          "description": "Indicates the type of care team.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/care-team-category"
+          }
+        },
         "mapping": [
           {
             "identity": "w5",
@@ -838,7 +883,7 @@
         "path": "CareTeam.name",
         "short": "Name of the team, such as crisis assessment team",
         "definition": "A label for human use intended to distinguish like teams.  E.g. the \"red\" vs. \"green\" trauma teams.",
-        "comments": "The meaning/purpose of the team is conveyed in CareTeam.category.  This element may also convey semantics of the team (e.g. \"Red trauma team\"), but it's primary purpose is to distinguish between identical teams in a human-friendly way.  (\"Team 18735\" isn't as friendly . ).",
+        "comment": "The meaning/purpose of the team is conveyed in CareTeam.category.  This element may also convey semantics of the team (e.g. \"Red trauma team\"), but its primary purpose is to distinguish between identical teams in a human-friendly way.  (\"Team 18735\" isn't as friendly . ).",
         "min": 0,
         "max": "1",
         "type": [
@@ -854,6 +899,9 @@
         "short": "Who care team is for",
         "definition": "Identifies the patient or group whose intended care is handled by the team.",
         "requirements": "Allows the team to care for a group (e.g. marriage) therapy.",
+        "alias": [
+          "patient"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -874,6 +922,34 @@
           }
         ]
       },
+      {
+        "id": "CareTeam:shr-actor-NoPrimaryCareProvider.context",
+        "path": "CareTeam.context",
+        "short": "Encounter or episode associated with CareTeam",
+        "definition": "The encounter or episode of care that establishes the context for this care team.",
+        "alias": [
+          "encounter"
+        ],
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "w5",
+            "map": "context"
+          }
+        ]
+      },
       {
         "id": "CareTeam:shr-actor-NoPrimaryCareProvider.period",
         "path": "CareTeam.period",
@@ -907,6 +983,9 @@
             "code": "BackboneElement"
           }
         ],
+        "condition": [
+          "ctm-1"
+        ],
         "constraint": [
           {
             "key": "ele-1",
@@ -915,6 +994,13 @@
             "expression": "children().count() > id.count()",
             "xpath": "@value|f:*|h:div",
             "source": "Element"
+          },
+          {
+            "key": "ctm-1",
+            "severity": "error",
+            "human": "CareTeam.participant.onBehalfOf can only be populated when CareTeam.participant.member is a Practitioner",
+            "expression": "onBehalfOf.exists() implies (member.resolve() is Practitioner)",
+            "xpath": "contains(f:member, '/Practitioner') or not(exists(f:onBehalfOf))"
           }
         ],
         "mapping": [
@@ -924,7 +1010,7 @@
           },
           {
             "identity": "rim",
-            "map": ".participation[typeCode=PFM]"
+            "map": ".participation[typeCode=PRF]"
           }
         ]
       },
@@ -960,7 +1046,7 @@
         "path": "CareTeam.participant.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -989,7 +1075,7 @@
         "path": "CareTeam.participant.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1021,7 +1107,7 @@
         "path": "CareTeam.participant.role",
         "short": "Type of involvement",
         "definition": "Indicates specific responsibility of an individual within the care team, such as \"Primary care physician\", \"Trained social worker counselor\", \"Caregiver\", etc.",
-        "comments": "Roles may sometimes be inferred by type of Practitioner.  These are relationships that hold only within the context of the care team.  General relationships should be handled as properties of the Patient resource directly.",
+        "comment": "Roles may sometimes be inferred by type of Practitioner.  These are relationships that hold only within the context of the care team.  General relationships should be handled as properties of the Patient resource directly.",
         "min": 1,
         "max": "1",
         "type": [
@@ -1042,7 +1128,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-actor-HealthcareRoleVS"
+            "reference": "http://standardhealthrecord.org/shr/actor/vs/HealthcareRoleVS"
           }
         },
         "mapping": [
@@ -1061,7 +1147,7 @@
         "path": "CareTeam.participant.member",
         "short": "Who is involved",
         "definition": "The specific person or organization who is participating/expected to participate in the care team.",
-        "comments": "Patient only needs to be listed if they have a role other than \"subject of care\".\n\nMember is optional because some participants may be known only by their role, particularly in draft plans.",
+        "comment": "Patient only needs to be listed if they have a role other than \"subject of care\".\n\nMember is optional because some participants may be known only by their role, particularly in draft plans.",
         "min": 0,
         "max": "0",
         "type": [
@@ -1080,6 +1166,10 @@
           {
             "code": "Reference",
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CareTeam"
           }
         ],
         "isSummary": true,
@@ -1098,6 +1188,22 @@
           }
         ]
       },
+      {
+        "id": "CareTeam:shr-actor-NoPrimaryCareProvider.participant.onBehalfOf",
+        "path": "CareTeam.participant.onBehalfOf",
+        "short": "Organization of the practitioner",
+        "definition": "The organization of the practitioner.",
+        "requirements": "Practitioners can be associated with multiple organizations.  This element indicates which organization they were acting on behalf of.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
+          }
+        ],
+        "isSummary": true
+      },
       {
         "id": "CareTeam:shr-actor-NoPrimaryCareProvider.participant.period",
         "path": "CareTeam.participant.period",
@@ -1112,6 +1218,58 @@
           }
         ]
       },
+      {
+        "id": "CareTeam:shr-actor-NoPrimaryCareProvider.reasonCode",
+        "path": "CareTeam.reasonCode",
+        "short": "Why the care team exists",
+        "definition": "Describes why the care team exists.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "CareTeamReason"
+            }
+          ],
+          "strength": "example",
+          "description": "Indicates the reason for the care team.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/clinical-findings"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "w5",
+            "map": "why"
+          }
+        ]
+      },
+      {
+        "id": "CareTeam:shr-actor-NoPrimaryCareProvider.reasonReference",
+        "path": "CareTeam.reasonReference",
+        "short": "Why the care team exists",
+        "definition": "Condition(s) that this care team addresses.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Condition"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "w5",
+            "map": "why"
+          }
+        ]
+      },
       {
         "id": "CareTeam:shr-actor-NoPrimaryCareProvider.managingOrganization",
         "path": "CareTeam.managingOrganization",
@@ -1127,6 +1285,19 @@
           }
         ],
         "isSummary": true
+      },
+      {
+        "id": "CareTeam:shr-actor-NoPrimaryCareProvider.note",
+        "path": "CareTeam.note",
+        "short": "Comments made about the CareTeam",
+        "definition": "Comments made about the CareTeam.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Annotation"
+          }
+        ]
       }
     ]
   },
@@ -1199,7 +1370,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-actor-HealthcareRoleVS"
+            "reference": "http://standardhealthrecord.org/shr/actor/vs/HealthcareRoleVS"
           }
         }
       },
@@ -1224,6 +1395,10 @@
           {
             "code": "Reference",
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CareTeam"
           }
         ]
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-actor-Organization.json b/lib/resources/standard_health_record/StructureDefinition-shr-actor-Organization.json
old mode 100755
new mode 100644
index e099d04..5af8f82
--- a/lib/resources/standard_health_record/StructureDefinition-shr-actor-Organization.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-actor-Organization.json
@@ -3,7 +3,7 @@
   "id": "shr-actor-Organization",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR Organization Profile</b></p>\n  <p>A social or legal structure formed by human beings.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.actor.Organization maps to Organization:\n  OrganizationName maps to name\n  OrganizationAlias maps to alias  // I wish FHIR allowed multiple names, but it doesn&#039;t\n  OrganizationType maps to type\n  OrganizationIdentifyingCode maps to identifier\n  AddressUsed maps to address\n  Telecom maps to telecom\n  ActiveFlag maps to active\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR Organization Profile</b></p>\n  <p>A social or legal structure formed by human beings.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.actor.Organization maps to Organization:\n  OrganizationName maps to name\n  OrganizationAlias maps to alias  // I wish FHIR allowed multiple names, but it doesn't\n  OrganizationType maps to type\n  OrganizationIdentifyingCode maps to identifier\n  AddressUsed maps to address\n  Telecom maps to telecom\n  ActiveFlag maps to active\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-actor-Organization",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.actor.Organization"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Organization Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.528Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.840Z",
   "description": "A social or legal structure formed by human beings.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "v2",
@@ -133,7 +134,7 @@
         "path": "Organization.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -172,7 +173,7 @@
         "path": "Organization.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -193,7 +194,7 @@
         "path": "Organization.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -213,6 +214,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -227,7 +236,7 @@
         "path": "Organization.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -261,7 +270,7 @@
         "path": "Organization.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -291,7 +300,7 @@
         "path": "Organization.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -320,7 +329,7 @@
         "path": "Organization.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -387,7 +396,7 @@
         "path": "Organization.active",
         "short": "Whether the organization's record is still in active use",
         "definition": "Whether the organization's record is still in active use.",
-        "comments": "Default is true.\n\nThis active flag is not intended to be used to mark an organizations as temporarily closed or under construction. Instead the Location(s) within the Organization should have the suspended status. If further details of the reason for the suspension are required, then an extension on this element should be used.",
+        "comment": "Default is true.\n\nThis active flag is not intended to be used to mark an organizations as temporarily closed or under construction. Instead the Location(s) within the Organization should have the suspended status. If further details of the reason for the suspension are required, then an extension on this element should be used.\n\nThis element is labeled as a modifier because it may be used to mark that the resource was created in error.",
         "requirements": "Need a flag to indicate a record is no longer to be used and should generally be hidden for the user in the UI.",
         "min": 0,
         "max": "1",
@@ -422,8 +431,8 @@
         "id": "Organization:shr-actor-Organization.type",
         "path": "Organization.type",
         "short": "Kind of organization",
-        "definition": "The kind of organization that this is.",
-        "comments": "Organizations can be corporations, wards, sections, clinical teams, government departments, etc. Note that code is generally a classifier of the type of organization; in many applications, codes are used to identity a particular organization (say, ward) as opposed to another of the same type - these are identifiers, not codes.",
+        "definition": "The kind(s) of organization that this is.",
+        "comment": "Organizations can be corporations, wards, sections, clinical teams, government departments, etc. Note that code is generally a classifier of the type of organization; in many applications, codes are used to identity a particular organization (say, ward) as opposed to another of the same type - these are identifiers, not codes\n\nWhen considering if multiple types are appropriate, you should evaluate if child organizations would be a more appropriate use of the concept, as different types likely are in different sub-areas of the organization. This is most likely to be used where type values have orthogonal values, such as a religious, academic and medical center.\n\nWe expect that some jurisdictions will profile this optionality to be a single cardinality.",
         "requirements": "Need to be able to track the kind of organization that this is - different organization types have different uses.",
         "min": 1,
         "max": "1",
@@ -435,6 +444,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "OrganizationType"
+            }
+          ],
           "strength": "example",
           "description": "Used to categorize the organization",
           "valueSetReference": {
@@ -465,7 +480,7 @@
         "path": "Organization.name",
         "short": "Name used for the organization",
         "definition": "A name associated with the organization.",
-        "comments": "If the name of an organization changes, consider putting the old name in the alias column so that it can still be located through searches.",
+        "comment": "If the name of an organization changes, consider putting the old name in the alias column so that it can still be located through searches.",
         "requirements": "Need to use the name as the label of the organization.",
         "min": 1,
         "max": "1",
@@ -498,8 +513,8 @@
         "path": "Organization.alias",
         "short": "A list of alternate names that the organization is known as, or was known as in the past",
         "definition": "A list of alternate names that the organization is known as, or was known as in the past.",
-        "comments": "There are no dates associated with the alias/historic names, as this is not intended to track when names were used, but to assist in searching so that older names can still result in identifying the organization.",
-        "requirements": "Over time locations and organizations go through many changes and can be known by different names.\n\nFor searching knowing previous names that the location was known by can be very useful.",
+        "comment": "There are no dates associated with the alias/historic names, as this is not intended to track when names were used, but to assist in searching so that older names can still result in identifying the organization.",
+        "requirements": "Over time locations and organizations go through many changes and can be known by different names.\n\nFor searching knowing previous names that the organization was known by can be very useful.",
         "min": 0,
         "max": "*",
         "type": [
@@ -519,7 +534,7 @@
         "path": "Organization.telecom",
         "short": "A contact detail for the organization",
         "definition": "A contact detail for the organization.",
-        "comments": "The use code home is not to be used. Note that these contacts are not the contact details of people who are employed by or represent the organization, but official contacts for the organization itself.",
+        "comment": "The use code home is not to be used. Note that these contacts are not the contact details of people who are employed by or represent the organization, but official contacts for the organization itself.",
         "requirements": "Human contact for the organization.",
         "min": 0,
         "max": "*",
@@ -561,7 +576,7 @@
         "path": "Organization.address",
         "short": "An address for the organization",
         "definition": "An address for the organization.",
-        "comments": "Organization may have multiple addresses with different uses or applicable periods. The use code home is not to be used.",
+        "comment": "Organization may have multiple addresses with different uses or applicable periods. The use code home is not to be used.",
         "requirements": "May need to keep track of the organization's addresses for contacting, billing or reporting requirements.",
         "min": 0,
         "max": "*",
@@ -633,7 +648,7 @@
         "path": "Organization.contact",
         "short": "Contact for the organization for a certain purpose",
         "definition": "Contact for the organization for a certain purpose.",
-        "comments": "Where multiple contacts for the same purpose are provided there is a standard extension that can be used to determine which one is the preferred contact to use.",
+        "comment": "Where multiple contacts for the same purpose are provided there is a standard extension that can be used to determine which one is the preferred contact to use.",
         "requirements": "Need to keep track of assigned contact points within bigger organization.",
         "min": 0,
         "max": "*",
@@ -691,7 +706,7 @@
         "path": "Organization.contact.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -720,7 +735,7 @@
         "path": "Organization.contact.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -761,6 +776,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ContactPartyType"
+            }
+          ],
           "strength": "extensible",
           "description": "The purpose for which you would contact a contact party",
           "valueSetReference": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-actor-Participant-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-actor-Participant-extension.json
old mode 100755
new mode 100644
index a8e8a7e..41ebc7a
--- a/lib/resources/standard_health_record/StructureDefinition-shr-actor-Participant-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-actor-Participant-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.actor.Participant"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Participant Extension",
   "title": "SHR Participant Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.350Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.280Z",
   "description": "A statement about an actor who did (or did not) participate in a certain task or activity. Unlike a HealthcareInvolvement which continues over period of time, the participant is associated with doing or not doing a specific task, such admitting a patient, performing a procedure, or taking a measurement.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -111,9 +112,12 @@
         "id": "Extension:participant.extension",
         "path": "Extension.extension",
         "slicing": {
-          "id": "183",
+          "id": "180",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -323,7 +327,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-actor-ParticipationType-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-actor-ParticipationType-extension.json
old mode 100755
new mode 100644
index 945a534..cae329c
--- a/lib/resources/standard_health_record/StructureDefinition-shr-actor-ParticipationType-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-actor-ParticipationType-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.actor.ParticipationType"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ParticipationType Extension",
   "title": "SHR ParticipationType Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.350Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.281Z",
   "description": "The detail of how the performer engaged in the task, for example, as the attending physician, surgical assistant, etc.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-actor-Practitioner-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-actor-Practitioner-extension.json
old mode 100755
new mode 100644
index 7599ace..ed07f7e
--- a/lib/resources/standard_health_record/StructureDefinition-shr-actor-Practitioner-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-actor-Practitioner-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.actor.Practitioner"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Practitioner Extension",
   "title": "SHR Practitioner Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.350Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.281Z",
   "description": "A person who practices a healing art.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-actor-Practitioner.json b/lib/resources/standard_health_record/StructureDefinition-shr-actor-Practitioner.json
old mode 100755
new mode 100644
index 8f46520..5491a7a
--- a/lib/resources/standard_health_record/StructureDefinition-shr-actor-Practitioner.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-actor-Practitioner.json
@@ -3,7 +3,7 @@
   "id": "shr-actor-Practitioner",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR Practitioner Profile</b></p>\n  <p>A person who practices a healing art.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.actor.Practitioner maps to Practitioner:\n  HumanName maps to name\n  DateOfBirth maps to birthDate\n  AdministrativeGender maps to gender\n  AddressUsed maps to address\n  Telecom maps to telecom\n  LanguageUsed maps to communication\n  Affiliation maps to role.organization  // not exactly\n  NationalProviderIdentifier maps to identifier\n  MedicalSpecialty maps to role.specialty\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR Practitioner Profile</b></p>\n  <p>A person who practices a healing art.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.actor.Practitioner maps to Practitioner:\n  HumanName maps to name\n  DateOfBirth maps to birthDate\n  AdministrativeGender maps to gender\n  AddressUsed maps to address\n  Telecom maps to telecom\n  LanguageUsed maps to communication\n  NationalProviderIdentifier maps to identifier\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-actor-Practitioner",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.actor.Practitioner"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Practitioner Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.521Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,10 +27,9 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.837Z",
   "description": "A person who practices a healing art.",
   "purpose": "Need to track doctors, staff, locums etc. for both healthcare practitioners, funders, etc.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "v2",
@@ -63,7 +64,7 @@
         "path": "Practitioner",
         "short": "SHR Practitioner Profile",
         "definition": "A person who practices a healing art.",
-        "comments": "Note that a cab driver no longer fits the bill. You probably would be interested in the organization rather than the individual?",
+        "comment": "Note that a cab driver no longer fits the bill. You probably would be interested in the organization rather than the individual?",
         "min": 0,
         "max": "*",
         "constraint": [
@@ -128,7 +129,7 @@
         "path": "Practitioner.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -167,7 +168,7 @@
         "path": "Practitioner.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -188,7 +189,7 @@
         "path": "Practitioner.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -208,6 +209,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -222,7 +231,7 @@
         "path": "Practitioner.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -256,7 +265,7 @@
         "path": "Practitioner.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -287,14 +296,17 @@
         "slicing": {
           "id": "9",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -323,6 +335,7 @@
         "path": "Practitioner.extension",
         "sliceName": "anonymized",
         "definition": "Flag indicating if personally identifiable information has been withheld.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -355,6 +368,7 @@
         "path": "Practitioner.extension",
         "sliceName": "fictionalperson",
         "definition": "Flag indicating if this record represents a fictional (synthetic, not real) person.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -387,6 +401,7 @@
         "path": "Practitioner.extension",
         "sliceName": "deceased",
         "definition": "An indication that the person is no longer living, given by a date, time of death, or a boolean value which, when true, indicates the person is deceased.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -414,12 +429,78 @@
           }
         ]
       },
+      {
+        "id": "Practitioner:shr-actor-Practitioner.extension:affiliation",
+        "path": "Practitioner.extension",
+        "sliceName": "affiliation",
+        "definition": "Membership, association, or connection to an organization.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "DomainResource.extension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-actor-Affiliation-extension"
+          }
+        ],
+        "mustSupport": false,
+        "isModifier": false,
+        "isSummary": false,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "N/A"
+          }
+        ]
+      },
+      {
+        "id": "Practitioner:shr-actor-Practitioner.extension:medicalspecialty",
+        "path": "Practitioner.extension",
+        "sliceName": "medicalspecialty",
+        "definition": "A branch of medicine practiced by the provider.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "DomainResource.extension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-actor-MedicalSpecialty-extension"
+          }
+        ],
+        "mustSupport": false,
+        "isModifier": false,
+        "isSummary": false,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "N/A"
+          }
+        ]
+      },
       {
         "id": "Practitioner:shr-actor-Practitioner.modifierExtension",
         "path": "Practitioner.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -483,7 +564,7 @@
         "path": "Practitioner.active",
         "short": "Whether this practitioner's record is in active use",
         "definition": "Whether this practitioner's record is in active use.",
-        "comments": "Default is true. \r\rIf the practitioner is not in use by one organization, then it should mark the period on the PractitonerRole with an end date (even if they are active) as they may be active in another role.",
+        "comment": "Default is true. \r\rIf the practitioner is not in use by one organization, then it should mark the period on the PractitonerRole with an end date (even if they are active) as they may be active in another role.",
         "requirements": "Need to be able to mark a practitioner record as not to be used because it was created in error.",
         "min": 0,
         "max": "1",
@@ -510,7 +591,7 @@
         "path": "Practitioner.name",
         "short": "The name(s) associated with the practitioner",
         "definition": "The name(s) associated with the practitioner.",
-        "comments": "The selection of the use property should ensure that there is a single usual name specified, and others use the nickname (alias), old, or other values as appropriate.\r\rIn general select the value to be used in the ResourceReference.display based on this:\r\r1. There is more than 1 name\r2. Use = usual\r3. Period is current to the date of the usage\r4. Use = official\r5. Other order as decided by internal business rules.",
+        "comment": "The selection of the use property should ensure that there is a single usual name specified, and others use the nickname (alias), old, or other values as appropriate.\r\rIn general select the value to be used in the ResourceReference.display based on this:\r\r1. There is more than 1 name\r2. Use = usual\r3. Period is current to the date of the usage\r4. Use = official\r5. Other order as decided by internal business rules.",
         "requirements": "The name(s) that a Practitioner is known by. Where there are multiple, the name that the practitioner is usually known as should be used in the display.",
         "min": 1,
         "max": "1",
@@ -541,7 +622,7 @@
         "path": "Practitioner.telecom",
         "short": "A contact detail for the practitioner (that apply to all roles)",
         "definition": "A contact detail for the practitioner, e.g. a telephone number or an email address.",
-        "comments": "Person may have multiple ways to be contacted with different uses or applicable periods.  May need to have options for contacting the person urgently, and also to help with identification\r\rThese typically will have home numbers, or mobile numbers that are not role specific.",
+        "comment": "Person may have multiple ways to be contacted with different uses or applicable periods.  May need to have options for contacting the person urgently, and also to help with identification\r\rThese typically will have home numbers, or mobile numbers that are not role specific.",
         "requirements": "Need to know how to reach a practitioner independent to any roles the practitioner may have.",
         "min": 0,
         "max": "*",
@@ -572,7 +653,7 @@
         "path": "Practitioner.address",
         "short": "Address(es) of the practitioner that are not role specific (typically home address)",
         "definition": "Address(es) of the practitioner that are not role specific (typically home address). \rWork addresses are not typically entered in this property as they are usually role dependent.",
-        "comments": "The PractitionerRole does not have an address value on it, as it is expected that the location property be used for this purpose (which has an address).",
+        "comment": "The PractitionerRole does not have an address value on it, as it is expected that the location property be used for this purpose (which has an address).",
         "requirements": "The home/mailing address of the practitioner is often required for employee administration purposes, and also for some rostering services where the start point (practitioners home) can be used in calculations.",
         "min": 0,
         "max": "*",
@@ -613,6 +694,16 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AdministrativeGender"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
+            }
+          ],
           "strength": "required",
           "description": "The gender of a person used for administrative purposes.",
           "valueSetReference": {
@@ -687,359 +778,6 @@
           }
         ]
       },
-      {
-        "id": "Practitioner:shr-actor-Practitioner.role",
-        "path": "Practitioner.role",
-        "short": "Roles/organizations the practitioner is associated with",
-        "definition": "The list of roles/organizations that the practitioner is associated with.",
-        "comments": "The address to be used for this PractitionerRole is in the referenced location (removing duplication across all the services provided at the location).",
-        "min": 0,
-        "max": "*",
-        "type": [
-          {
-            "code": "BackboneElement"
-          }
-        ],
-        "constraint": [
-          {
-            "key": "ele-1",
-            "severity": "error",
-            "human": "All FHIR elements must have a @value or children",
-            "expression": "children().count() > id.count()",
-            "xpath": "@value|f:*|h:div",
-            "source": "Element"
-          }
-        ],
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": ".playingEntity.playingRole"
-          }
-        ]
-      },
-      {
-        "id": "Practitioner:shr-actor-Practitioner.role.id",
-        "path": "Practitioner.role.id",
-        "representation": [
-          "xmlAttr"
-        ],
-        "short": "xml:id (or equivalent in JSON)",
-        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "Element.id",
-          "min": 0,
-          "max": "1"
-        },
-        "type": [
-          {
-            "code": "string"
-          }
-        ],
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "n/a"
-          }
-        ]
-      },
-      {
-        "id": "Practitioner:shr-actor-Practitioner.role.extension",
-        "path": "Practitioner.role.extension",
-        "short": "Additional Content defined by implementations",
-        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
-        "alias": [
-          "extensions",
-          "user content"
-        ],
-        "min": 0,
-        "max": "*",
-        "base": {
-          "path": "Element.extension",
-          "min": 0,
-          "max": "*"
-        },
-        "type": [
-          {
-            "code": "Extension"
-          }
-        ],
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "n/a"
-          }
-        ]
-      },
-      {
-        "id": "Practitioner:shr-actor-Practitioner.role.modifierExtension",
-        "path": "Practitioner.role.modifierExtension",
-        "short": "Extensions that cannot be ignored",
-        "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
-        "alias": [
-          "extensions",
-          "user content",
-          "modifiers"
-        ],
-        "min": 0,
-        "max": "*",
-        "base": {
-          "path": "BackboneElement.modifierExtension",
-          "min": 0,
-          "max": "*"
-        },
-        "type": [
-          {
-            "code": "Extension"
-          }
-        ],
-        "isModifier": true,
-        "isSummary": true,
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "N/A"
-          }
-        ]
-      },
-      {
-        "id": "Practitioner:shr-actor-Practitioner.role.organization",
-        "path": "Practitioner.role.organization",
-        "short": "Organization where the roles are performed",
-        "definition": "The organization where the Practitioner performs the roles associated.",
-        "min": 0,
-        "max": "1",
-        "type": [
-          {
-            "code": "Reference",
-            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-actor-Organization"
-          }
-        ],
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": ".playingEntity.playingRole.scopingOrganization"
-          }
-        ]
-      },
-      {
-        "id": "Practitioner:shr-actor-Practitioner.role.code",
-        "path": "Practitioner.role.code",
-        "short": "Roles which this practitioner may perform",
-        "definition": "Roles which this practitioner is authorized to perform for the organization.",
-        "comments": "A person may have more than one role. At least one role is required.",
-        "requirements": "Need to know what authority the practitioner has - what can they do?",
-        "min": 0,
-        "max": "1",
-        "type": [
-          {
-            "code": "CodeableConcept"
-          }
-        ],
-        "isSummary": true,
-        "binding": {
-          "strength": "example",
-          "description": "The role a person plays representing an organization",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/practitioner-role"
-          }
-        },
-        "mapping": [
-          {
-            "identity": "v2",
-            "map": "PRD-1 / STF-18  / PRA-3  / PRT-4  / ROL-3 / ORC-12 / OBR-16 / PV1-7 / PV1-8 / PV1-9 / PV1-17"
-          },
-          {
-            "identity": "rim",
-            "map": ".playingEntity.playingRole.code"
-          },
-          {
-            "identity": "servd",
-            "map": "(ServD maps Practitioners and Organizations via another entity, so this concept is not available)"
-          }
-        ]
-      },
-      {
-        "id": "Practitioner:shr-actor-Practitioner.role.specialty",
-        "path": "Practitioner.role.specialty",
-        "short": "Specific specialty of the practitioner",
-        "definition": "Specific specialty of the practitioner.",
-        "min": 0,
-        "max": "*",
-        "type": [
-          {
-            "code": "CodeableConcept",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
-          }
-        ],
-        "isSummary": true,
-        "binding": {
-          "strength": "required",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/c80-practice-codes"
-          }
-        },
-        "mapping": [
-          {
-            "identity": "v2",
-            "map": "PRA-5"
-          },
-          {
-            "identity": "rim",
-            "map": ".playingEntity.playingRole[classCode=QUAL].code"
-          },
-          {
-            "identity": "servd",
-            "map": "./Specialty"
-          }
-        ]
-      },
-      {
-        "id": "Practitioner:shr-actor-Practitioner.role.identifier",
-        "path": "Practitioner.role.identifier",
-        "short": "Business Identifiers that are specific to a role/location",
-        "definition": "Business Identifiers that are specific to a role/location.",
-        "requirements": "Some business identifiers are specific to a location and should be able to be associated.",
-        "min": 0,
-        "max": "*",
-        "type": [
-          {
-            "code": "Identifier"
-          }
-        ],
-        "isSummary": true,
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": ".playingEntity.playingRole.id"
-          }
-        ]
-      },
-      {
-        "id": "Practitioner:shr-actor-Practitioner.role.telecom",
-        "path": "Practitioner.role.telecom",
-        "short": "Contact details that are specific to the role/location/service",
-        "definition": "Contact details that are specific to the role/location/service.",
-        "requirements": "Often practitioners have a dedicated line for each location (or service) that they work at, and need to be able to define separate contact details for each of these.",
-        "min": 0,
-        "max": "*",
-        "type": [
-          {
-            "code": "ContactPoint"
-          }
-        ],
-        "isSummary": true,
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": ".playingEntity.playingRole.telecom"
-          }
-        ]
-      },
-      {
-        "id": "Practitioner:shr-actor-Practitioner.role.period",
-        "path": "Practitioner.role.period",
-        "short": "The period during which the practitioner is authorized to perform in these role(s)",
-        "definition": "The period during which the person is authorized to act as a practitioner in these role(s) for the organization.",
-        "requirements": "Even after the agencies is revoked, the fact that it existed must still be recorded.",
-        "min": 0,
-        "max": "1",
-        "type": [
-          {
-            "code": "Period"
-          }
-        ],
-        "isSummary": true,
-        "mapping": [
-          {
-            "identity": "v2",
-            "map": "PRD-8/9 / PRA-5.4"
-          },
-          {
-            "identity": "rim",
-            "map": ".playingEntity.playingRole.effectiveTime"
-          },
-          {
-            "identity": "servd",
-            "map": "(ServD maps Practitioners and Organizations via another entity, so this concept is not available)"
-          },
-          {
-            "identity": "w5",
-            "map": "when.done"
-          }
-        ]
-      },
-      {
-        "id": "Practitioner:shr-actor-Practitioner.role.location",
-        "path": "Practitioner.role.location",
-        "short": "The location(s) at which this practitioner provides care",
-        "definition": "The location(s) at which this practitioner provides care.",
-        "min": 0,
-        "max": "*",
-        "type": [
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Location"
-          }
-        ],
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": ".playingEntity.playingRole.location.source[classCode=SDLOC]"
-          },
-          {
-            "identity": "servd",
-            "map": "(ServD maps Practitioners and Organizations via another entity, so this concept is not available)<br/> However these are accessed via the Site.ServiceSite.ServiceSiteProvider record. (The Site has the location)"
-          },
-          {
-            "identity": "w5",
-            "map": "where"
-          }
-        ]
-      },
-      {
-        "id": "Practitioner:shr-actor-Practitioner.role.healthcareService",
-        "path": "Practitioner.role.healthcareService",
-        "short": "The list of healthcare services that this worker provides for this role's Organization/Location(s)",
-        "definition": "The list of healthcare services that this worker provides for this role's Organization/Location(s).",
-        "min": 0,
-        "max": "*",
-        "type": [
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/HealthcareService"
-          }
-        ],
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "n/a"
-          }
-        ]
-      },
-      {
-        "id": "Practitioner:shr-actor-Practitioner.role.endpoint",
-        "path": "Practitioner.role.endpoint",
-        "short": "Technical endpoints providing access to services operated for the PractitonerRole",
-        "definition": "Technical endpoints providing access to services operated for the PractitonerRole.",
-        "min": 0,
-        "max": "*",
-        "type": [
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Endpoint"
-          }
-        ],
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "n/a"
-          }
-        ]
-      },
       {
         "id": "Practitioner:shr-actor-Practitioner.qualification",
         "path": "Practitioner.qualification",
@@ -1109,7 +847,7 @@
         "path": "Practitioner.qualification.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1138,7 +876,7 @@
         "path": "Practitioner.qualification.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1198,10 +936,16 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Qualification"
+            }
+          ],
           "strength": "example",
           "description": "Specific qualification the practitioner has to provide a service",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/anzsco-occupations"
+            "reference": "http://hl7.org/fhir/ValueSet/v2-2.7-0360"
           }
         },
         "mapping": [
@@ -1264,7 +1008,7 @@
         "path": "Practitioner.communication",
         "short": "A language the practitioner is able to use in patient communication",
         "definition": "A language the practitioner is able to use in patient communication.",
-        "comments": "The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.",
+        "comment": "The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.",
         "requirements": "Knowing which language a practitioner speaks can help in facilitating communication with patients.",
         "min": 0,
         "max": "*",
@@ -1281,6 +1025,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -1362,6 +1114,38 @@
         "isModifier": false,
         "isSummary": false
       },
+      {
+        "id": "Practitioner:shr-actor-Practitioner.extension:affiliation",
+        "path": "Practitioner.extension",
+        "sliceName": "affiliation",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Extension",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-actor-Affiliation-extension"
+          }
+        ],
+        "mustSupport": false,
+        "isModifier": false,
+        "isSummary": false
+      },
+      {
+        "id": "Practitioner:shr-actor-Practitioner.extension:medicalspecialty",
+        "path": "Practitioner.extension",
+        "sliceName": "medicalspecialty",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Extension",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-actor-MedicalSpecialty-extension"
+          }
+        ],
+        "mustSupport": false,
+        "isModifier": false,
+        "isSummary": false
+      },
       {
         "id": "Practitioner:shr-actor-Practitioner.identifier",
         "path": "Practitioner.identifier",
@@ -1406,36 +1190,6 @@
           }
         ]
       },
-      {
-        "id": "Practitioner:shr-actor-Practitioner.role",
-        "path": "Practitioner.role"
-      },
-      {
-        "id": "Practitioner:shr-actor-Practitioner.role.organization",
-        "path": "Practitioner.role.organization",
-        "type": [
-          {
-            "code": "Reference",
-            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-actor-Organization"
-          }
-        ]
-      },
-      {
-        "id": "Practitioner:shr-actor-Practitioner.role.specialty",
-        "path": "Practitioner.role.specialty",
-        "type": [
-          {
-            "code": "CodeableConcept",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
-          }
-        ],
-        "binding": {
-          "strength": "required",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/c80-practice-codes"
-          }
-        }
-      },
       {
         "id": "Practitioner:shr-actor-Practitioner.communication",
         "path": "Practitioner.communication",
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-actor-PrimaryCareProvider.json b/lib/resources/standard_health_record/StructureDefinition-shr-actor-PrimaryCareProvider.json
old mode 100755
new mode 100644
index 02fdf23..790ee39
--- a/lib/resources/standard_health_record/StructureDefinition-shr-actor-PrimaryCareProvider.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-actor-PrimaryCareProvider.json
@@ -3,7 +3,7 @@
   "id": "shr-actor-PrimaryCareProvider",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR PrimaryCareProvider Profile</b></p>\n  <p>The medical professional responsible for first-line care of an individual.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.actor.PrimaryCareProvider maps to CareTeam:\n  participant is 1..1\n  Provider maps to participant.member\n  HealthcareRole maps to participant.role\n  GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to participant.period\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR PrimaryCareProvider Profile</b></p>\n  <p>The medical professional responsible for first-line care of an individual.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.actor.PrimaryCareProvider maps to CareTeam:\n  constrain participant to 1..1\n  Provider maps to participant.member\n  HealthcareRole maps to participant.role\n  GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to participant.period\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-actor-PrimaryCareProvider",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.actor.PrimaryCareProvider"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR PrimaryCareProvider Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.559Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.850Z",
   "description": "The medical professional responsible for first-line care of an individual.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "w5",
@@ -109,7 +110,7 @@
         "path": "CareTeam.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -148,7 +149,7 @@
         "path": "CareTeam.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -169,7 +170,7 @@
         "path": "CareTeam.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -189,6 +190,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -203,7 +212,7 @@
         "path": "CareTeam.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -237,7 +246,7 @@
         "path": "CareTeam.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -268,14 +277,17 @@
         "slicing": {
           "id": "15",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -304,6 +316,7 @@
         "path": "CareTeam.extension",
         "sliceName": "priority",
         "definition": "An ordinal numbered priority where 1=highest priority, 2=second highest priority, etc.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -336,7 +349,7 @@
         "path": "CareTeam.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -384,17 +397,31 @@
       {
         "id": "CareTeam:shr-actor-PrimaryCareProvider.status",
         "path": "CareTeam.status",
-        "short": "active | suspended | inactive | entered in error",
-        "definition": "Indicates whether the care team is currently active, suspended, inactive, or entered in error.",
+        "short": "proposed | active | suspended | inactive | entered-in-error",
+        "definition": "Indicates the current state of the care team.",
+        "comment": "This element is labeled as a modifier because the status contains the code entered-in-error that marks the care team as not currently valid.",
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "CodeableConcept"
+            "code": "code"
           }
         ],
         "isModifier": true,
         "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "CareTeamStatus"
+            }
+          ],
+          "strength": "required",
+          "description": "Indicates the status of the care team.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/care-team-status"
+          }
+        },
         "mapping": [
           {
             "identity": "w5",
@@ -407,7 +434,7 @@
         "path": "CareTeam.category",
         "short": "Type of team",
         "definition": "Identifies what kind of team.  This is to support differentiation between multiple co-existing teams, such as care plan team, episode of care team, longitudinal care team.",
-        "comments": "There may be multiple axis of categorization and one team may serve multiple purposes.",
+        "comment": "There may be multiple axis of categorization and one team may serve multiple purposes.",
         "requirements": "Used for filtering what teams(s) are retrieved and displayed to different types of users.",
         "min": 0,
         "max": "*",
@@ -417,6 +444,19 @@
           }
         ],
         "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "CareTeamCategory"
+            }
+          ],
+          "strength": "example",
+          "description": "Indicates the type of care team.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/care-team-category"
+          }
+        },
         "mapping": [
           {
             "identity": "w5",
@@ -429,7 +469,7 @@
         "path": "CareTeam.name",
         "short": "Name of the team, such as crisis assessment team",
         "definition": "A label for human use intended to distinguish like teams.  E.g. the \"red\" vs. \"green\" trauma teams.",
-        "comments": "The meaning/purpose of the team is conveyed in CareTeam.category.  This element may also convey semantics of the team (e.g. \"Red trauma team\"), but it's primary purpose is to distinguish between identical teams in a human-friendly way.  (\"Team 18735\" isn't as friendly . ).",
+        "comment": "The meaning/purpose of the team is conveyed in CareTeam.category.  This element may also convey semantics of the team (e.g. \"Red trauma team\"), but its primary purpose is to distinguish between identical teams in a human-friendly way.  (\"Team 18735\" isn't as friendly . ).",
         "min": 0,
         "max": "1",
         "type": [
@@ -445,6 +485,9 @@
         "short": "Who care team is for",
         "definition": "Identifies the patient or group whose intended care is handled by the team.",
         "requirements": "Allows the team to care for a group (e.g. marriage) therapy.",
+        "alias": [
+          "patient"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -465,6 +508,34 @@
           }
         ]
       },
+      {
+        "id": "CareTeam:shr-actor-PrimaryCareProvider.context",
+        "path": "CareTeam.context",
+        "short": "Encounter or episode associated with CareTeam",
+        "definition": "The encounter or episode of care that establishes the context for this care team.",
+        "alias": [
+          "encounter"
+        ],
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "w5",
+            "map": "context"
+          }
+        ]
+      },
       {
         "id": "CareTeam:shr-actor-PrimaryCareProvider.period",
         "path": "CareTeam.period",
@@ -498,6 +569,9 @@
             "code": "BackboneElement"
           }
         ],
+        "condition": [
+          "ctm-1"
+        ],
         "constraint": [
           {
             "key": "ele-1",
@@ -506,6 +580,13 @@
             "expression": "children().count() > id.count()",
             "xpath": "@value|f:*|h:div",
             "source": "Element"
+          },
+          {
+            "key": "ctm-1",
+            "severity": "error",
+            "human": "CareTeam.participant.onBehalfOf can only be populated when CareTeam.participant.member is a Practitioner",
+            "expression": "onBehalfOf.exists() implies (member.resolve() is Practitioner)",
+            "xpath": "contains(f:member, '/Practitioner') or not(exists(f:onBehalfOf))"
           }
         ],
         "mapping": [
@@ -515,7 +596,7 @@
           },
           {
             "identity": "rim",
-            "map": ".participation[typeCode=PFM]"
+            "map": ".participation[typeCode=PRF]"
           }
         ]
       },
@@ -551,7 +632,7 @@
         "path": "CareTeam.participant.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -580,7 +661,7 @@
         "path": "CareTeam.participant.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -612,7 +693,7 @@
         "path": "CareTeam.participant.role",
         "short": "Type of involvement",
         "definition": "Indicates specific responsibility of an individual within the care team, such as \"Primary care physician\", \"Trained social worker counselor\", \"Caregiver\", etc.",
-        "comments": "Roles may sometimes be inferred by type of Practitioner.  These are relationships that hold only within the context of the care team.  General relationships should be handled as properties of the Patient resource directly.",
+        "comment": "Roles may sometimes be inferred by type of Practitioner.  These are relationships that hold only within the context of the care team.  General relationships should be handled as properties of the Patient resource directly.",
         "min": 1,
         "max": "1",
         "type": [
@@ -633,7 +714,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-actor-HealthcareRoleVS"
+            "reference": "http://standardhealthrecord.org/shr/actor/vs/HealthcareRoleVS"
           }
         },
         "mapping": [
@@ -652,7 +733,7 @@
         "path": "CareTeam.participant.member",
         "short": "Who is involved",
         "definition": "The specific person or organization who is participating/expected to participate in the care team.",
-        "comments": "Patient only needs to be listed if they have a role other than \"subject of care\".\n\nMember is optional because some participants may be known only by their role, particularly in draft plans.",
+        "comment": "Patient only needs to be listed if they have a role other than \"subject of care\".\n\nMember is optional because some participants may be known only by their role, particularly in draft plans.",
         "min": 1,
         "max": "1",
         "type": [
@@ -671,6 +752,10 @@
           {
             "code": "Reference",
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CareTeam"
           }
         ],
         "isSummary": true,
@@ -689,6 +774,22 @@
           }
         ]
       },
+      {
+        "id": "CareTeam:shr-actor-PrimaryCareProvider.participant.onBehalfOf",
+        "path": "CareTeam.participant.onBehalfOf",
+        "short": "Organization of the practitioner",
+        "definition": "The organization of the practitioner.",
+        "requirements": "Practitioners can be associated with multiple organizations.  This element indicates which organization they were acting on behalf of.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
+          }
+        ],
+        "isSummary": true
+      },
       {
         "id": "CareTeam:shr-actor-PrimaryCareProvider.participant.period",
         "path": "CareTeam.participant.period",
@@ -703,6 +804,58 @@
           }
         ]
       },
+      {
+        "id": "CareTeam:shr-actor-PrimaryCareProvider.reasonCode",
+        "path": "CareTeam.reasonCode",
+        "short": "Why the care team exists",
+        "definition": "Describes why the care team exists.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "CareTeamReason"
+            }
+          ],
+          "strength": "example",
+          "description": "Indicates the reason for the care team.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/clinical-findings"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "w5",
+            "map": "why"
+          }
+        ]
+      },
+      {
+        "id": "CareTeam:shr-actor-PrimaryCareProvider.reasonReference",
+        "path": "CareTeam.reasonReference",
+        "short": "Why the care team exists",
+        "definition": "Condition(s) that this care team addresses.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Condition"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "w5",
+            "map": "why"
+          }
+        ]
+      },
       {
         "id": "CareTeam:shr-actor-PrimaryCareProvider.managingOrganization",
         "path": "CareTeam.managingOrganization",
@@ -718,6 +871,19 @@
           }
         ],
         "isSummary": true
+      },
+      {
+        "id": "CareTeam:shr-actor-PrimaryCareProvider.note",
+        "path": "CareTeam.note",
+        "short": "Comments made about the CareTeam",
+        "definition": "Comments made about the CareTeam.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Annotation"
+          }
+        ]
       }
     ]
   },
@@ -773,7 +939,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-actor-HealthcareRoleVS"
+            "reference": "http://standardhealthrecord.org/shr/actor/vs/HealthcareRoleVS"
           }
         }
       },
@@ -798,6 +964,10 @@
           {
             "code": "Reference",
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CareTeam"
           }
         ]
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-actor-ProviderRelationship.json b/lib/resources/standard_health_record/StructureDefinition-shr-actor-ProviderRelationship.json
old mode 100755
new mode 100644
index 820cf60..acc158a
--- a/lib/resources/standard_health_record/StructureDefinition-shr-actor-ProviderRelationship.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-actor-ProviderRelationship.json
@@ -3,7 +3,7 @@
   "id": "shr-actor-ProviderRelationship",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR ProviderRelationship Profile</b></p>\n  <p>A person or organization responsible for providing a service to the person of record. Such a relationship can exist without a specific encounter or services being rendered; for example, an emergency contact relationship can exist without ever calling upon that person. The entry can also be used to state that a provider relationship does not exist, e.g., patient does not have a primary care provider.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.actor.ProviderRelationship maps to CareTeam:\n  participant is 1..1\n  Provider maps to participant.member\n  HealthcareRole maps to participant.role\n  GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to participant.period\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR ProviderRelationship Profile</b></p>\n  <p>A person or organization responsible for providing a service to the person of record. Such a relationship can exist without a specific encounter or services being rendered; for example, an emergency contact relationship can exist without ever calling upon that person. The entry can also be used to state that a provider relationship does not exist, e.g., patient does not have a primary care provider.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.actor.ProviderRelationship maps to CareTeam:\n  constrain participant to 1..1\n  Provider maps to participant.member\n  HealthcareRole maps to participant.role\n  GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to participant.period\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-actor-ProviderRelationship",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.actor.ProviderRelationship"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ProviderRelationship Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.546Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.843Z",
   "description": "A person or organization responsible for providing a service to the person of record. Such a relationship can exist without a specific encounter or services being rendered; for example, an emergency contact relationship can exist without ever calling upon that person. The entry can also be used to state that a provider relationship does not exist, e.g., patient does not have a primary care provider.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "w5",
@@ -109,7 +110,7 @@
         "path": "CareTeam.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -148,7 +149,7 @@
         "path": "CareTeam.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -169,7 +170,7 @@
         "path": "CareTeam.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -189,6 +190,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -203,7 +212,7 @@
         "path": "CareTeam.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -237,7 +246,7 @@
         "path": "CareTeam.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -268,14 +277,17 @@
         "slicing": {
           "id": "11",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -304,6 +316,7 @@
         "path": "CareTeam.extension",
         "sliceName": "priority",
         "definition": "An ordinal numbered priority where 1=highest priority, 2=second highest priority, etc.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -337,14 +350,17 @@
         "slicing": {
           "id": "12",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -374,6 +390,7 @@
         "path": "CareTeam.modifierExtension",
         "sliceName": "nonoccurrencemodifier",
         "definition": "When true, indicates either that the event or action documented in the entry did not occur, or the the thing documented is absent or does not exist.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -424,17 +441,31 @@
       {
         "id": "CareTeam:shr-actor-ProviderRelationship.status",
         "path": "CareTeam.status",
-        "short": "active | suspended | inactive | entered in error",
-        "definition": "Indicates whether the care team is currently active, suspended, inactive, or entered in error.",
+        "short": "proposed | active | suspended | inactive | entered-in-error",
+        "definition": "Indicates the current state of the care team.",
+        "comment": "This element is labeled as a modifier because the status contains the code entered-in-error that marks the care team as not currently valid.",
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "CodeableConcept"
+            "code": "code"
           }
         ],
         "isModifier": true,
         "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "CareTeamStatus"
+            }
+          ],
+          "strength": "required",
+          "description": "Indicates the status of the care team.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/care-team-status"
+          }
+        },
         "mapping": [
           {
             "identity": "w5",
@@ -447,7 +478,7 @@
         "path": "CareTeam.category",
         "short": "Type of team",
         "definition": "Identifies what kind of team.  This is to support differentiation between multiple co-existing teams, such as care plan team, episode of care team, longitudinal care team.",
-        "comments": "There may be multiple axis of categorization and one team may serve multiple purposes.",
+        "comment": "There may be multiple axis of categorization and one team may serve multiple purposes.",
         "requirements": "Used for filtering what teams(s) are retrieved and displayed to different types of users.",
         "min": 0,
         "max": "*",
@@ -457,6 +488,19 @@
           }
         ],
         "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "CareTeamCategory"
+            }
+          ],
+          "strength": "example",
+          "description": "Indicates the type of care team.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/care-team-category"
+          }
+        },
         "mapping": [
           {
             "identity": "w5",
@@ -469,7 +513,7 @@
         "path": "CareTeam.name",
         "short": "Name of the team, such as crisis assessment team",
         "definition": "A label for human use intended to distinguish like teams.  E.g. the \"red\" vs. \"green\" trauma teams.",
-        "comments": "The meaning/purpose of the team is conveyed in CareTeam.category.  This element may also convey semantics of the team (e.g. \"Red trauma team\"), but it's primary purpose is to distinguish between identical teams in a human-friendly way.  (\"Team 18735\" isn't as friendly . ).",
+        "comment": "The meaning/purpose of the team is conveyed in CareTeam.category.  This element may also convey semantics of the team (e.g. \"Red trauma team\"), but its primary purpose is to distinguish between identical teams in a human-friendly way.  (\"Team 18735\" isn't as friendly . ).",
         "min": 0,
         "max": "1",
         "type": [
@@ -485,6 +529,9 @@
         "short": "Who care team is for",
         "definition": "Identifies the patient or group whose intended care is handled by the team.",
         "requirements": "Allows the team to care for a group (e.g. marriage) therapy.",
+        "alias": [
+          "patient"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -505,6 +552,34 @@
           }
         ]
       },
+      {
+        "id": "CareTeam:shr-actor-ProviderRelationship.context",
+        "path": "CareTeam.context",
+        "short": "Encounter or episode associated with CareTeam",
+        "definition": "The encounter or episode of care that establishes the context for this care team.",
+        "alias": [
+          "encounter"
+        ],
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "w5",
+            "map": "context"
+          }
+        ]
+      },
       {
         "id": "CareTeam:shr-actor-ProviderRelationship.period",
         "path": "CareTeam.period",
@@ -538,6 +613,9 @@
             "code": "BackboneElement"
           }
         ],
+        "condition": [
+          "ctm-1"
+        ],
         "constraint": [
           {
             "key": "ele-1",
@@ -546,6 +624,13 @@
             "expression": "children().count() > id.count()",
             "xpath": "@value|f:*|h:div",
             "source": "Element"
+          },
+          {
+            "key": "ctm-1",
+            "severity": "error",
+            "human": "CareTeam.participant.onBehalfOf can only be populated when CareTeam.participant.member is a Practitioner",
+            "expression": "onBehalfOf.exists() implies (member.resolve() is Practitioner)",
+            "xpath": "contains(f:member, '/Practitioner') or not(exists(f:onBehalfOf))"
           }
         ],
         "mapping": [
@@ -555,7 +640,7 @@
           },
           {
             "identity": "rim",
-            "map": ".participation[typeCode=PFM]"
+            "map": ".participation[typeCode=PRF]"
           }
         ]
       },
@@ -591,7 +676,7 @@
         "path": "CareTeam.participant.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -620,7 +705,7 @@
         "path": "CareTeam.participant.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -652,7 +737,7 @@
         "path": "CareTeam.participant.role",
         "short": "Type of involvement",
         "definition": "Indicates specific responsibility of an individual within the care team, such as \"Primary care physician\", \"Trained social worker counselor\", \"Caregiver\", etc.",
-        "comments": "Roles may sometimes be inferred by type of Practitioner.  These are relationships that hold only within the context of the care team.  General relationships should be handled as properties of the Patient resource directly.",
+        "comment": "Roles may sometimes be inferred by type of Practitioner.  These are relationships that hold only within the context of the care team.  General relationships should be handled as properties of the Patient resource directly.",
         "min": 1,
         "max": "1",
         "type": [
@@ -665,7 +750,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-actor-HealthcareRoleVS"
+            "reference": "http://standardhealthrecord.org/shr/actor/vs/HealthcareRoleVS"
           }
         },
         "mapping": [
@@ -684,7 +769,7 @@
         "path": "CareTeam.participant.member",
         "short": "Who is involved",
         "definition": "The specific person or organization who is participating/expected to participate in the care team.",
-        "comments": "Patient only needs to be listed if they have a role other than \"subject of care\".\n\nMember is optional because some participants may be known only by their role, particularly in draft plans.",
+        "comment": "Patient only needs to be listed if they have a role other than \"subject of care\".\n\nMember is optional because some participants may be known only by their role, particularly in draft plans.",
         "min": 0,
         "max": "1",
         "type": [
@@ -703,6 +788,10 @@
           {
             "code": "Reference",
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CareTeam"
           }
         ],
         "isSummary": true,
@@ -721,6 +810,22 @@
           }
         ]
       },
+      {
+        "id": "CareTeam:shr-actor-ProviderRelationship.participant.onBehalfOf",
+        "path": "CareTeam.participant.onBehalfOf",
+        "short": "Organization of the practitioner",
+        "definition": "The organization of the practitioner.",
+        "requirements": "Practitioners can be associated with multiple organizations.  This element indicates which organization they were acting on behalf of.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
+          }
+        ],
+        "isSummary": true
+      },
       {
         "id": "CareTeam:shr-actor-ProviderRelationship.participant.period",
         "path": "CareTeam.participant.period",
@@ -735,6 +840,58 @@
           }
         ]
       },
+      {
+        "id": "CareTeam:shr-actor-ProviderRelationship.reasonCode",
+        "path": "CareTeam.reasonCode",
+        "short": "Why the care team exists",
+        "definition": "Describes why the care team exists.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "CareTeamReason"
+            }
+          ],
+          "strength": "example",
+          "description": "Indicates the reason for the care team.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/clinical-findings"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "w5",
+            "map": "why"
+          }
+        ]
+      },
+      {
+        "id": "CareTeam:shr-actor-ProviderRelationship.reasonReference",
+        "path": "CareTeam.reasonReference",
+        "short": "Why the care team exists",
+        "definition": "Condition(s) that this care team addresses.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Condition"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "w5",
+            "map": "why"
+          }
+        ]
+      },
       {
         "id": "CareTeam:shr-actor-ProviderRelationship.managingOrganization",
         "path": "CareTeam.managingOrganization",
@@ -750,6 +907,19 @@
           }
         ],
         "isSummary": true
+      },
+      {
+        "id": "CareTeam:shr-actor-ProviderRelationship.note",
+        "path": "CareTeam.note",
+        "short": "Comments made about the CareTeam",
+        "definition": "Comments made about the CareTeam.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Annotation"
+          }
+        ]
       }
     ]
   },
@@ -813,7 +983,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-actor-HealthcareRoleVS"
+            "reference": "http://standardhealthrecord.org/shr/actor/vs/HealthcareRoleVS"
           }
         }
       },
@@ -836,6 +1006,10 @@
           {
             "code": "Reference",
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CareTeam"
           }
         ]
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-actor-RelatedPerson-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-actor-RelatedPerson-extension.json
old mode 100755
new mode 100644
index b9d8c61..c44e4a8
--- a/lib/resources/standard_health_record/StructureDefinition-shr-actor-RelatedPerson-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-actor-RelatedPerson-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.actor.RelatedPerson"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR RelatedPerson Extension",
   "title": "SHR RelatedPerson Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.350Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.281Z",
   "description": "A person, other than a practitioner or the patient (the person of record) who is relevant to the health or social situation of the subject.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-actor-RelatedPerson.json b/lib/resources/standard_health_record/StructureDefinition-shr-actor-RelatedPerson.json
old mode 100755
new mode 100644
index 01f538f..7000298
--- a/lib/resources/standard_health_record/StructureDefinition-shr-actor-RelatedPerson.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-actor-RelatedPerson.json
@@ -12,8 +12,10 @@
       "value": "shr.actor.RelatedPerson"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR RelatedPerson Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.504Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,10 +27,9 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.824Z",
   "description": "A person, other than a practitioner or the patient (the person of record) who is relevant to the health or social situation of the subject.",
   "purpose": "Need to track persons related to the patient or the healthcare process.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "rim",
@@ -114,7 +115,7 @@
         "path": "RelatedPerson.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -153,7 +154,7 @@
         "path": "RelatedPerson.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -174,7 +175,7 @@
         "path": "RelatedPerson.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -194,6 +195,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -208,7 +217,7 @@
         "path": "RelatedPerson.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -242,7 +251,7 @@
         "path": "RelatedPerson.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -273,14 +282,17 @@
         "slicing": {
           "id": "8",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -309,6 +321,7 @@
         "path": "RelatedPerson.extension",
         "sliceName": "anonymized",
         "definition": "Flag indicating if personally identifiable information has been withheld.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -341,6 +354,7 @@
         "path": "RelatedPerson.extension",
         "sliceName": "fictionalperson",
         "definition": "Flag indicating if this record represents a fictional (synthetic, not real) person.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -373,6 +387,7 @@
         "path": "RelatedPerson.extension",
         "sliceName": "languageused",
         "definition": "Language used for communication by a human, either the subject of record, parent, or other involved person.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -405,6 +420,7 @@
         "path": "RelatedPerson.extension",
         "sliceName": "deceased",
         "definition": "An indication that the person is no longer living, given by a date, time of death, or a boolean value which, when true, indicates the person is deceased.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -437,7 +453,7 @@
         "path": "RelatedPerson.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -496,6 +512,7 @@
         "path": "RelatedPerson.active",
         "short": "Whether this related person's record is in active use",
         "definition": "Whether this related person record is in active use.",
+        "comment": "This element is labeled as a modifier because it may be used to mark that the resource was created in error.",
         "requirements": "Need to be able to mark a related person record as not to be used, such as if it was created in error.",
         "min": 0,
         "max": "1",
@@ -559,7 +576,13 @@
         ],
         "isSummary": true,
         "binding": {
-          "strength": "extensible",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "PatientRelationshipType"
+            }
+          ],
+          "strength": "preferred",
           "description": "The nature of the relationship between a patient and the related person",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/relatedperson-relationshiptype"
@@ -611,7 +634,7 @@
         "path": "RelatedPerson.telecom",
         "short": "A contact detail for the person",
         "definition": "A contact detail for the person, e.g. a telephone number or an email address.",
-        "comments": "Person may have multiple ways to be contacted with different uses or applicable periods.  May need to have options for contacting the person urgently, and also to help with identification.",
+        "comment": "Person may have multiple ways to be contacted with different uses or applicable periods.  May need to have options for contacting the person urgently, and also to help with identification.",
         "requirements": "People have (primary) ways to contact them in some way such as phone, email.",
         "min": 0,
         "max": "*",
@@ -648,6 +671,16 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AdministrativeGender"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
+            }
+          ],
           "strength": "required",
           "description": "The gender of a person used for administrative purposes.",
           "valueSetReference": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-actor-SpokenLanguageProficiency-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-actor-SpokenLanguageProficiency-extension.json
old mode 100755
new mode 100644
index 8486301..36d7ba2
--- a/lib/resources/standard_health_record/StructureDefinition-shr-actor-SpokenLanguageProficiency-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-actor-SpokenLanguageProficiency-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.actor.SpokenLanguageProficiency"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR SpokenLanguageProficiency Extension",
   "title": "SHR SpokenLanguageProficiency Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.515Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.830Z",
   "description": "Accuracy and fluency in spoken communication in a language.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -170,7 +170,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-PerformanceGradingScaleVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/PerformanceGradingScaleVS"
           }
         },
         "mapping": [
@@ -221,7 +221,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-PerformanceGradingScaleVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/PerformanceGradingScaleVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-actor-WrittenLanguageProficiency-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-actor-WrittenLanguageProficiency-extension.json
old mode 100755
new mode 100644
index 6dfca3c..c560d42
--- a/lib/resources/standard_health_record/StructureDefinition-shr-actor-WrittenLanguageProficiency-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-actor-WrittenLanguageProficiency-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.actor.WrittenLanguageProficiency"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR WrittenLanguageProficiency Extension",
   "title": "SHR WrittenLanguageProficiency Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.515Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.830Z",
   "description": "Accuracy and fluency of reading and writing in a language.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -170,7 +170,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-PerformanceGradingScaleVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/PerformanceGradingScaleVS"
           }
         },
         "mapping": [
@@ -221,7 +221,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-PerformanceGradingScaleVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/PerformanceGradingScaleVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-adverse-AdverseReaction-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-adverse-AdverseReaction-extension.json
old mode 100755
new mode 100644
index eee9574..94648f1
--- a/lib/resources/standard_health_record/StructureDefinition-shr-adverse-AdverseReaction-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-adverse-AdverseReaction-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.adverse.AdverseReaction"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR AdverseReaction Extension",
   "title": "SHR AdverseReaction Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.734Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.919Z",
   "description": "Any noxious and unintended response to a medical product, procedure, or other intervention, for which a causal relationship to an intervention is at least a reasonable possibility i.e., the relationship cannot be ruled out. It is not necessarily associated with a previously-recorded SubstanceRisk. This entry could be used to record the occurrence or non-occurrence of an adverse reaction.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-adverse-AdverseReaction.json b/lib/resources/standard_health_record/StructureDefinition-shr-adverse-AdverseReaction.json
old mode 100755
new mode 100644
index 46fdfad..6cac710
--- a/lib/resources/standard_health_record/StructureDefinition-shr-adverse-AdverseReaction.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-adverse-AdverseReaction.json
@@ -12,8 +12,10 @@
       "value": "shr.adverse.AdverseReaction"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR AdverseReaction Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.708Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.911Z",
   "description": "Any noxious and unintended response to a medical product, procedure, or other intervention, for which a causal relationship to an intervention is at least a reasonable possibility i.e., the relationship cannot be ruled out. It is not necessarily associated with a previously-recorded SubstanceRisk. This entry could be used to record the occurrence or non-occurrence of an adverse reaction.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "sct-concept",
@@ -107,7 +108,7 @@
             "severity": "error",
             "human": "If condition is abated, then clinicalStatus must be either inactive, resolved, or remission",
             "expression": "abatement.empty() or (abatement as boolean).not()  or clinicalStatus='resolved' or clinicalStatus='remission' or clinicalStatus='inactive'",
-            "xpath": "xpath: not(f:abatementBoolean='true' or (not(exists(f:abatementBoolean)) and exists(*[starts-with(local-name(.), 'abatement')])) or f:clinicalStatus/@value=('resolved', 'remission', 'inactive')"
+            "xpath": "not(f:abatementBoolean='true' or (not(exists(f:abatementBoolean)) and exists(*[starts-with(local-name(.), 'abatement')])) or f:clinicalStatus/@value=('resolved', 'remission', 'inactive'))"
           },
           {
             "key": "con-3",
@@ -145,7 +146,7 @@
         "path": "Condition.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -184,7 +185,7 @@
         "path": "Condition.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -205,7 +206,7 @@
         "path": "Condition.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -225,6 +226,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -239,7 +248,7 @@
         "path": "Condition.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -273,7 +282,7 @@
         "path": "Condition.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -302,16 +311,19 @@
         "id": "Condition:shr-adverse-AdverseReaction.extension",
         "path": "Condition.extension",
         "slicing": {
-          "id": "39",
+          "id": "37",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -340,6 +352,7 @@
         "path": "Condition.extension",
         "sliceName": "generalizedlikelihood",
         "definition": "Quantitative or qualitative measure of likelihood.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -372,6 +385,7 @@
         "path": "Condition.extension",
         "sliceName": "supportingevidencequality",
         "definition": "An assessment of the quality and/or quantity of the source information that supports judgment.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -404,6 +418,7 @@
         "path": "Condition.extension",
         "sliceName": "includeonproblemlist",
         "definition": "Whether or not to include this problem on the subject's current problem list.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -436,6 +451,7 @@
         "path": "Condition.extension",
         "sliceName": "whenclinicallyrecognized",
         "definition": "The time at which a condition or problem was first identified in a healthcare context.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -468,6 +484,7 @@
         "path": "Condition.extension",
         "sliceName": "preexisting",
         "definition": "If the problem or condition existed before the current episode of care.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -500,6 +517,7 @@
         "path": "Condition.extension",
         "sliceName": "criticality",
         "definition": "A clinical judgment of potential clinical harm, or seriousness, of a condition. When the worst case result is assessed to have a life-threatening or organ system threatening potential, it is considered to be of high criticality.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -532,6 +550,7 @@
         "path": "Condition.extension",
         "sliceName": "adversereactionattribution",
         "definition": "The cause of the adverse reaction (either known or theorized).",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -563,16 +582,19 @@
         "id": "Condition:shr-adverse-AdverseReaction.modifierExtension",
         "path": "Condition.modifierExtension",
         "slicing": {
-          "id": "40",
+          "id": "38",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -602,6 +624,7 @@
         "path": "Condition.modifierExtension",
         "sliceName": "nonoccurrencemodifier",
         "definition": "When true, indicates either that the event or action documented in the entry did not occur, or the the thing documented is absent or does not exist.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -659,6 +682,7 @@
         "path": "Condition.clinicalStatus",
         "short": "active | recurrence | inactive | remission | resolved",
         "definition": "The clinical status of the condition.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the condition as not currently valid or of concern.",
         "min": 1,
         "max": "1",
         "type": [
@@ -666,9 +690,19 @@
             "code": "code"
           }
         ],
+        "condition": [
+          "con-3",
+          "con-4"
+        ],
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ConditionClinicalStatus"
+            }
+          ],
           "strength": "required",
           "description": "The clinical status of the condition or diagnosis.",
           "valueSetReference": {
@@ -684,6 +718,10 @@
             "identity": "v2",
             "map": "PRB-14 / DG1-6"
           },
+          {
+            "identity": "rim",
+            "map": "Observation ACT\n.inboundRelationship[typeCode=COMP].source[classCode=OBS, code=\"clinicalStatus\", moodCode=EVN].value"
+          },
           {
             "identity": "w5",
             "map": "status"
@@ -695,7 +733,7 @@
         "path": "Condition.verificationStatus",
         "short": "provisional | differential | confirmed | refuted | entered-in-error | unknown",
         "definition": "The verification status to support the clinical status of the condition.",
-        "comments": "verificationStatus is not required.  For example, when a patient has abdominal pain in the ED, there is not likely going to be a verification status.",
+        "comment": "verificationStatus is not required.  For example, when a patient has abdominal pain in the ED, there is not likely going to be a verification status.\n\nThis element is labeled as a modifier because the status contains the code refuted and entered-in-error that mark the Condition as not currently valid.",
         "min": 0,
         "max": "1",
         "type": [
@@ -704,9 +742,18 @@
           }
         ],
         "defaultValueCode": "unknown",
+        "condition": [
+          "con-3"
+        ],
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ConditionVerificationStatus"
+            }
+          ],
           "strength": "required",
           "description": "The verification status to support or decline the clinical status of the condition or diagnosis.",
           "valueSetReference": {
@@ -724,7 +771,7 @@
           },
           {
             "identity": "rim",
-            "map": ".code (pre or post-coordinated in)  Can use valueNegationInd for refuted"
+            "map": "Observation ACT\n.inboundRelationship[typeCode=COMP].source[classCode=OBS, code=\"verificationStatus\", moodCode=EVN].value"
           },
           {
             "identity": "sct-attr",
@@ -740,16 +787,19 @@
         "id": "Condition:shr-adverse-AdverseReaction.category",
         "path": "Condition.category",
         "slicing": {
-          "id": "37",
+          "id": "35",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "problem-list-item | encounter-diagnosis",
         "definition": "A category assigned to the condition.",
-        "comments": "The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts.",
+        "comment": "The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts.",
         "min": 1,
         "max": "*",
         "type": [
@@ -761,7 +811,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-problem-ProblemCategoryVS"
+            "reference": "http://standardhealthrecord.org/shr/problem/vs/ProblemCategoryVS"
           }
         },
         "mapping": [
@@ -798,7 +848,7 @@
         "fixedCodeableConcept": {
           "coding": [
             {
-              "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-problem-ProblemCategoryVS",
+              "system": "http://standardhealthrecord.org/shr/problem/cs/ProblemCategoryCS",
               "code": "adverse_reaction"
             }
           ]
@@ -809,7 +859,7 @@
         "path": "Condition.severity",
         "short": "Subjective severity of condition",
         "definition": "A subjective assessment of the severity of the condition as evaluated by the clinician.",
-        "comments": "Coding of the severity with a terminology is preferred, where possible.",
+        "comment": "Coding of the severity with a terminology is preferred, where possible.",
         "min": 0,
         "max": "1",
         "type": [
@@ -819,6 +869,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ConditionSeverity"
+            }
+          ],
           "strength": "preferred",
           "description": "A subjective assessment of the severity of the condition as evaluated by the clinician.",
           "valueSetReference": {
@@ -853,6 +909,10 @@
         "path": "Condition.code",
         "short": "Identification of the condition, problem or diagnosis",
         "definition": "Identification of the condition, problem or diagnosis.",
+        "requirements": "0..1 to account for primarily narrative only resources.",
+        "alias": [
+          "type"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -863,10 +923,9 @@
         ],
         "isSummary": true,
         "binding": {
-          "strength": "example",
-          "description": "Identification of the condition or diagnosis.",
+          "strength": "required",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/condition-code"
+            "reference": "http://standardhealthrecord.org/shr/adverse/vs/MedDRAVS"
           }
         },
         "mapping": [
@@ -897,7 +956,7 @@
         "path": "Condition.bodySite",
         "short": "Anatomical location, if relevant",
         "definition": "The anatomical location where this condition manifests itself.",
-        "comments": "Only used if not implicit in code found in Condition.code. If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [body-site-instance](extension-body-site-instance.html).  May be a summary code, or a reference to a very precise definition of the location, or both.",
+        "comment": "Only used if not implicit in code found in Condition.code. If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [body-site-instance](extension-body-site-instance.html).  May be a summary code, or a reference to a very precise definition of the location, or both.",
         "min": 0,
         "max": "*",
         "type": [
@@ -910,7 +969,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
           }
         },
         "mapping": [
@@ -934,6 +993,9 @@
         "short": "Who has the condition?",
         "definition": "Indicates the patient or group who the condition record is associated with.",
         "requirements": "Group is typically used for veterinary or public health use cases.",
+        "alias": [
+          "patient"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -965,9 +1027,12 @@
       {
         "id": "Condition:shr-adverse-AdverseReaction.context",
         "path": "Condition.context",
-        "short": "Encounter when condition first asserted",
+        "short": "Encounter or episode when condition first asserted",
         "definition": "Encounter during which the condition was first asserted.",
-        "comments": "This record indicates the encounter this particular record is associated with.  In the case of a \"new\" diagnosis reflecting ongoing/revised information about the condition, this might be distinct from the first encounter in which the underlying condition was first \"known\".",
+        "comment": "This record indicates the encounter this particular record is associated with.  In the case of a \"new\" diagnosis reflecting ongoing/revised information about the condition, this might be distinct from the first encounter in which the underlying condition was first \"known\".",
+        "alias": [
+          "encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -980,6 +1045,7 @@
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -1000,7 +1066,7 @@
         "path": "Condition.onset[x]",
         "short": "Estimated or actual date,  date-time, or age",
         "definition": "Estimated or actual date or date-time  the condition began, in the opinion of the clinician.",
-        "comments": "Age is generally used when the patient reports an age at which the Condition began to occur.",
+        "comment": "Age is generally used when the patient reports an age at which the Condition began to occur.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1041,7 +1107,7 @@
         "path": "Condition.abatement[x]",
         "short": "If/when in resolution/remission",
         "definition": "The date or estimated date that the condition resolved or went into remission. This is called \"abatement\" because of the many overloaded connotations associated with \"remission\" or \"resolution\" - Conditions are never really resolved, but they can abate.",
-        "comments": "There is no explicit distinction between resolution and remission because in many cases the distinction is not clear. Age is generally used when the patient reports an age at which the Condition abated.  If there is no abatement element, it is unknown whether the condition has resolved or entered remission; applications and users should generally assume that the condition is still valid.  When abatementString exists, it implies the condition is abated.",
+        "comment": "There is no explicit distinction between resolution and remission because in many cases the distinction is not clear. Age is generally used when the patient reports an age at which the Condition abated.  If there is no abatement element, it is unknown whether the condition has resolved or entered remission; applications and users should generally assume that the condition is still valid.  When abatementString exists, it implies the condition is abated.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1064,6 +1130,9 @@
             "code": "string"
           }
         ],
+        "condition": [
+          "con-4"
+        ],
         "mapping": [
           {
             "identity": "rim",
@@ -1080,14 +1149,15 @@
         "path": "Condition.assertedDate",
         "short": "Date record was believed accurate",
         "definition": "The date on which the existance of the Condition was first asserted or acknowledged.",
-        "comments": "The assertedDate represents the date when this particular Condition record was created in the EHR, not the date of the most recent update in terms of when severity, abatement, etc. were specified.  The date of the last record modification can be retrieved from the resource metadata.",
+        "comment": "The assertedDate represents the date when this particular Condition record was created in the EHR, not the date of the most recent update in terms of when severity, abatement, etc. were specified.  The date of the last record modification can be retrieved from the resource metadata.",
         "min": 1,
         "max": "1",
         "type": [
           {
-            "code": "date"
+            "code": "dateTime"
           }
         ],
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -1208,7 +1278,7 @@
         "path": "Condition.stage.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1237,7 +1307,7 @@
         "path": "Condition.stage.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1283,7 +1353,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-problem-GradeOrStageVS"
+            "reference": "http://standardhealthrecord.org/shr/problem/vs/GradeOrStageVS"
           }
         },
         "mapping": [
@@ -1337,7 +1407,7 @@
         "path": "Condition.evidence",
         "short": "Supporting evidence",
         "definition": "Supporting Evidence / manifestations that are the basis on which this condition is suspected or confirmed.",
-        "comments": "The evidence may be a simple list of coded symptoms/manifestations, or references to observations or formal assessments, or both.",
+        "comment": "The evidence may be a simple list of coded symptoms/manifestations, or references to observations or formal assessments, or both.",
         "min": 1,
         "max": "*",
         "type": [
@@ -1401,7 +1471,7 @@
         "path": "Condition.evidence.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1430,7 +1500,7 @@
         "path": "Condition.evidence.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1463,7 +1533,7 @@
         "short": "Manifestation/symptom",
         "definition": "A manifestation or symptom that led to the recording of this condition.",
         "min": 1,
-        "max": "1",
+        "max": "*",
         "type": [
           {
             "code": "CodeableConcept",
@@ -1473,10 +1543,11 @@
         "condition": [
           "con-2"
         ],
+        "isSummary": true,
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-ManifestationVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/ManifestationVS"
           }
         },
         "mapping": [
@@ -1487,6 +1558,10 @@
           {
             "identity": "rim",
             "map": "[code=\"diagnosis\"].value"
+          },
+          {
+            "identity": "w5",
+            "map": "why"
           }
         ]
       },
@@ -1506,10 +1581,15 @@
         "condition": [
           "con-2"
         ],
+        "isSummary": true,
         "mapping": [
           {
             "identity": "rim",
             "map": ".self"
+          },
+          {
+            "identity": "w5",
+            "map": "why"
           }
         ]
       },
@@ -1684,9 +1764,12 @@
         "id": "Condition:shr-adverse-AdverseReaction.category",
         "path": "Condition.category",
         "slicing": {
-          "id": "37",
+          "id": "35",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -1702,7 +1785,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-problem-ProblemCategoryVS"
+            "reference": "http://standardhealthrecord.org/shr/problem/vs/ProblemCategoryVS"
           }
         }
       },
@@ -1721,7 +1804,7 @@
         "fixedCodeableConcept": {
           "coding": [
             {
-              "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-problem-ProblemCategoryVS",
+              "system": "http://standardhealthrecord.org/shr/problem/cs/ProblemCategoryCS",
               "code": "adverse_reaction"
             }
           ]
@@ -1740,12 +1823,20 @@
       {
         "id": "Condition:shr-adverse-AdverseReaction.code",
         "path": "Condition.code",
+        "min": 1,
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept",
             "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
           }
-        ]
+        ],
+        "binding": {
+          "strength": "required",
+          "valueSetReference": {
+            "reference": "http://standardhealthrecord.org/shr/adverse/vs/MedDRAVS"
+          }
+        }
       },
       {
         "id": "Condition:shr-adverse-AdverseReaction.bodySite",
@@ -1759,7 +1850,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
           }
         }
       },
@@ -1803,7 +1894,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-problem-GradeOrStageVS"
+            "reference": "http://standardhealthrecord.org/shr/problem/vs/GradeOrStageVS"
           }
         }
       },
@@ -1817,7 +1908,7 @@
         "id": "Condition:shr-adverse-AdverseReaction.evidence.code",
         "path": "Condition.evidence.code",
         "min": 1,
-        "max": "1",
+        "max": "*",
         "type": [
           {
             "code": "CodeableConcept",
@@ -1827,7 +1918,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-ManifestationVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/ManifestationVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-adverse-AdverseReactionAttribution-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-adverse-AdverseReactionAttribution-extension.json
old mode 100755
new mode 100644
index ce7ac04..65d8342
--- a/lib/resources/standard_health_record/StructureDefinition-shr-adverse-AdverseReactionAttribution-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-adverse-AdverseReactionAttribution-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.adverse.AdverseReactionAttribution"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR AdverseReactionAttribution Extension",
   "title": "SHR AdverseReactionAttribution Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.717Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.913Z",
   "description": "The cause of the adverse reaction (either known or theorized).",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -105,9 +106,12 @@
         "id": "Extension:adversereactionattribution.extension",
         "path": "Extension.extension",
         "slicing": {
-          "id": "38",
+          "id": "36",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -187,7 +191,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-adverse-AttributionCertainty-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-adverse-AttributionCertainty-extension.json
old mode 100755
new mode 100644
index 602f1cf..a65e951
--- a/lib/resources/standard_health_record/StructureDefinition-shr-adverse-AttributionCertainty-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-adverse-AttributionCertainty-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.adverse.AttributionCertainty"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR AttributionCertainty Extension",
   "title": "SHR AttributionCertainty Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.717Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.913Z",
   "description": "A specific identifiable level (defined qualitatively or quantitatively) of probability of adverse event being caused or associated with the product or procedure administration to a patient.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-allergy-AllergyIntolerance.json b/lib/resources/standard_health_record/StructureDefinition-shr-allergy-AllergyIntolerance.json
old mode 100755
new mode 100644
index 5037181..31bfed6
--- a/lib/resources/standard_health_record/StructureDefinition-shr-allergy-AllergyIntolerance.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-allergy-AllergyIntolerance.json
@@ -3,7 +3,7 @@
   "id": "shr-allergy-AllergyIntolerance",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR AllergyIntolerance Profile</b></p>\n  <p>A statement pertaining to an individual&#039;s allergies and intolerances to substances or classes of substances. Can be used to record that a substance does not pose an elevated risk to the subject (NonOccurrenceModifier = true).</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.allergy.AllergyIntolerance maps to AllergyIntolerance:\n  Entry.Informant maps to asserter\n  Entry.Author maps to recorder\n  Entry.OriginalCreationDate maps to assertedDate\n  AllergenIrritant maps to code\n  AdverseReactionType maps to type\n  Criticality maps to criticality\n  SubstanceCategory maps to category\n  AllergyVerificationStatus maps to verificationStatus\n  Onset maps to onset[x]\n  MostRecentOccurrence maps to lastOccurrence\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR AllergyIntolerance Profile</b></p>\n  <p>A statement pertaining to an individual's allergies and intolerances to substances or classes of substances. Can be used to record that a substance does not pose an elevated risk to the subject (NonOccurrenceModifier = true).</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.allergy.AllergyIntolerance maps to AllergyIntolerance:\n  Entry.Informant maps to asserter\n  Entry.Author maps to recorder\n  Entry.OriginalCreationDate maps to assertedDate\n  AllergenIrritant maps to code\n  AdverseReactionType maps to type\n  Criticality maps to criticality\n  SubstanceCategory maps to category\n  AllergyVerificationStatus maps to verificationStatus\n  Onset maps to onset[x]\n  MostRecentOccurrence maps to lastOccurrence\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-allergy-AllergyIntolerance",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.allergy.AllergyIntolerance"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR AllergyIntolerance Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.726Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,10 +27,9 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.918Z",
   "description": "A statement pertaining to an individual's allergies and intolerances to substances or classes of substances. Can be used to record that a substance does not pose an elevated risk to the subject (NonOccurrenceModifier = true).",
   "purpose": "To record a clinical assessment of a propensity, or potential risk to an individual, of an adverse reaction upon future exposure to the specified substance, or class of substance.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "rim",
@@ -58,7 +59,7 @@
         "path": "AllergyIntolerance",
         "short": "SHR AllergyIntolerance Profile",
         "definition": "A statement pertaining to an individual's allergies and intolerances to substances or classes of substances. Can be used to record that a substance does not pose an elevated risk to the subject (NonOccurrenceModifier = true).",
-        "comments": "Substances include, but are not limited to: a therapeutic substance administered correctly at an appropriate dosage for the individual; food; material derived from plants or animals; or venom from insect stings.",
+        "comment": "Substances include, but are not limited to: a therapeutic substance administered correctly at an appropriate dosage for the individual; food; material derived from plants or animals; or venom from insect stings.",
         "alias": [
           "Allergy",
           "Intolerance",
@@ -134,7 +135,7 @@
         "path": "AllergyIntolerance.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -173,7 +174,7 @@
         "path": "AllergyIntolerance.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -194,7 +195,7 @@
         "path": "AllergyIntolerance.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -214,6 +215,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -228,7 +237,7 @@
         "path": "AllergyIntolerance.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -262,7 +271,7 @@
         "path": "AllergyIntolerance.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -291,16 +300,19 @@
         "id": "AllergyIntolerance:shr-allergy-AllergyIntolerance.extension",
         "path": "AllergyIntolerance.extension",
         "slicing": {
-          "id": "42",
+          "id": "40",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -329,6 +341,7 @@
         "path": "AllergyIntolerance.extension",
         "sliceName": "manifestation",
         "definition": "A complaint or observed (subjective) indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -361,6 +374,7 @@
         "path": "AllergyIntolerance.extension",
         "sliceName": "abatement",
         "definition": "The end, remission or resolution.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -393,6 +407,7 @@
         "path": "AllergyIntolerance.extension",
         "sliceName": "adversereaction",
         "definition": "Any noxious and unintended response to a medical product, procedure, or other intervention, for which a causal relationship to an intervention is at least a reasonable possibility i.e., the relationship cannot be ruled out. It is not necessarily associated with a previously-recorded SubstanceRisk. This entry could be used to record the occurrence or non-occurrence of an adverse reaction.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -424,16 +439,19 @@
         "id": "AllergyIntolerance:shr-allergy-AllergyIntolerance.modifierExtension",
         "path": "AllergyIntolerance.modifierExtension",
         "slicing": {
-          "id": "43",
+          "id": "41",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -463,6 +481,7 @@
         "path": "AllergyIntolerance.modifierExtension",
         "sliceName": "nonoccurrencemodifier",
         "definition": "When true, indicates either that the event or action documented in the entry did not occur, or the the thing documented is absent or does not exist.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -523,6 +542,7 @@
         "path": "AllergyIntolerance.clinicalStatus",
         "short": "active | inactive | resolved",
         "definition": "The clinical status of the allergy or intolerance.",
+        "comment": "This element is labeled as a modifier because the status contains the codes inactive and resolved that mark the AllergyIntolerance as not currently valid.",
         "min": 0,
         "max": "1",
         "type": [
@@ -530,9 +550,19 @@
             "code": "code"
           }
         ],
+        "condition": [
+          "ait-1",
+          "ait-2"
+        ],
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AllergyIntoleranceClinicalStatus"
+            }
+          ],
           "strength": "required",
           "description": "The clinical status of the allergy or intolerance.",
           "valueSetReference": {
@@ -540,6 +570,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "rim",
+            "map": "Observation ACT\n.inboundRelationship[typeCode=COMP].source[classCode=OBS, code=\"clinicalStatus\", moodCode=EVN].value"
+          },
           {
             "identity": "w5",
             "map": "status"
@@ -551,7 +585,7 @@
         "path": "AllergyIntolerance.verificationStatus",
         "short": "unconfirmed | confirmed | refuted | entered-in-error",
         "definition": "Assertion about certainty associated with the propensity, or potential risk, of a reaction to the identified substance (including pharmaceutical product).",
-        "comments": "Decision support would typically raise alerts for 'confirmed' and 'unconfirmed' and ignore a 'refuted' reaction. In particular, 'refuted' may be useful for reconciliation of the Adverse Reaction List.",
+        "comment": "This element is labeled as a modifier because the status contains the codes refuted and entered-in-error that mark the AllergyIntolerance as not currently valid.",
         "min": 1,
         "max": "1",
         "type": [
@@ -559,16 +593,23 @@
             "code": "code"
           }
         ],
+        "condition": [
+          "ait-1",
+          "ait-2"
+        ],
         "isModifier": true,
         "isSummary": true,
         "binding": {
           "strength": "required",
-          "description": "Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/allergy-verification-status"
+            "reference": "http://standardhealthrecord.org/shr/allergy/vs/AllergyVerificationStatusVS"
           }
         },
         "mapping": [
+          {
+            "identity": "rim",
+            "map": "Observation ACT\n.inboundRelationship[typeCode=COMP].source[classCode=OBS, code=\"verificationStatus\", moodCode=EVN].value"
+          },
           {
             "identity": "w5",
             "map": "status"
@@ -580,7 +621,7 @@
         "path": "AllergyIntolerance.type",
         "short": "allergy | intolerance - Underlying mechanism (if known)",
         "definition": "Identification of the underlying physiological mechanism for the reaction risk.",
-        "comments": "Allergic (typically immune-mediated) reactions have been traditionally regarded as an indicator for potential escalation to significant future risk. Contemporary knowledge suggests that some reactions previously thought to be immune-mediated are, in fact, non-immune, but in some cases can still pose a life threatening risk. It is acknowledged that many clinicians may not be in a position to distinguish the mechanism of a particular reaction. Often the term \"allergy\" is used rather generically and may overlap with the use of \"intolerance\" - in practice the boundaries between these two concepts may not be well-defined or understood. This data element is included nevertheless, because many legacy systems have captured this attribute. Immunologic testing may provide supporting evidence for the basis of the reaction and the causative substance, but no tests are 100% sensitive or specific for sensitivity to a particular substance. If, as is commonly the case, it is unclear whether the reaction is due to an allergy or an intolerance, then the type element should be omitted from the resource.",
+        "comment": "Allergic (typically immune-mediated) reactions have been traditionally regarded as an indicator for potential escalation to significant future risk. Contemporary knowledge suggests that some reactions previously thought to be immune-mediated are, in fact, non-immune, but in some cases can still pose a life threatening risk. It is acknowledged that many clinicians may not be in a position to distinguish the mechanism of a particular reaction. Often the term \"allergy\" is used rather generically and may overlap with the use of \"intolerance\" - in practice the boundaries between these two concepts may not be well-defined or understood. This data element is included nevertheless, because many legacy systems have captured this attribute. Immunologic testing may provide supporting evidence for the basis of the reaction and the causative substance, but no tests are 100% sensitive or specific for sensitivity to a particular substance. If, as is commonly the case, it is unclear whether the reaction is due to an allergy or an intolerance, then the type element should be omitted from the resource.",
         "alias": [
           "Category",
           "Class"
@@ -594,6 +635,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AllergyIntoleranceType"
+            }
+          ],
           "strength": "required",
           "description": "Identification of the underlying physiological mechanism for a Reaction Risk.",
           "valueSetReference": {
@@ -618,9 +665,9 @@
       {
         "id": "AllergyIntolerance:shr-allergy-AllergyIntolerance.category",
         "path": "AllergyIntolerance.category",
-        "short": "food | medication | biologic | environment",
+        "short": "food | medication | environment | biologic",
         "definition": "Category of the identified substance.",
-        "comments": "This data element has been included because it is currently being captured in some clinical systems. This data can be derived from the substance where coding systems are used, and is effectively redundant in that situation.  When searching on category, consider the implications of AllergyIntolerance resources without a category.  For example, when searching on category = medication, medication allergies that don't have a category valued will not be returned.  Refer to [search](search.html) for more information on how to search category with a :missing modifier to get allergies that don't have a category.",
+        "comment": "This data element has been included because it is currently being captured in some clinical systems. This data can be derived from the substance where coding systems are used, and is effectively redundant in that situation.  When searching on category, consider the implications of AllergyIntolerance resources without a category.  For example, when searching on category = medication, medication allergies that don't have a category valued will not be returned.  Refer to [search](search.html) for more information on how to search category with a :missing modifier to get allergies that don't have a category.  Additionally, category should be used with caution because category can be subjective based on the sender.",
         "alias": [
           "Category",
           "Type",
@@ -636,6 +683,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AllergyIntoleranceCategory"
+            }
+          ],
           "strength": "required",
           "description": "Category of an identified substance.",
           "valueSetReference": {
@@ -662,7 +715,7 @@
         "path": "AllergyIntolerance.criticality",
         "short": "low | high | unable-to-assess",
         "definition": "Estimate of the potential clinical harm, or seriousness, of the reaction to the identified substance.",
-        "comments": "The default criticality value for any propensity to an adverse reaction should be 'Low Risk', indicating at the very least a relative contraindication to deliberate or voluntary exposure to the substance. 'High Risk' is flagged if the clinician has identified a propensity for a more serious or potentially life-threatening reaction, such as anaphylaxis, and implies an absolute contraindication to deliberate or voluntary exposure to the substance. If this element is missing, the criticality is unknown (though it may be known elsewhere).",
+        "comment": "The default criticality value for any propensity to an adverse reaction should be 'Low Risk', indicating at the very least a relative contraindication to deliberate or voluntary exposure to the substance. 'High Risk' is flagged if the clinician has identified a propensity for a more serious or potentially life-threatening reaction, such as anaphylaxis, and implies an absolute contraindication to deliberate or voluntary exposure to the substance. If this element is missing, the criticality is unknown (though it may be known elsewhere).\n\nSystems that capture a severity at the condition level are actually representing the concept of criticality whereas the severity documented at the reaction level is representing the true reaction severity.  Existing systems that are capturing both condition criticality and reaction severity may use the term \"severity\" to represent both.  Criticality is the worst it could be in the future (i.e. situation-agnostic) whereas severity is situation-dependent.",
         "alias": [
           "Severity",
           "Seriousness",
@@ -678,6 +731,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AllergyIntoleranceCriticality"
+            }
+          ],
           "strength": "required",
           "description": "Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.",
           "valueSetReference": {
@@ -702,9 +761,9 @@
       {
         "id": "AllergyIntolerance:shr-allergy-AllergyIntolerance.code",
         "path": "AllergyIntolerance.code",
-        "short": "Allergy or intolerance code",
+        "short": "Code that identifies the allergy or intolerance",
         "definition": "Code for an allergy or intolerance statement (either a positive or a negated/excluded statement).  This may be a code for a substance or pharmaceutical product that is considered to be responsible for the adverse reaction risk (e.g., \"Latex\"), an allergy or intolerance condition (e.g., \"Latex allergy\"), or a negated/excluded code for a specific substance or class (e.g., \"No latex allergy\") or a general or categorical negated statement (e.g.,  \"No known allergy\", \"No known drug allergies\").",
-        "comments": "It is strongly recommended that this element be populated using a terminology, where possible. For example, some terminologies used include RxNorm, SNOMED CT, DM+D, NDFRT, ICD-9, IDC-10, UNI, ATC and CPT. Plain text should only be used if there is no appropriate terminology available. Additional details can be specified in the text.\r\rWhen a substance or product code is specified for the 'code' element, the \"default\" semantic context is that this is a positive statement of an allergy or intolerance (depending on the value of the 'type' element, if present) condition to the specified substance/product.  In the corresponding SNOMED CT allergy model, the specified substance/product is the target (destination) of the \"Causative agent\" relationship.\r\rThe 'substanceExposureRisk' extension is available as a structured and more flexible alternative to the 'code' element for making positive or negative allergy or intolerance statements.  This extension provides the capability to make \"no known allergy\" (or \"no risk of adverse reaction\") statements regarding any coded substance/product (including cases when a pre-coordinated \"no allergy to x\" concept for that substance/product does not exist).  If the 'substanceExposureRisk' extension is present, the AllergyIntolerance.code element SHALL be omitted.",
+        "comment": "It is strongly recommended that this element be populated using a terminology, where possible. For example, some terminologies used include RxNorm, SNOMED CT, DM+D, NDFRT, ICD-9, IDC-10, UNI, ATC and CPT. Plain text should only be used if there is no appropriate terminology available. Additional details can be specified in the text.\r\rWhen a substance or product code is specified for the 'code' element, the \"default\" semantic context is that this is a positive statement of an allergy or intolerance (depending on the value of the 'type' element, if present) condition to the specified substance/product.  In the corresponding SNOMED CT allergy model, the specified substance/product is the target (destination) of the \"Causative agent\" relationship.\r\rThe 'substanceExposureRisk' extension is available as a structured and more flexible alternative to the 'code' element for making positive or negative allergy or intolerance statements.  This extension provides the capability to make \"no known allergy\" (or \"no risk of adverse reaction\") statements regarding any coded substance/product (including cases when a pre-coordinated \"no allergy to x\" concept for that substance/product does not exist).  If the 'substanceExposureRisk' extension is present, the AllergyIntolerance.code element SHALL be omitted.",
         "alias": [
           "Code"
         ],
@@ -720,7 +779,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-allergy-AllergenIrritantVS"
+            "reference": "http://standardhealthrecord.org/shr/allergy/vs/AllergenIrritantVS"
           }
         },
         "mapping": [
@@ -868,7 +927,7 @@
         "path": "AllergyIntolerance.asserter",
         "short": "Source of the information about the allergy",
         "definition": "The source of the information about the allergy that is recorded.",
-        "comments": "The recorder takes repsonsibility for the content, but can reference the source from where they got it.",
+        "comment": "The recorder takes repsonsibility for the content, but can reference the source from where they got it.",
         "alias": [
           "Source",
           "Informant"
@@ -910,7 +969,7 @@
         "path": "AllergyIntolerance.lastOccurrence",
         "short": "Date(/time) of last known occurrence of a reaction",
         "definition": "Represents the date and/or time of the last known occurrence of a reaction event.",
-        "comments": "This date may be replicated by one of the Onset of Reaction dates. Where a textual representation of the date of last occurrence is required e.g. 'In Childhood, '10 years ago' the Comment element should be used.",
+        "comment": "This date may be replicated by one of the Onset of Reaction dates. Where a textual representation of the date of last occurrence is required e.g. 'In Childhood, '10 years ago' the Comment element should be used.",
         "min": 0,
         "max": "1",
         "type": [
@@ -930,7 +989,7 @@
         "path": "AllergyIntolerance.note",
         "short": "Additional text not captured in other fields",
         "definition": "Additional narrative about the propensity for the Adverse Reaction, not captured in other fields.",
-        "comments": "For example: including reason for flagging a seriousness of 'High Risk'; and instructions related to future exposure or administration of the substance, such as administration within an Intensive Care Unit or under corticosteroid cover. The notes should be related to an allergy or intolerance as a condition in general and not related to any particular episode of it. For episode notes and descriptions, use AllergyIntolerance.event.description and  AllergyIntolerance.event.notes.",
+        "comment": "For example: including reason for flagging a seriousness of 'High Risk'; and instructions related to future exposure or administration of the substance, such as administration within an Intensive Care Unit or under corticosteroid cover. The notes should be related to an allergy or intolerance as a condition in general and not related to any particular episode of it. For episode notes and descriptions, use AllergyIntolerance.event.description and  AllergyIntolerance.event.notes.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1006,7 +1065,7 @@
         "path": "AllergyIntolerance.reaction.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1035,7 +1094,7 @@
         "path": "AllergyIntolerance.reaction.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1067,7 +1126,7 @@
         "path": "AllergyIntolerance.reaction.substance",
         "short": "Specific substance or pharmaceutical product considered to be responsible for event",
         "definition": "Identification of the specific substance (or pharmaceutical product) considered to be responsible for the Adverse Reaction event. Note: the substance for a specific reaction may be different from the substance identified as the cause of the risk, but it must be consistent with it. For instance, it may be a more specific substance (e.g. a brand medication) or a composite product that includes the identified substance. It must be clinically safe to only process the 'code' and ignore the 'reaction.substance'.",
-        "comments": "Coding of the specific substance (or pharmaceutical product) with a terminology capable of triggering decision support should be used wherever possible.  The 'code' element allows for the use of a specific substance or pharmaceutical product, or a group or class of substances. In the case of an allergy or intolerance to a class of substances, (for example, \"penicillins\"), the 'reaction.substance' element could be used to code the specific substance that was identifed as having caused the reaction (for example, \"amoxycillin\"). Duplication of the value in the 'code' and 'reaction.substance' elements is acceptable when a specific substance has been recorded in 'code'.",
+        "comment": "Coding of the specific substance (or pharmaceutical product) with a terminology capable of triggering decision support should be used wherever possible.  The 'code' element allows for the use of a specific substance or pharmaceutical product, or a group or class of substances. In the case of an allergy or intolerance to a class of substances, (for example, \"penicillins\"), the 'reaction.substance' element could be used to code the specific substance that was identifed as having caused the reaction (for example, \"amoxycillin\"). Duplication of the value in the 'code' and 'reaction.substance' elements is acceptable when a specific substance has been recorded in 'code'.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1076,6 +1135,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "SubstanceCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes defining the type of the substance (including pharmaceutical products).",
           "valueSetReference": {
@@ -1089,42 +1154,12 @@
           }
         ]
       },
-      {
-        "id": "AllergyIntolerance:shr-allergy-AllergyIntolerance.reaction.certainty",
-        "path": "AllergyIntolerance.reaction.certainty",
-        "short": "unlikely | likely | confirmed | unknown",
-        "definition": "Statement about the degree of clinical certainty that the specific substance was the cause of the manifestation in this reaction event.",
-        "comments": "When certainty is missing, it means no information exists (although it could be in narrative).  By contrast, the unknown code is used when there is an explicit assertion that certainty is not known, such as when a patient eats a meal and it is unknown which food caused the reaction.",
-        "alias": [
-          "Cause"
-        ],
-        "min": 0,
-        "max": "1",
-        "type": [
-          {
-            "code": "code"
-          }
-        ],
-        "binding": {
-          "strength": "required",
-          "description": "Statement about the degree of clinical certainty that a specific substance was the cause of the manifestation in an reaction event.",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/reaction-event-certainty"
-          }
-        },
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "uncertaintyCode"
-          }
-        ]
-      },
       {
         "id": "AllergyIntolerance:shr-allergy-AllergyIntolerance.reaction.manifestation",
         "path": "AllergyIntolerance.reaction.manifestation",
         "short": "Clinical symptoms/signs associated with the Event",
         "definition": "Clinical symptoms and/or signs that are observed or associated with the adverse reaction event.",
-        "comments": "Manifestation can be expressed as a single word, phrase or brief description. For example: nausea, rash or no reaction. It is preferable that manifestation should be coded with a terminology, where possible. The values entered here may be used to display on an application screen as part of a list of adverse reactions, as recommended in the UK NHS CUI guidelines.  Terminologies commonly used include, but are not limited to, SNOMED CT or ICD10.",
+        "comment": "Manifestation can be expressed as a single word, phrase or brief description. For example: nausea, rash or no reaction. It is preferable that manifestation should be coded with a terminology, where possible. The values entered here may be used to display on an application screen as part of a list of adverse reactions, as recommended in the UK NHS CUI guidelines.  Terminologies commonly used include, but are not limited to, SNOMED CT or ICD10.",
         "alias": [
           "Symptoms",
           "Signs"
@@ -1137,10 +1172,16 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Manifestation"
+            }
+          ],
           "strength": "example",
           "description": "Clinical symptoms and/or signs that are observed or associated with an Adverse Reaction Event.",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/manifestation-codes"
+            "reference": "http://hl7.org/fhir/ValueSet/clinical-findings"
           }
         },
         "mapping": [
@@ -1159,7 +1200,7 @@
         "path": "AllergyIntolerance.reaction.description",
         "short": "Description of the event as a whole",
         "definition": "Text description about the reaction as a whole, including details of the manifestation if required.",
-        "comments": "Use the description to provide any details of a particular event of the occurred reaction such as circumstances, reaction specifics, what happened before/after. Information, related to the event, but not describing a particular care should be captured in the comment field. For example: at the age of four, the patient was given penicillin for strep throat and subsequently developed severe hives.",
+        "comment": "Use the description to provide any details of a particular event of the occurred reaction such as circumstances, reaction specifics, what happened before/after. Information, related to the event, but not describing a particular care should be captured in the comment field. For example: at the age of four, the patient was given penicillin for strep throat and subsequently developed severe hives.",
         "alias": [
           "Narrative",
           "Text"
@@ -1206,7 +1247,7 @@
         "path": "AllergyIntolerance.reaction.severity",
         "short": "mild | moderate | severe (of event as a whole)",
         "definition": "Clinical assessment of the severity of the reaction event as a whole, potentially considering multiple different manifestations.",
-        "comments": "It is acknowledged that this assessment is very subjective. There may be some some specific practice domains where objective scales have been applied. Objective scales can be included in this model as extensions.",
+        "comment": "It is acknowledged that this assessment is very subjective. There may be some some specific practice domains where objective scales have been applied. Objective scales can be included in this model as extensions.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1215,6 +1256,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AllergyIntoleranceSeverity"
+            }
+          ],
           "strength": "required",
           "description": "Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations.",
           "valueSetReference": {
@@ -1233,7 +1280,7 @@
         "path": "AllergyIntolerance.reaction.exposureRoute",
         "short": "How the subject was exposed to the substance",
         "definition": "Identification of the route by which the subject was exposed to the substance.",
-        "comments": "Coding of the route of exposure with a terminology should be used wherever possible.",
+        "comment": "Coding of the route of exposure with a terminology should be used wherever possible.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1242,6 +1289,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "RouteOfAdministration"
+            }
+          ],
           "strength": "example",
           "description": "A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.",
           "valueSetReference": {
@@ -1260,7 +1313,7 @@
         "path": "AllergyIntolerance.reaction.note",
         "short": "Text about event not captured in other fields",
         "definition": "Additional text about the adverse reaction event not captured in other fields.",
-        "comments": "Use this field to record information indirectly related to a particular event and not captured in the description. For example: Clinical records are no longer available, recorded based on information provided to the patient by her mother and her mother is deceased.",
+        "comment": "Use this field to record information indirectly related to a particular event and not captured in the description. For example: Clinical records are no longer available, recorded based on information provided to the patient by her mother and her mother is deceased.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1349,6 +1402,16 @@
         "isModifier": true,
         "isSummary": false
       },
+      {
+        "id": "AllergyIntolerance:shr-allergy-AllergyIntolerance.verificationStatus",
+        "path": "AllergyIntolerance.verificationStatus",
+        "binding": {
+          "strength": "required",
+          "valueSetReference": {
+            "reference": "http://standardhealthrecord.org/shr/allergy/vs/AllergyVerificationStatusVS"
+          }
+        }
+      },
       {
         "id": "AllergyIntolerance:shr-allergy-AllergyIntolerance.code",
         "path": "AllergyIntolerance.code",
@@ -1361,7 +1424,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-allergy-AllergenIrritantVS"
+            "reference": "http://standardhealthrecord.org/shr/allergy/vs/AllergenIrritantVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-allergy-DrugAllergy.json b/lib/resources/standard_health_record/StructureDefinition-shr-allergy-DrugAllergy.json
old mode 100755
new mode 100644
index 4e1912e..2da2ced
--- a/lib/resources/standard_health_record/StructureDefinition-shr-allergy-DrugAllergy.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-allergy-DrugAllergy.json
@@ -12,8 +12,10 @@
       "value": "shr.allergy.DrugAllergy"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR DrugAllergy Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.741Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,10 +27,9 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.922Z",
   "description": "An immune or biochemical adverse reaction to a medication.",
   "purpose": "To record a clinical assessment of a propensity, or potential risk to an individual, of an adverse reaction upon future exposure to the specified substance, or class of substance.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "rim",
@@ -58,7 +59,7 @@
         "path": "AllergyIntolerance",
         "short": "SHR DrugAllergy Profile",
         "definition": "An immune or biochemical adverse reaction to a medication.",
-        "comments": "Substances include, but are not limited to: a therapeutic substance administered correctly at an appropriate dosage for the individual; food; material derived from plants or animals; or venom from insect stings.",
+        "comment": "Substances include, but are not limited to: a therapeutic substance administered correctly at an appropriate dosage for the individual; food; material derived from plants or animals; or venom from insect stings.",
         "alias": [
           "Allergy",
           "Intolerance",
@@ -134,7 +135,7 @@
         "path": "AllergyIntolerance.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -173,7 +174,7 @@
         "path": "AllergyIntolerance.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -194,7 +195,7 @@
         "path": "AllergyIntolerance.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -214,6 +215,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -228,7 +237,7 @@
         "path": "AllergyIntolerance.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -262,7 +271,7 @@
         "path": "AllergyIntolerance.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -291,16 +300,19 @@
         "id": "AllergyIntolerance:shr-allergy-DrugAllergy.extension",
         "path": "AllergyIntolerance.extension",
         "slicing": {
-          "id": "44",
+          "id": "42",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -329,6 +341,7 @@
         "path": "AllergyIntolerance.extension",
         "sliceName": "manifestation",
         "definition": "A complaint or observed (subjective) indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -361,6 +374,7 @@
         "path": "AllergyIntolerance.extension",
         "sliceName": "abatement",
         "definition": "The end, remission or resolution.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -393,6 +407,7 @@
         "path": "AllergyIntolerance.extension",
         "sliceName": "adversereaction",
         "definition": "Any noxious and unintended response to a medical product, procedure, or other intervention, for which a causal relationship to an intervention is at least a reasonable possibility i.e., the relationship cannot be ruled out. It is not necessarily associated with a previously-recorded SubstanceRisk. This entry could be used to record the occurrence or non-occurrence of an adverse reaction.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -424,16 +439,19 @@
         "id": "AllergyIntolerance:shr-allergy-DrugAllergy.modifierExtension",
         "path": "AllergyIntolerance.modifierExtension",
         "slicing": {
-          "id": "45",
+          "id": "43",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -463,6 +481,7 @@
         "path": "AllergyIntolerance.modifierExtension",
         "sliceName": "nonoccurrencemodifier",
         "definition": "When true, indicates either that the event or action documented in the entry did not occur, or the the thing documented is absent or does not exist.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -523,6 +542,7 @@
         "path": "AllergyIntolerance.clinicalStatus",
         "short": "active | inactive | resolved",
         "definition": "The clinical status of the allergy or intolerance.",
+        "comment": "This element is labeled as a modifier because the status contains the codes inactive and resolved that mark the AllergyIntolerance as not currently valid.",
         "min": 0,
         "max": "1",
         "type": [
@@ -530,9 +550,19 @@
             "code": "code"
           }
         ],
+        "condition": [
+          "ait-1",
+          "ait-2"
+        ],
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AllergyIntoleranceClinicalStatus"
+            }
+          ],
           "strength": "required",
           "description": "The clinical status of the allergy or intolerance.",
           "valueSetReference": {
@@ -540,6 +570,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "rim",
+            "map": "Observation ACT\n.inboundRelationship[typeCode=COMP].source[classCode=OBS, code=\"clinicalStatus\", moodCode=EVN].value"
+          },
           {
             "identity": "w5",
             "map": "status"
@@ -551,7 +585,7 @@
         "path": "AllergyIntolerance.verificationStatus",
         "short": "unconfirmed | confirmed | refuted | entered-in-error",
         "definition": "Assertion about certainty associated with the propensity, or potential risk, of a reaction to the identified substance (including pharmaceutical product).",
-        "comments": "Decision support would typically raise alerts for 'confirmed' and 'unconfirmed' and ignore a 'refuted' reaction. In particular, 'refuted' may be useful for reconciliation of the Adverse Reaction List.",
+        "comment": "This element is labeled as a modifier because the status contains the codes refuted and entered-in-error that mark the AllergyIntolerance as not currently valid.",
         "min": 1,
         "max": "1",
         "type": [
@@ -559,16 +593,23 @@
             "code": "code"
           }
         ],
+        "condition": [
+          "ait-1",
+          "ait-2"
+        ],
         "isModifier": true,
         "isSummary": true,
         "binding": {
           "strength": "required",
-          "description": "Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/allergy-verification-status"
+            "reference": "http://standardhealthrecord.org/shr/allergy/vs/AllergyVerificationStatusVS"
           }
         },
         "mapping": [
+          {
+            "identity": "rim",
+            "map": "Observation ACT\n.inboundRelationship[typeCode=COMP].source[classCode=OBS, code=\"verificationStatus\", moodCode=EVN].value"
+          },
           {
             "identity": "w5",
             "map": "status"
@@ -580,7 +621,7 @@
         "path": "AllergyIntolerance.type",
         "short": "allergy | intolerance - Underlying mechanism (if known)",
         "definition": "Identification of the underlying physiological mechanism for the reaction risk.",
-        "comments": "Allergic (typically immune-mediated) reactions have been traditionally regarded as an indicator for potential escalation to significant future risk. Contemporary knowledge suggests that some reactions previously thought to be immune-mediated are, in fact, non-immune, but in some cases can still pose a life threatening risk. It is acknowledged that many clinicians may not be in a position to distinguish the mechanism of a particular reaction. Often the term \"allergy\" is used rather generically and may overlap with the use of \"intolerance\" - in practice the boundaries between these two concepts may not be well-defined or understood. This data element is included nevertheless, because many legacy systems have captured this attribute. Immunologic testing may provide supporting evidence for the basis of the reaction and the causative substance, but no tests are 100% sensitive or specific for sensitivity to a particular substance. If, as is commonly the case, it is unclear whether the reaction is due to an allergy or an intolerance, then the type element should be omitted from the resource.",
+        "comment": "Allergic (typically immune-mediated) reactions have been traditionally regarded as an indicator for potential escalation to significant future risk. Contemporary knowledge suggests that some reactions previously thought to be immune-mediated are, in fact, non-immune, but in some cases can still pose a life threatening risk. It is acknowledged that many clinicians may not be in a position to distinguish the mechanism of a particular reaction. Often the term \"allergy\" is used rather generically and may overlap with the use of \"intolerance\" - in practice the boundaries between these two concepts may not be well-defined or understood. This data element is included nevertheless, because many legacy systems have captured this attribute. Immunologic testing may provide supporting evidence for the basis of the reaction and the causative substance, but no tests are 100% sensitive or specific for sensitivity to a particular substance. If, as is commonly the case, it is unclear whether the reaction is due to an allergy or an intolerance, then the type element should be omitted from the resource.",
         "alias": [
           "Category",
           "Class"
@@ -595,6 +636,12 @@
         "fixedCode": "allergy",
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AllergyIntoleranceType"
+            }
+          ],
           "strength": "required",
           "description": "Identification of the underlying physiological mechanism for a Reaction Risk.",
           "valueSetReference": {
@@ -619,9 +666,9 @@
       {
         "id": "AllergyIntolerance:shr-allergy-DrugAllergy.category",
         "path": "AllergyIntolerance.category",
-        "short": "food | medication | biologic | environment",
+        "short": "food | medication | environment | biologic",
         "definition": "Category of the identified substance.",
-        "comments": "This data element has been included because it is currently being captured in some clinical systems. This data can be derived from the substance where coding systems are used, and is effectively redundant in that situation.  When searching on category, consider the implications of AllergyIntolerance resources without a category.  For example, when searching on category = medication, medication allergies that don't have a category valued will not be returned.  Refer to [search](search.html) for more information on how to search category with a :missing modifier to get allergies that don't have a category.",
+        "comment": "This data element has been included because it is currently being captured in some clinical systems. This data can be derived from the substance where coding systems are used, and is effectively redundant in that situation.  When searching on category, consider the implications of AllergyIntolerance resources without a category.  For example, when searching on category = medication, medication allergies that don't have a category valued will not be returned.  Refer to [search](search.html) for more information on how to search category with a :missing modifier to get allergies that don't have a category.  Additionally, category should be used with caution because category can be subjective based on the sender.",
         "alias": [
           "Category",
           "Type",
@@ -638,6 +685,12 @@
         "fixedCode": "drug",
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AllergyIntoleranceCategory"
+            }
+          ],
           "strength": "required",
           "description": "Category of an identified substance.",
           "valueSetReference": {
@@ -664,7 +717,7 @@
         "path": "AllergyIntolerance.criticality",
         "short": "low | high | unable-to-assess",
         "definition": "Estimate of the potential clinical harm, or seriousness, of the reaction to the identified substance.",
-        "comments": "The default criticality value for any propensity to an adverse reaction should be 'Low Risk', indicating at the very least a relative contraindication to deliberate or voluntary exposure to the substance. 'High Risk' is flagged if the clinician has identified a propensity for a more serious or potentially life-threatening reaction, such as anaphylaxis, and implies an absolute contraindication to deliberate or voluntary exposure to the substance. If this element is missing, the criticality is unknown (though it may be known elsewhere).",
+        "comment": "The default criticality value for any propensity to an adverse reaction should be 'Low Risk', indicating at the very least a relative contraindication to deliberate or voluntary exposure to the substance. 'High Risk' is flagged if the clinician has identified a propensity for a more serious or potentially life-threatening reaction, such as anaphylaxis, and implies an absolute contraindication to deliberate or voluntary exposure to the substance. If this element is missing, the criticality is unknown (though it may be known elsewhere).\n\nSystems that capture a severity at the condition level are actually representing the concept of criticality whereas the severity documented at the reaction level is representing the true reaction severity.  Existing systems that are capturing both condition criticality and reaction severity may use the term \"severity\" to represent both.  Criticality is the worst it could be in the future (i.e. situation-agnostic) whereas severity is situation-dependent.",
         "alias": [
           "Severity",
           "Seriousness",
@@ -680,6 +733,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AllergyIntoleranceCriticality"
+            }
+          ],
           "strength": "required",
           "description": "Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.",
           "valueSetReference": {
@@ -704,9 +763,9 @@
       {
         "id": "AllergyIntolerance:shr-allergy-DrugAllergy.code",
         "path": "AllergyIntolerance.code",
-        "short": "Allergy or intolerance code",
+        "short": "Code that identifies the allergy or intolerance",
         "definition": "Code for an allergy or intolerance statement (either a positive or a negated/excluded statement).  This may be a code for a substance or pharmaceutical product that is considered to be responsible for the adverse reaction risk (e.g., \"Latex\"), an allergy or intolerance condition (e.g., \"Latex allergy\"), or a negated/excluded code for a specific substance or class (e.g., \"No latex allergy\") or a general or categorical negated statement (e.g.,  \"No known allergy\", \"No known drug allergies\").",
-        "comments": "It is strongly recommended that this element be populated using a terminology, where possible. For example, some terminologies used include RxNorm, SNOMED CT, DM+D, NDFRT, ICD-9, IDC-10, UNI, ATC and CPT. Plain text should only be used if there is no appropriate terminology available. Additional details can be specified in the text.\r\rWhen a substance or product code is specified for the 'code' element, the \"default\" semantic context is that this is a positive statement of an allergy or intolerance (depending on the value of the 'type' element, if present) condition to the specified substance/product.  In the corresponding SNOMED CT allergy model, the specified substance/product is the target (destination) of the \"Causative agent\" relationship.\r\rThe 'substanceExposureRisk' extension is available as a structured and more flexible alternative to the 'code' element for making positive or negative allergy or intolerance statements.  This extension provides the capability to make \"no known allergy\" (or \"no risk of adverse reaction\") statements regarding any coded substance/product (including cases when a pre-coordinated \"no allergy to x\" concept for that substance/product does not exist).  If the 'substanceExposureRisk' extension is present, the AllergyIntolerance.code element SHALL be omitted.",
+        "comment": "It is strongly recommended that this element be populated using a terminology, where possible. For example, some terminologies used include RxNorm, SNOMED CT, DM+D, NDFRT, ICD-9, IDC-10, UNI, ATC and CPT. Plain text should only be used if there is no appropriate terminology available. Additional details can be specified in the text.\r\rWhen a substance or product code is specified for the 'code' element, the \"default\" semantic context is that this is a positive statement of an allergy or intolerance (depending on the value of the 'type' element, if present) condition to the specified substance/product.  In the corresponding SNOMED CT allergy model, the specified substance/product is the target (destination) of the \"Causative agent\" relationship.\r\rThe 'substanceExposureRisk' extension is available as a structured and more flexible alternative to the 'code' element for making positive or negative allergy or intolerance statements.  This extension provides the capability to make \"no known allergy\" (or \"no risk of adverse reaction\") statements regarding any coded substance/product (including cases when a pre-coordinated \"no allergy to x\" concept for that substance/product does not exist).  If the 'substanceExposureRisk' extension is present, the AllergyIntolerance.code element SHALL be omitted.",
         "alias": [
           "Code"
         ],
@@ -722,7 +781,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-allergy-DrugIngredientVS"
+            "reference": "http://standardhealthrecord.org/shr/allergy/vs/DrugIngredientVS"
           }
         },
         "mapping": [
@@ -870,7 +929,7 @@
         "path": "AllergyIntolerance.asserter",
         "short": "Source of the information about the allergy",
         "definition": "The source of the information about the allergy that is recorded.",
-        "comments": "The recorder takes repsonsibility for the content, but can reference the source from where they got it.",
+        "comment": "The recorder takes repsonsibility for the content, but can reference the source from where they got it.",
         "alias": [
           "Source",
           "Informant"
@@ -912,7 +971,7 @@
         "path": "AllergyIntolerance.lastOccurrence",
         "short": "Date(/time) of last known occurrence of a reaction",
         "definition": "Represents the date and/or time of the last known occurrence of a reaction event.",
-        "comments": "This date may be replicated by one of the Onset of Reaction dates. Where a textual representation of the date of last occurrence is required e.g. 'In Childhood, '10 years ago' the Comment element should be used.",
+        "comment": "This date may be replicated by one of the Onset of Reaction dates. Where a textual representation of the date of last occurrence is required e.g. 'In Childhood, '10 years ago' the Comment element should be used.",
         "min": 0,
         "max": "1",
         "type": [
@@ -932,7 +991,7 @@
         "path": "AllergyIntolerance.note",
         "short": "Additional text not captured in other fields",
         "definition": "Additional narrative about the propensity for the Adverse Reaction, not captured in other fields.",
-        "comments": "For example: including reason for flagging a seriousness of 'High Risk'; and instructions related to future exposure or administration of the substance, such as administration within an Intensive Care Unit or under corticosteroid cover. The notes should be related to an allergy or intolerance as a condition in general and not related to any particular episode of it. For episode notes and descriptions, use AllergyIntolerance.event.description and  AllergyIntolerance.event.notes.",
+        "comment": "For example: including reason for flagging a seriousness of 'High Risk'; and instructions related to future exposure or administration of the substance, such as administration within an Intensive Care Unit or under corticosteroid cover. The notes should be related to an allergy or intolerance as a condition in general and not related to any particular episode of it. For episode notes and descriptions, use AllergyIntolerance.event.description and  AllergyIntolerance.event.notes.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1008,7 +1067,7 @@
         "path": "AllergyIntolerance.reaction.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1037,7 +1096,7 @@
         "path": "AllergyIntolerance.reaction.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1069,7 +1128,7 @@
         "path": "AllergyIntolerance.reaction.substance",
         "short": "Specific substance or pharmaceutical product considered to be responsible for event",
         "definition": "Identification of the specific substance (or pharmaceutical product) considered to be responsible for the Adverse Reaction event. Note: the substance for a specific reaction may be different from the substance identified as the cause of the risk, but it must be consistent with it. For instance, it may be a more specific substance (e.g. a brand medication) or a composite product that includes the identified substance. It must be clinically safe to only process the 'code' and ignore the 'reaction.substance'.",
-        "comments": "Coding of the specific substance (or pharmaceutical product) with a terminology capable of triggering decision support should be used wherever possible.  The 'code' element allows for the use of a specific substance or pharmaceutical product, or a group or class of substances. In the case of an allergy or intolerance to a class of substances, (for example, \"penicillins\"), the 'reaction.substance' element could be used to code the specific substance that was identifed as having caused the reaction (for example, \"amoxycillin\"). Duplication of the value in the 'code' and 'reaction.substance' elements is acceptable when a specific substance has been recorded in 'code'.",
+        "comment": "Coding of the specific substance (or pharmaceutical product) with a terminology capable of triggering decision support should be used wherever possible.  The 'code' element allows for the use of a specific substance or pharmaceutical product, or a group or class of substances. In the case of an allergy or intolerance to a class of substances, (for example, \"penicillins\"), the 'reaction.substance' element could be used to code the specific substance that was identifed as having caused the reaction (for example, \"amoxycillin\"). Duplication of the value in the 'code' and 'reaction.substance' elements is acceptable when a specific substance has been recorded in 'code'.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1078,6 +1137,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "SubstanceCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes defining the type of the substance (including pharmaceutical products).",
           "valueSetReference": {
@@ -1091,42 +1156,12 @@
           }
         ]
       },
-      {
-        "id": "AllergyIntolerance:shr-allergy-DrugAllergy.reaction.certainty",
-        "path": "AllergyIntolerance.reaction.certainty",
-        "short": "unlikely | likely | confirmed | unknown",
-        "definition": "Statement about the degree of clinical certainty that the specific substance was the cause of the manifestation in this reaction event.",
-        "comments": "When certainty is missing, it means no information exists (although it could be in narrative).  By contrast, the unknown code is used when there is an explicit assertion that certainty is not known, such as when a patient eats a meal and it is unknown which food caused the reaction.",
-        "alias": [
-          "Cause"
-        ],
-        "min": 0,
-        "max": "1",
-        "type": [
-          {
-            "code": "code"
-          }
-        ],
-        "binding": {
-          "strength": "required",
-          "description": "Statement about the degree of clinical certainty that a specific substance was the cause of the manifestation in an reaction event.",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/reaction-event-certainty"
-          }
-        },
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "uncertaintyCode"
-          }
-        ]
-      },
       {
         "id": "AllergyIntolerance:shr-allergy-DrugAllergy.reaction.manifestation",
         "path": "AllergyIntolerance.reaction.manifestation",
         "short": "Clinical symptoms/signs associated with the Event",
         "definition": "Clinical symptoms and/or signs that are observed or associated with the adverse reaction event.",
-        "comments": "Manifestation can be expressed as a single word, phrase or brief description. For example: nausea, rash or no reaction. It is preferable that manifestation should be coded with a terminology, where possible. The values entered here may be used to display on an application screen as part of a list of adverse reactions, as recommended in the UK NHS CUI guidelines.  Terminologies commonly used include, but are not limited to, SNOMED CT or ICD10.",
+        "comment": "Manifestation can be expressed as a single word, phrase or brief description. For example: nausea, rash or no reaction. It is preferable that manifestation should be coded with a terminology, where possible. The values entered here may be used to display on an application screen as part of a list of adverse reactions, as recommended in the UK NHS CUI guidelines.  Terminologies commonly used include, but are not limited to, SNOMED CT or ICD10.",
         "alias": [
           "Symptoms",
           "Signs"
@@ -1139,10 +1174,16 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Manifestation"
+            }
+          ],
           "strength": "example",
           "description": "Clinical symptoms and/or signs that are observed or associated with an Adverse Reaction Event.",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/manifestation-codes"
+            "reference": "http://hl7.org/fhir/ValueSet/clinical-findings"
           }
         },
         "mapping": [
@@ -1161,7 +1202,7 @@
         "path": "AllergyIntolerance.reaction.description",
         "short": "Description of the event as a whole",
         "definition": "Text description about the reaction as a whole, including details of the manifestation if required.",
-        "comments": "Use the description to provide any details of a particular event of the occurred reaction such as circumstances, reaction specifics, what happened before/after. Information, related to the event, but not describing a particular care should be captured in the comment field. For example: at the age of four, the patient was given penicillin for strep throat and subsequently developed severe hives.",
+        "comment": "Use the description to provide any details of a particular event of the occurred reaction such as circumstances, reaction specifics, what happened before/after. Information, related to the event, but not describing a particular care should be captured in the comment field. For example: at the age of four, the patient was given penicillin for strep throat and subsequently developed severe hives.",
         "alias": [
           "Narrative",
           "Text"
@@ -1208,7 +1249,7 @@
         "path": "AllergyIntolerance.reaction.severity",
         "short": "mild | moderate | severe (of event as a whole)",
         "definition": "Clinical assessment of the severity of the reaction event as a whole, potentially considering multiple different manifestations.",
-        "comments": "It is acknowledged that this assessment is very subjective. There may be some some specific practice domains where objective scales have been applied. Objective scales can be included in this model as extensions.",
+        "comment": "It is acknowledged that this assessment is very subjective. There may be some some specific practice domains where objective scales have been applied. Objective scales can be included in this model as extensions.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1217,6 +1258,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AllergyIntoleranceSeverity"
+            }
+          ],
           "strength": "required",
           "description": "Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations.",
           "valueSetReference": {
@@ -1235,7 +1282,7 @@
         "path": "AllergyIntolerance.reaction.exposureRoute",
         "short": "How the subject was exposed to the substance",
         "definition": "Identification of the route by which the subject was exposed to the substance.",
-        "comments": "Coding of the route of exposure with a terminology should be used wherever possible.",
+        "comment": "Coding of the route of exposure with a terminology should be used wherever possible.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1244,6 +1291,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "RouteOfAdministration"
+            }
+          ],
           "strength": "example",
           "description": "A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.",
           "valueSetReference": {
@@ -1262,7 +1315,7 @@
         "path": "AllergyIntolerance.reaction.note",
         "short": "Text about event not captured in other fields",
         "definition": "Additional text about the adverse reaction event not captured in other fields.",
-        "comments": "Use this field to record information indirectly related to a particular event and not captured in the description. For example: Clinical records are no longer available, recorded based on information provided to the patient by her mother and her mother is deceased.",
+        "comment": "Use this field to record information indirectly related to a particular event and not captured in the description. For example: Clinical records are no longer available, recorded based on information provided to the patient by her mother and her mother is deceased.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1351,6 +1404,16 @@
         "isModifier": true,
         "isSummary": false
       },
+      {
+        "id": "AllergyIntolerance:shr-allergy-DrugAllergy.verificationStatus",
+        "path": "AllergyIntolerance.verificationStatus",
+        "binding": {
+          "strength": "required",
+          "valueSetReference": {
+            "reference": "http://standardhealthrecord.org/shr/allergy/vs/AllergyVerificationStatusVS"
+          }
+        }
+      },
       {
         "id": "AllergyIntolerance:shr-allergy-DrugAllergy.type",
         "path": "AllergyIntolerance.type",
@@ -1377,7 +1440,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-allergy-DrugIngredientVS"
+            "reference": "http://standardhealthrecord.org/shr/allergy/vs/DrugIngredientVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-allergy-FoodAllergy-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-allergy-FoodAllergy-extension.json
old mode 100755
new mode 100644
index 51e4fec..494fba1
--- a/lib/resources/standard_health_record/StructureDefinition-shr-allergy-FoodAllergy-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-allergy-FoodAllergy-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.allergy.FoodAllergy"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR FoodAllergy Extension",
   "title": "SHR FoodAllergy Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.259Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.057Z",
   "description": "An immune or biochemical adverse reaction to a food substance.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-allergy-FoodAllergy.json b/lib/resources/standard_health_record/StructureDefinition-shr-allergy-FoodAllergy.json
old mode 100755
new mode 100644
index 6ad1f9d..6803ec8
--- a/lib/resources/standard_health_record/StructureDefinition-shr-allergy-FoodAllergy.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-allergy-FoodAllergy.json
@@ -12,8 +12,10 @@
       "value": "shr.allergy.FoodAllergy"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR FoodAllergy Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.758Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,10 +27,9 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.931Z",
   "description": "An immune or biochemical adverse reaction to a food substance.",
   "purpose": "To record a clinical assessment of a propensity, or potential risk to an individual, of an adverse reaction upon future exposure to the specified substance, or class of substance.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "rim",
@@ -58,7 +59,7 @@
         "path": "AllergyIntolerance",
         "short": "SHR FoodAllergy Profile",
         "definition": "An immune or biochemical adverse reaction to a food substance.",
-        "comments": "Substances include, but are not limited to: a therapeutic substance administered correctly at an appropriate dosage for the individual; food; material derived from plants or animals; or venom from insect stings.",
+        "comment": "Substances include, but are not limited to: a therapeutic substance administered correctly at an appropriate dosage for the individual; food; material derived from plants or animals; or venom from insect stings.",
         "alias": [
           "Allergy",
           "Intolerance",
@@ -134,7 +135,7 @@
         "path": "AllergyIntolerance.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -173,7 +174,7 @@
         "path": "AllergyIntolerance.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -194,7 +195,7 @@
         "path": "AllergyIntolerance.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -214,6 +215,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -228,7 +237,7 @@
         "path": "AllergyIntolerance.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -262,7 +271,7 @@
         "path": "AllergyIntolerance.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -291,16 +300,19 @@
         "id": "AllergyIntolerance:shr-allergy-FoodAllergy.extension",
         "path": "AllergyIntolerance.extension",
         "slicing": {
-          "id": "46",
+          "id": "44",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -329,6 +341,7 @@
         "path": "AllergyIntolerance.extension",
         "sliceName": "manifestation",
         "definition": "A complaint or observed (subjective) indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -361,6 +374,7 @@
         "path": "AllergyIntolerance.extension",
         "sliceName": "abatement",
         "definition": "The end, remission or resolution.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -393,6 +407,7 @@
         "path": "AllergyIntolerance.extension",
         "sliceName": "adversereaction",
         "definition": "Any noxious and unintended response to a medical product, procedure, or other intervention, for which a causal relationship to an intervention is at least a reasonable possibility i.e., the relationship cannot be ruled out. It is not necessarily associated with a previously-recorded SubstanceRisk. This entry could be used to record the occurrence or non-occurrence of an adverse reaction.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -424,16 +439,19 @@
         "id": "AllergyIntolerance:shr-allergy-FoodAllergy.modifierExtension",
         "path": "AllergyIntolerance.modifierExtension",
         "slicing": {
-          "id": "47",
+          "id": "45",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -463,6 +481,7 @@
         "path": "AllergyIntolerance.modifierExtension",
         "sliceName": "nonoccurrencemodifier",
         "definition": "When true, indicates either that the event or action documented in the entry did not occur, or the the thing documented is absent or does not exist.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -523,6 +542,7 @@
         "path": "AllergyIntolerance.clinicalStatus",
         "short": "active | inactive | resolved",
         "definition": "The clinical status of the allergy or intolerance.",
+        "comment": "This element is labeled as a modifier because the status contains the codes inactive and resolved that mark the AllergyIntolerance as not currently valid.",
         "min": 0,
         "max": "1",
         "type": [
@@ -530,9 +550,19 @@
             "code": "code"
           }
         ],
+        "condition": [
+          "ait-1",
+          "ait-2"
+        ],
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AllergyIntoleranceClinicalStatus"
+            }
+          ],
           "strength": "required",
           "description": "The clinical status of the allergy or intolerance.",
           "valueSetReference": {
@@ -540,6 +570,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "rim",
+            "map": "Observation ACT\n.inboundRelationship[typeCode=COMP].source[classCode=OBS, code=\"clinicalStatus\", moodCode=EVN].value"
+          },
           {
             "identity": "w5",
             "map": "status"
@@ -551,7 +585,7 @@
         "path": "AllergyIntolerance.verificationStatus",
         "short": "unconfirmed | confirmed | refuted | entered-in-error",
         "definition": "Assertion about certainty associated with the propensity, or potential risk, of a reaction to the identified substance (including pharmaceutical product).",
-        "comments": "Decision support would typically raise alerts for 'confirmed' and 'unconfirmed' and ignore a 'refuted' reaction. In particular, 'refuted' may be useful for reconciliation of the Adverse Reaction List.",
+        "comment": "This element is labeled as a modifier because the status contains the codes refuted and entered-in-error that mark the AllergyIntolerance as not currently valid.",
         "min": 1,
         "max": "1",
         "type": [
@@ -559,16 +593,23 @@
             "code": "code"
           }
         ],
+        "condition": [
+          "ait-1",
+          "ait-2"
+        ],
         "isModifier": true,
         "isSummary": true,
         "binding": {
           "strength": "required",
-          "description": "Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/allergy-verification-status"
+            "reference": "http://standardhealthrecord.org/shr/allergy/vs/AllergyVerificationStatusVS"
           }
         },
         "mapping": [
+          {
+            "identity": "rim",
+            "map": "Observation ACT\n.inboundRelationship[typeCode=COMP].source[classCode=OBS, code=\"verificationStatus\", moodCode=EVN].value"
+          },
           {
             "identity": "w5",
             "map": "status"
@@ -580,7 +621,7 @@
         "path": "AllergyIntolerance.type",
         "short": "allergy | intolerance - Underlying mechanism (if known)",
         "definition": "Identification of the underlying physiological mechanism for the reaction risk.",
-        "comments": "Allergic (typically immune-mediated) reactions have been traditionally regarded as an indicator for potential escalation to significant future risk. Contemporary knowledge suggests that some reactions previously thought to be immune-mediated are, in fact, non-immune, but in some cases can still pose a life threatening risk. It is acknowledged that many clinicians may not be in a position to distinguish the mechanism of a particular reaction. Often the term \"allergy\" is used rather generically and may overlap with the use of \"intolerance\" - in practice the boundaries between these two concepts may not be well-defined or understood. This data element is included nevertheless, because many legacy systems have captured this attribute. Immunologic testing may provide supporting evidence for the basis of the reaction and the causative substance, but no tests are 100% sensitive or specific for sensitivity to a particular substance. If, as is commonly the case, it is unclear whether the reaction is due to an allergy or an intolerance, then the type element should be omitted from the resource.",
+        "comment": "Allergic (typically immune-mediated) reactions have been traditionally regarded as an indicator for potential escalation to significant future risk. Contemporary knowledge suggests that some reactions previously thought to be immune-mediated are, in fact, non-immune, but in some cases can still pose a life threatening risk. It is acknowledged that many clinicians may not be in a position to distinguish the mechanism of a particular reaction. Often the term \"allergy\" is used rather generically and may overlap with the use of \"intolerance\" - in practice the boundaries between these two concepts may not be well-defined or understood. This data element is included nevertheless, because many legacy systems have captured this attribute. Immunologic testing may provide supporting evidence for the basis of the reaction and the causative substance, but no tests are 100% sensitive or specific for sensitivity to a particular substance. If, as is commonly the case, it is unclear whether the reaction is due to an allergy or an intolerance, then the type element should be omitted from the resource.",
         "alias": [
           "Category",
           "Class"
@@ -595,6 +636,12 @@
         "fixedCode": "allergy",
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AllergyIntoleranceType"
+            }
+          ],
           "strength": "required",
           "description": "Identification of the underlying physiological mechanism for a Reaction Risk.",
           "valueSetReference": {
@@ -619,9 +666,9 @@
       {
         "id": "AllergyIntolerance:shr-allergy-FoodAllergy.category",
         "path": "AllergyIntolerance.category",
-        "short": "food | medication | biologic | environment",
+        "short": "food | medication | environment | biologic",
         "definition": "Category of the identified substance.",
-        "comments": "This data element has been included because it is currently being captured in some clinical systems. This data can be derived from the substance where coding systems are used, and is effectively redundant in that situation.  When searching on category, consider the implications of AllergyIntolerance resources without a category.  For example, when searching on category = medication, medication allergies that don't have a category valued will not be returned.  Refer to [search](search.html) for more information on how to search category with a :missing modifier to get allergies that don't have a category.",
+        "comment": "This data element has been included because it is currently being captured in some clinical systems. This data can be derived from the substance where coding systems are used, and is effectively redundant in that situation.  When searching on category, consider the implications of AllergyIntolerance resources without a category.  For example, when searching on category = medication, medication allergies that don't have a category valued will not be returned.  Refer to [search](search.html) for more information on how to search category with a :missing modifier to get allergies that don't have a category.  Additionally, category should be used with caution because category can be subjective based on the sender.",
         "alias": [
           "Category",
           "Type",
@@ -638,6 +685,12 @@
         "fixedCode": "food",
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AllergyIntoleranceCategory"
+            }
+          ],
           "strength": "required",
           "description": "Category of an identified substance.",
           "valueSetReference": {
@@ -664,7 +717,7 @@
         "path": "AllergyIntolerance.criticality",
         "short": "low | high | unable-to-assess",
         "definition": "Estimate of the potential clinical harm, or seriousness, of the reaction to the identified substance.",
-        "comments": "The default criticality value for any propensity to an adverse reaction should be 'Low Risk', indicating at the very least a relative contraindication to deliberate or voluntary exposure to the substance. 'High Risk' is flagged if the clinician has identified a propensity for a more serious or potentially life-threatening reaction, such as anaphylaxis, and implies an absolute contraindication to deliberate or voluntary exposure to the substance. If this element is missing, the criticality is unknown (though it may be known elsewhere).",
+        "comment": "The default criticality value for any propensity to an adverse reaction should be 'Low Risk', indicating at the very least a relative contraindication to deliberate or voluntary exposure to the substance. 'High Risk' is flagged if the clinician has identified a propensity for a more serious or potentially life-threatening reaction, such as anaphylaxis, and implies an absolute contraindication to deliberate or voluntary exposure to the substance. If this element is missing, the criticality is unknown (though it may be known elsewhere).\n\nSystems that capture a severity at the condition level are actually representing the concept of criticality whereas the severity documented at the reaction level is representing the true reaction severity.  Existing systems that are capturing both condition criticality and reaction severity may use the term \"severity\" to represent both.  Criticality is the worst it could be in the future (i.e. situation-agnostic) whereas severity is situation-dependent.",
         "alias": [
           "Severity",
           "Seriousness",
@@ -680,6 +733,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AllergyIntoleranceCriticality"
+            }
+          ],
           "strength": "required",
           "description": "Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.",
           "valueSetReference": {
@@ -704,9 +763,9 @@
       {
         "id": "AllergyIntolerance:shr-allergy-FoodAllergy.code",
         "path": "AllergyIntolerance.code",
-        "short": "Allergy or intolerance code",
+        "short": "Code that identifies the allergy or intolerance",
         "definition": "Code for an allergy or intolerance statement (either a positive or a negated/excluded statement).  This may be a code for a substance or pharmaceutical product that is considered to be responsible for the adverse reaction risk (e.g., \"Latex\"), an allergy or intolerance condition (e.g., \"Latex allergy\"), or a negated/excluded code for a specific substance or class (e.g., \"No latex allergy\") or a general or categorical negated statement (e.g.,  \"No known allergy\", \"No known drug allergies\").",
-        "comments": "It is strongly recommended that this element be populated using a terminology, where possible. For example, some terminologies used include RxNorm, SNOMED CT, DM+D, NDFRT, ICD-9, IDC-10, UNI, ATC and CPT. Plain text should only be used if there is no appropriate terminology available. Additional details can be specified in the text.\r\rWhen a substance or product code is specified for the 'code' element, the \"default\" semantic context is that this is a positive statement of an allergy or intolerance (depending on the value of the 'type' element, if present) condition to the specified substance/product.  In the corresponding SNOMED CT allergy model, the specified substance/product is the target (destination) of the \"Causative agent\" relationship.\r\rThe 'substanceExposureRisk' extension is available as a structured and more flexible alternative to the 'code' element for making positive or negative allergy or intolerance statements.  This extension provides the capability to make \"no known allergy\" (or \"no risk of adverse reaction\") statements regarding any coded substance/product (including cases when a pre-coordinated \"no allergy to x\" concept for that substance/product does not exist).  If the 'substanceExposureRisk' extension is present, the AllergyIntolerance.code element SHALL be omitted.",
+        "comment": "It is strongly recommended that this element be populated using a terminology, where possible. For example, some terminologies used include RxNorm, SNOMED CT, DM+D, NDFRT, ICD-9, IDC-10, UNI, ATC and CPT. Plain text should only be used if there is no appropriate terminology available. Additional details can be specified in the text.\r\rWhen a substance or product code is specified for the 'code' element, the \"default\" semantic context is that this is a positive statement of an allergy or intolerance (depending on the value of the 'type' element, if present) condition to the specified substance/product.  In the corresponding SNOMED CT allergy model, the specified substance/product is the target (destination) of the \"Causative agent\" relationship.\r\rThe 'substanceExposureRisk' extension is available as a structured and more flexible alternative to the 'code' element for making positive or negative allergy or intolerance statements.  This extension provides the capability to make \"no known allergy\" (or \"no risk of adverse reaction\") statements regarding any coded substance/product (including cases when a pre-coordinated \"no allergy to x\" concept for that substance/product does not exist).  If the 'substanceExposureRisk' extension is present, the AllergyIntolerance.code element SHALL be omitted.",
         "alias": [
           "Code"
         ],
@@ -722,7 +781,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-allergy-FoodSubstanceVS"
+            "reference": "http://standardhealthrecord.org/shr/allergy/vs/FoodSubstanceVS"
           }
         },
         "mapping": [
@@ -870,7 +929,7 @@
         "path": "AllergyIntolerance.asserter",
         "short": "Source of the information about the allergy",
         "definition": "The source of the information about the allergy that is recorded.",
-        "comments": "The recorder takes repsonsibility for the content, but can reference the source from where they got it.",
+        "comment": "The recorder takes repsonsibility for the content, but can reference the source from where they got it.",
         "alias": [
           "Source",
           "Informant"
@@ -912,7 +971,7 @@
         "path": "AllergyIntolerance.lastOccurrence",
         "short": "Date(/time) of last known occurrence of a reaction",
         "definition": "Represents the date and/or time of the last known occurrence of a reaction event.",
-        "comments": "This date may be replicated by one of the Onset of Reaction dates. Where a textual representation of the date of last occurrence is required e.g. 'In Childhood, '10 years ago' the Comment element should be used.",
+        "comment": "This date may be replicated by one of the Onset of Reaction dates. Where a textual representation of the date of last occurrence is required e.g. 'In Childhood, '10 years ago' the Comment element should be used.",
         "min": 0,
         "max": "1",
         "type": [
@@ -932,7 +991,7 @@
         "path": "AllergyIntolerance.note",
         "short": "Additional text not captured in other fields",
         "definition": "Additional narrative about the propensity for the Adverse Reaction, not captured in other fields.",
-        "comments": "For example: including reason for flagging a seriousness of 'High Risk'; and instructions related to future exposure or administration of the substance, such as administration within an Intensive Care Unit or under corticosteroid cover. The notes should be related to an allergy or intolerance as a condition in general and not related to any particular episode of it. For episode notes and descriptions, use AllergyIntolerance.event.description and  AllergyIntolerance.event.notes.",
+        "comment": "For example: including reason for flagging a seriousness of 'High Risk'; and instructions related to future exposure or administration of the substance, such as administration within an Intensive Care Unit or under corticosteroid cover. The notes should be related to an allergy or intolerance as a condition in general and not related to any particular episode of it. For episode notes and descriptions, use AllergyIntolerance.event.description and  AllergyIntolerance.event.notes.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1008,7 +1067,7 @@
         "path": "AllergyIntolerance.reaction.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1037,7 +1096,7 @@
         "path": "AllergyIntolerance.reaction.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1069,7 +1128,7 @@
         "path": "AllergyIntolerance.reaction.substance",
         "short": "Specific substance or pharmaceutical product considered to be responsible for event",
         "definition": "Identification of the specific substance (or pharmaceutical product) considered to be responsible for the Adverse Reaction event. Note: the substance for a specific reaction may be different from the substance identified as the cause of the risk, but it must be consistent with it. For instance, it may be a more specific substance (e.g. a brand medication) or a composite product that includes the identified substance. It must be clinically safe to only process the 'code' and ignore the 'reaction.substance'.",
-        "comments": "Coding of the specific substance (or pharmaceutical product) with a terminology capable of triggering decision support should be used wherever possible.  The 'code' element allows for the use of a specific substance or pharmaceutical product, or a group or class of substances. In the case of an allergy or intolerance to a class of substances, (for example, \"penicillins\"), the 'reaction.substance' element could be used to code the specific substance that was identifed as having caused the reaction (for example, \"amoxycillin\"). Duplication of the value in the 'code' and 'reaction.substance' elements is acceptable when a specific substance has been recorded in 'code'.",
+        "comment": "Coding of the specific substance (or pharmaceutical product) with a terminology capable of triggering decision support should be used wherever possible.  The 'code' element allows for the use of a specific substance or pharmaceutical product, or a group or class of substances. In the case of an allergy or intolerance to a class of substances, (for example, \"penicillins\"), the 'reaction.substance' element could be used to code the specific substance that was identifed as having caused the reaction (for example, \"amoxycillin\"). Duplication of the value in the 'code' and 'reaction.substance' elements is acceptable when a specific substance has been recorded in 'code'.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1078,6 +1137,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "SubstanceCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes defining the type of the substance (including pharmaceutical products).",
           "valueSetReference": {
@@ -1091,42 +1156,12 @@
           }
         ]
       },
-      {
-        "id": "AllergyIntolerance:shr-allergy-FoodAllergy.reaction.certainty",
-        "path": "AllergyIntolerance.reaction.certainty",
-        "short": "unlikely | likely | confirmed | unknown",
-        "definition": "Statement about the degree of clinical certainty that the specific substance was the cause of the manifestation in this reaction event.",
-        "comments": "When certainty is missing, it means no information exists (although it could be in narrative).  By contrast, the unknown code is used when there is an explicit assertion that certainty is not known, such as when a patient eats a meal and it is unknown which food caused the reaction.",
-        "alias": [
-          "Cause"
-        ],
-        "min": 0,
-        "max": "1",
-        "type": [
-          {
-            "code": "code"
-          }
-        ],
-        "binding": {
-          "strength": "required",
-          "description": "Statement about the degree of clinical certainty that a specific substance was the cause of the manifestation in an reaction event.",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/reaction-event-certainty"
-          }
-        },
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "uncertaintyCode"
-          }
-        ]
-      },
       {
         "id": "AllergyIntolerance:shr-allergy-FoodAllergy.reaction.manifestation",
         "path": "AllergyIntolerance.reaction.manifestation",
         "short": "Clinical symptoms/signs associated with the Event",
         "definition": "Clinical symptoms and/or signs that are observed or associated with the adverse reaction event.",
-        "comments": "Manifestation can be expressed as a single word, phrase or brief description. For example: nausea, rash or no reaction. It is preferable that manifestation should be coded with a terminology, where possible. The values entered here may be used to display on an application screen as part of a list of adverse reactions, as recommended in the UK NHS CUI guidelines.  Terminologies commonly used include, but are not limited to, SNOMED CT or ICD10.",
+        "comment": "Manifestation can be expressed as a single word, phrase or brief description. For example: nausea, rash or no reaction. It is preferable that manifestation should be coded with a terminology, where possible. The values entered here may be used to display on an application screen as part of a list of adverse reactions, as recommended in the UK NHS CUI guidelines.  Terminologies commonly used include, but are not limited to, SNOMED CT or ICD10.",
         "alias": [
           "Symptoms",
           "Signs"
@@ -1139,10 +1174,16 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Manifestation"
+            }
+          ],
           "strength": "example",
           "description": "Clinical symptoms and/or signs that are observed or associated with an Adverse Reaction Event.",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/manifestation-codes"
+            "reference": "http://hl7.org/fhir/ValueSet/clinical-findings"
           }
         },
         "mapping": [
@@ -1161,7 +1202,7 @@
         "path": "AllergyIntolerance.reaction.description",
         "short": "Description of the event as a whole",
         "definition": "Text description about the reaction as a whole, including details of the manifestation if required.",
-        "comments": "Use the description to provide any details of a particular event of the occurred reaction such as circumstances, reaction specifics, what happened before/after. Information, related to the event, but not describing a particular care should be captured in the comment field. For example: at the age of four, the patient was given penicillin for strep throat and subsequently developed severe hives.",
+        "comment": "Use the description to provide any details of a particular event of the occurred reaction such as circumstances, reaction specifics, what happened before/after. Information, related to the event, but not describing a particular care should be captured in the comment field. For example: at the age of four, the patient was given penicillin for strep throat and subsequently developed severe hives.",
         "alias": [
           "Narrative",
           "Text"
@@ -1208,7 +1249,7 @@
         "path": "AllergyIntolerance.reaction.severity",
         "short": "mild | moderate | severe (of event as a whole)",
         "definition": "Clinical assessment of the severity of the reaction event as a whole, potentially considering multiple different manifestations.",
-        "comments": "It is acknowledged that this assessment is very subjective. There may be some some specific practice domains where objective scales have been applied. Objective scales can be included in this model as extensions.",
+        "comment": "It is acknowledged that this assessment is very subjective. There may be some some specific practice domains where objective scales have been applied. Objective scales can be included in this model as extensions.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1217,6 +1258,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AllergyIntoleranceSeverity"
+            }
+          ],
           "strength": "required",
           "description": "Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations.",
           "valueSetReference": {
@@ -1235,7 +1282,7 @@
         "path": "AllergyIntolerance.reaction.exposureRoute",
         "short": "How the subject was exposed to the substance",
         "definition": "Identification of the route by which the subject was exposed to the substance.",
-        "comments": "Coding of the route of exposure with a terminology should be used wherever possible.",
+        "comment": "Coding of the route of exposure with a terminology should be used wherever possible.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1244,6 +1291,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "RouteOfAdministration"
+            }
+          ],
           "strength": "example",
           "description": "A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.",
           "valueSetReference": {
@@ -1262,7 +1315,7 @@
         "path": "AllergyIntolerance.reaction.note",
         "short": "Text about event not captured in other fields",
         "definition": "Additional text about the adverse reaction event not captured in other fields.",
-        "comments": "Use this field to record information indirectly related to a particular event and not captured in the description. For example: Clinical records are no longer available, recorded based on information provided to the patient by her mother and her mother is deceased.",
+        "comment": "Use this field to record information indirectly related to a particular event and not captured in the description. For example: Clinical records are no longer available, recorded based on information provided to the patient by her mother and her mother is deceased.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1351,6 +1404,16 @@
         "isModifier": true,
         "isSummary": false
       },
+      {
+        "id": "AllergyIntolerance:shr-allergy-FoodAllergy.verificationStatus",
+        "path": "AllergyIntolerance.verificationStatus",
+        "binding": {
+          "strength": "required",
+          "valueSetReference": {
+            "reference": "http://standardhealthrecord.org/shr/allergy/vs/AllergyVerificationStatusVS"
+          }
+        }
+      },
       {
         "id": "AllergyIntolerance:shr-allergy-FoodAllergy.type",
         "path": "AllergyIntolerance.type",
@@ -1377,7 +1440,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-allergy-FoodSubstanceVS"
+            "reference": "http://standardhealthrecord.org/shr/allergy/vs/FoodSubstanceVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-allergy-NoKnownAllergy.json b/lib/resources/standard_health_record/StructureDefinition-shr-allergy-NoKnownAllergy.json
old mode 100755
new mode 100644
index 31fc5da..3b7124a
--- a/lib/resources/standard_health_record/StructureDefinition-shr-allergy-NoKnownAllergy.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-allergy-NoKnownAllergy.json
@@ -12,8 +12,10 @@
       "value": "shr.allergy.NoKnownAllergy"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR NoKnownAllergy Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.773Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,10 +27,9 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.936Z",
   "description": "The subject has no known allergies to drugs, foods, biologics, or environmental factors.",
   "purpose": "To record a clinical assessment of a propensity, or potential risk to an individual, of an adverse reaction upon future exposure to the specified substance, or class of substance.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "rim",
@@ -58,7 +59,7 @@
         "path": "AllergyIntolerance",
         "short": "SHR NoKnownAllergy Profile",
         "definition": "The subject has no known allergies to drugs, foods, biologics, or environmental factors.",
-        "comments": "Substances include, but are not limited to: a therapeutic substance administered correctly at an appropriate dosage for the individual; food; material derived from plants or animals; or venom from insect stings.",
+        "comment": "Substances include, but are not limited to: a therapeutic substance administered correctly at an appropriate dosage for the individual; food; material derived from plants or animals; or venom from insect stings.",
         "alias": [
           "Allergy",
           "Intolerance",
@@ -134,7 +135,7 @@
         "path": "AllergyIntolerance.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -173,7 +174,7 @@
         "path": "AllergyIntolerance.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -194,7 +195,7 @@
         "path": "AllergyIntolerance.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -214,6 +215,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -228,7 +237,7 @@
         "path": "AllergyIntolerance.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -262,7 +271,7 @@
         "path": "AllergyIntolerance.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -291,16 +300,19 @@
         "id": "AllergyIntolerance:shr-allergy-NoKnownAllergy.extension",
         "path": "AllergyIntolerance.extension",
         "slicing": {
-          "id": "49",
+          "id": "47",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -329,6 +341,7 @@
         "path": "AllergyIntolerance.extension",
         "sliceName": "abatement",
         "definition": "The end, remission or resolution.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -360,16 +373,19 @@
         "id": "AllergyIntolerance:shr-allergy-NoKnownAllergy.modifierExtension",
         "path": "AllergyIntolerance.modifierExtension",
         "slicing": {
-          "id": "50",
+          "id": "48",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -399,6 +415,7 @@
         "path": "AllergyIntolerance.modifierExtension",
         "sliceName": "nonoccurrencemodifier",
         "definition": "When true, indicates either that the event or action documented in the entry did not occur, or the the thing documented is absent or does not exist.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -459,7 +476,10 @@
         "slicing": {
           "id": "10",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -559,7 +579,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -639,7 +658,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -828,6 +846,7 @@
         "path": "AllergyIntolerance.clinicalStatus",
         "short": "active | inactive | resolved",
         "definition": "The clinical status of the allergy or intolerance.",
+        "comment": "This element is labeled as a modifier because the status contains the codes inactive and resolved that mark the AllergyIntolerance as not currently valid.",
         "min": 0,
         "max": "1",
         "type": [
@@ -835,9 +854,19 @@
             "code": "code"
           }
         ],
+        "condition": [
+          "ait-1",
+          "ait-2"
+        ],
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AllergyIntoleranceClinicalStatus"
+            }
+          ],
           "strength": "required",
           "description": "The clinical status of the allergy or intolerance.",
           "valueSetReference": {
@@ -845,6 +874,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "rim",
+            "map": "Observation ACT\n.inboundRelationship[typeCode=COMP].source[classCode=OBS, code=\"clinicalStatus\", moodCode=EVN].value"
+          },
           {
             "identity": "w5",
             "map": "status"
@@ -856,7 +889,7 @@
         "path": "AllergyIntolerance.verificationStatus",
         "short": "unconfirmed | confirmed | refuted | entered-in-error",
         "definition": "Assertion about certainty associated with the propensity, or potential risk, of a reaction to the identified substance (including pharmaceutical product).",
-        "comments": "Decision support would typically raise alerts for 'confirmed' and 'unconfirmed' and ignore a 'refuted' reaction. In particular, 'refuted' may be useful for reconciliation of the Adverse Reaction List.",
+        "comment": "This element is labeled as a modifier because the status contains the codes refuted and entered-in-error that mark the AllergyIntolerance as not currently valid.",
         "min": 1,
         "max": "1",
         "type": [
@@ -865,16 +898,23 @@
           }
         ],
         "fixedCode": "unconfirmed",
+        "condition": [
+          "ait-1",
+          "ait-2"
+        ],
         "isModifier": true,
         "isSummary": true,
         "binding": {
           "strength": "required",
-          "description": "Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/allergy-verification-status"
+            "reference": "http://standardhealthrecord.org/shr/allergy/vs/AllergyVerificationStatusVS"
           }
         },
         "mapping": [
+          {
+            "identity": "rim",
+            "map": "Observation ACT\n.inboundRelationship[typeCode=COMP].source[classCode=OBS, code=\"verificationStatus\", moodCode=EVN].value"
+          },
           {
             "identity": "w5",
             "map": "status"
@@ -886,7 +926,7 @@
         "path": "AllergyIntolerance.type",
         "short": "allergy | intolerance - Underlying mechanism (if known)",
         "definition": "Identification of the underlying physiological mechanism for the reaction risk.",
-        "comments": "Allergic (typically immune-mediated) reactions have been traditionally regarded as an indicator for potential escalation to significant future risk. Contemporary knowledge suggests that some reactions previously thought to be immune-mediated are, in fact, non-immune, but in some cases can still pose a life threatening risk. It is acknowledged that many clinicians may not be in a position to distinguish the mechanism of a particular reaction. Often the term \"allergy\" is used rather generically and may overlap with the use of \"intolerance\" - in practice the boundaries between these two concepts may not be well-defined or understood. This data element is included nevertheless, because many legacy systems have captured this attribute. Immunologic testing may provide supporting evidence for the basis of the reaction and the causative substance, but no tests are 100% sensitive or specific for sensitivity to a particular substance. If, as is commonly the case, it is unclear whether the reaction is due to an allergy or an intolerance, then the type element should be omitted from the resource.",
+        "comment": "Allergic (typically immune-mediated) reactions have been traditionally regarded as an indicator for potential escalation to significant future risk. Contemporary knowledge suggests that some reactions previously thought to be immune-mediated are, in fact, non-immune, but in some cases can still pose a life threatening risk. It is acknowledged that many clinicians may not be in a position to distinguish the mechanism of a particular reaction. Often the term \"allergy\" is used rather generically and may overlap with the use of \"intolerance\" - in practice the boundaries between these two concepts may not be well-defined or understood. This data element is included nevertheless, because many legacy systems have captured this attribute. Immunologic testing may provide supporting evidence for the basis of the reaction and the causative substance, but no tests are 100% sensitive or specific for sensitivity to a particular substance. If, as is commonly the case, it is unclear whether the reaction is due to an allergy or an intolerance, then the type element should be omitted from the resource.",
         "alias": [
           "Category",
           "Class"
@@ -901,6 +941,12 @@
         "fixedCode": "allergy",
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AllergyIntoleranceType"
+            }
+          ],
           "strength": "required",
           "description": "Identification of the underlying physiological mechanism for a Reaction Risk.",
           "valueSetReference": {
@@ -926,16 +972,19 @@
         "id": "AllergyIntolerance:shr-allergy-NoKnownAllergy.category",
         "path": "AllergyIntolerance.category",
         "slicing": {
-          "id": "48",
+          "id": "46",
           "discriminator": [
-            "value"
+            {
+              "type": "value",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
-        "short": "food | medication | biologic | environment",
+        "short": "food | medication | environment | biologic",
         "definition": "Category of the identified substance.",
-        "comments": "This data element has been included because it is currently being captured in some clinical systems. This data can be derived from the substance where coding systems are used, and is effectively redundant in that situation.  When searching on category, consider the implications of AllergyIntolerance resources without a category.  For example, when searching on category = medication, medication allergies that don't have a category valued will not be returned.  Refer to [search](search.html) for more information on how to search category with a :missing modifier to get allergies that don't have a category.",
+        "comment": "This data element has been included because it is currently being captured in some clinical systems. This data can be derived from the substance where coding systems are used, and is effectively redundant in that situation.  When searching on category, consider the implications of AllergyIntolerance resources without a category.  For example, when searching on category = medication, medication allergies that don't have a category valued will not be returned.  Refer to [search](search.html) for more information on how to search category with a :missing modifier to get allergies that don't have a category.  Additionally, category should be used with caution because category can be subjective based on the sender.",
         "alias": [
           "Category",
           "Type",
@@ -951,6 +1000,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AllergyIntoleranceCategory"
+            }
+          ],
           "strength": "required",
           "description": "Category of an identified substance.",
           "valueSetReference": {
@@ -1029,7 +1084,7 @@
         "path": "AllergyIntolerance.criticality",
         "short": "low | high | unable-to-assess",
         "definition": "Estimate of the potential clinical harm, or seriousness, of the reaction to the identified substance.",
-        "comments": "The default criticality value for any propensity to an adverse reaction should be 'Low Risk', indicating at the very least a relative contraindication to deliberate or voluntary exposure to the substance. 'High Risk' is flagged if the clinician has identified a propensity for a more serious or potentially life-threatening reaction, such as anaphylaxis, and implies an absolute contraindication to deliberate or voluntary exposure to the substance. If this element is missing, the criticality is unknown (though it may be known elsewhere).",
+        "comment": "The default criticality value for any propensity to an adverse reaction should be 'Low Risk', indicating at the very least a relative contraindication to deliberate or voluntary exposure to the substance. 'High Risk' is flagged if the clinician has identified a propensity for a more serious or potentially life-threatening reaction, such as anaphylaxis, and implies an absolute contraindication to deliberate or voluntary exposure to the substance. If this element is missing, the criticality is unknown (though it may be known elsewhere).\n\nSystems that capture a severity at the condition level are actually representing the concept of criticality whereas the severity documented at the reaction level is representing the true reaction severity.  Existing systems that are capturing both condition criticality and reaction severity may use the term \"severity\" to represent both.  Criticality is the worst it could be in the future (i.e. situation-agnostic) whereas severity is situation-dependent.",
         "alias": [
           "Severity",
           "Seriousness",
@@ -1045,6 +1100,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AllergyIntoleranceCriticality"
+            }
+          ],
           "strength": "required",
           "description": "Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.",
           "valueSetReference": {
@@ -1069,9 +1130,9 @@
       {
         "id": "AllergyIntolerance:shr-allergy-NoKnownAllergy.code",
         "path": "AllergyIntolerance.code",
-        "short": "Allergy or intolerance code",
+        "short": "Code that identifies the allergy or intolerance",
         "definition": "Code for an allergy or intolerance statement (either a positive or a negated/excluded statement).  This may be a code for a substance or pharmaceutical product that is considered to be responsible for the adverse reaction risk (e.g., \"Latex\"), an allergy or intolerance condition (e.g., \"Latex allergy\"), or a negated/excluded code for a specific substance or class (e.g., \"No latex allergy\") or a general or categorical negated statement (e.g.,  \"No known allergy\", \"No known drug allergies\").",
-        "comments": "It is strongly recommended that this element be populated using a terminology, where possible. For example, some terminologies used include RxNorm, SNOMED CT, DM+D, NDFRT, ICD-9, IDC-10, UNI, ATC and CPT. Plain text should only be used if there is no appropriate terminology available. Additional details can be specified in the text.\r\rWhen a substance or product code is specified for the 'code' element, the \"default\" semantic context is that this is a positive statement of an allergy or intolerance (depending on the value of the 'type' element, if present) condition to the specified substance/product.  In the corresponding SNOMED CT allergy model, the specified substance/product is the target (destination) of the \"Causative agent\" relationship.\r\rThe 'substanceExposureRisk' extension is available as a structured and more flexible alternative to the 'code' element for making positive or negative allergy or intolerance statements.  This extension provides the capability to make \"no known allergy\" (or \"no risk of adverse reaction\") statements regarding any coded substance/product (including cases when a pre-coordinated \"no allergy to x\" concept for that substance/product does not exist).  If the 'substanceExposureRisk' extension is present, the AllergyIntolerance.code element SHALL be omitted.",
+        "comment": "It is strongly recommended that this element be populated using a terminology, where possible. For example, some terminologies used include RxNorm, SNOMED CT, DM+D, NDFRT, ICD-9, IDC-10, UNI, ATC and CPT. Plain text should only be used if there is no appropriate terminology available. Additional details can be specified in the text.\r\rWhen a substance or product code is specified for the 'code' element, the \"default\" semantic context is that this is a positive statement of an allergy or intolerance (depending on the value of the 'type' element, if present) condition to the specified substance/product.  In the corresponding SNOMED CT allergy model, the specified substance/product is the target (destination) of the \"Causative agent\" relationship.\r\rThe 'substanceExposureRisk' extension is available as a structured and more flexible alternative to the 'code' element for making positive or negative allergy or intolerance statements.  This extension provides the capability to make \"no known allergy\" (or \"no risk of adverse reaction\") statements regarding any coded substance/product (including cases when a pre-coordinated \"no allergy to x\" concept for that substance/product does not exist).  If the 'substanceExposureRisk' extension is present, the AllergyIntolerance.code element SHALL be omitted.",
         "alias": [
           "Code"
         ],
@@ -1087,7 +1148,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-allergy-AllergenIrritantVS"
+            "reference": "http://standardhealthrecord.org/shr/allergy/vs/AllergenIrritantVS"
           }
         },
         "mapping": [
@@ -1235,7 +1296,7 @@
         "path": "AllergyIntolerance.asserter",
         "short": "Source of the information about the allergy",
         "definition": "The source of the information about the allergy that is recorded.",
-        "comments": "The recorder takes repsonsibility for the content, but can reference the source from where they got it.",
+        "comment": "The recorder takes repsonsibility for the content, but can reference the source from where they got it.",
         "alias": [
           "Source",
           "Informant"
@@ -1277,7 +1338,7 @@
         "path": "AllergyIntolerance.lastOccurrence",
         "short": "Date(/time) of last known occurrence of a reaction",
         "definition": "Represents the date and/or time of the last known occurrence of a reaction event.",
-        "comments": "This date may be replicated by one of the Onset of Reaction dates. Where a textual representation of the date of last occurrence is required e.g. 'In Childhood, '10 years ago' the Comment element should be used.",
+        "comment": "This date may be replicated by one of the Onset of Reaction dates. Where a textual representation of the date of last occurrence is required e.g. 'In Childhood, '10 years ago' the Comment element should be used.",
         "min": 0,
         "max": "0",
         "type": [
@@ -1297,7 +1358,7 @@
         "path": "AllergyIntolerance.note",
         "short": "Additional text not captured in other fields",
         "definition": "Additional narrative about the propensity for the Adverse Reaction, not captured in other fields.",
-        "comments": "For example: including reason for flagging a seriousness of 'High Risk'; and instructions related to future exposure or administration of the substance, such as administration within an Intensive Care Unit or under corticosteroid cover. The notes should be related to an allergy or intolerance as a condition in general and not related to any particular episode of it. For episode notes and descriptions, use AllergyIntolerance.event.description and  AllergyIntolerance.event.notes.",
+        "comment": "For example: including reason for flagging a seriousness of 'High Risk'; and instructions related to future exposure or administration of the substance, such as administration within an Intensive Care Unit or under corticosteroid cover. The notes should be related to an allergy or intolerance as a condition in general and not related to any particular episode of it. For episode notes and descriptions, use AllergyIntolerance.event.description and  AllergyIntolerance.event.notes.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1373,7 +1434,7 @@
         "path": "AllergyIntolerance.reaction.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1402,7 +1463,7 @@
         "path": "AllergyIntolerance.reaction.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1434,7 +1495,7 @@
         "path": "AllergyIntolerance.reaction.substance",
         "short": "Specific substance or pharmaceutical product considered to be responsible for event",
         "definition": "Identification of the specific substance (or pharmaceutical product) considered to be responsible for the Adverse Reaction event. Note: the substance for a specific reaction may be different from the substance identified as the cause of the risk, but it must be consistent with it. For instance, it may be a more specific substance (e.g. a brand medication) or a composite product that includes the identified substance. It must be clinically safe to only process the 'code' and ignore the 'reaction.substance'.",
-        "comments": "Coding of the specific substance (or pharmaceutical product) with a terminology capable of triggering decision support should be used wherever possible.  The 'code' element allows for the use of a specific substance or pharmaceutical product, or a group or class of substances. In the case of an allergy or intolerance to a class of substances, (for example, \"penicillins\"), the 'reaction.substance' element could be used to code the specific substance that was identifed as having caused the reaction (for example, \"amoxycillin\"). Duplication of the value in the 'code' and 'reaction.substance' elements is acceptable when a specific substance has been recorded in 'code'.",
+        "comment": "Coding of the specific substance (or pharmaceutical product) with a terminology capable of triggering decision support should be used wherever possible.  The 'code' element allows for the use of a specific substance or pharmaceutical product, or a group or class of substances. In the case of an allergy or intolerance to a class of substances, (for example, \"penicillins\"), the 'reaction.substance' element could be used to code the specific substance that was identifed as having caused the reaction (for example, \"amoxycillin\"). Duplication of the value in the 'code' and 'reaction.substance' elements is acceptable when a specific substance has been recorded in 'code'.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1443,6 +1504,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "SubstanceCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes defining the type of the substance (including pharmaceutical products).",
           "valueSetReference": {
@@ -1456,42 +1523,12 @@
           }
         ]
       },
-      {
-        "id": "AllergyIntolerance:shr-allergy-NoKnownAllergy.reaction.certainty",
-        "path": "AllergyIntolerance.reaction.certainty",
-        "short": "unlikely | likely | confirmed | unknown",
-        "definition": "Statement about the degree of clinical certainty that the specific substance was the cause of the manifestation in this reaction event.",
-        "comments": "When certainty is missing, it means no information exists (although it could be in narrative).  By contrast, the unknown code is used when there is an explicit assertion that certainty is not known, such as when a patient eats a meal and it is unknown which food caused the reaction.",
-        "alias": [
-          "Cause"
-        ],
-        "min": 0,
-        "max": "1",
-        "type": [
-          {
-            "code": "code"
-          }
-        ],
-        "binding": {
-          "strength": "required",
-          "description": "Statement about the degree of clinical certainty that a specific substance was the cause of the manifestation in an reaction event.",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/reaction-event-certainty"
-          }
-        },
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "uncertaintyCode"
-          }
-        ]
-      },
       {
         "id": "AllergyIntolerance:shr-allergy-NoKnownAllergy.reaction.manifestation",
         "path": "AllergyIntolerance.reaction.manifestation",
         "short": "Clinical symptoms/signs associated with the Event",
         "definition": "Clinical symptoms and/or signs that are observed or associated with the adverse reaction event.",
-        "comments": "Manifestation can be expressed as a single word, phrase or brief description. For example: nausea, rash or no reaction. It is preferable that manifestation should be coded with a terminology, where possible. The values entered here may be used to display on an application screen as part of a list of adverse reactions, as recommended in the UK NHS CUI guidelines.  Terminologies commonly used include, but are not limited to, SNOMED CT or ICD10.",
+        "comment": "Manifestation can be expressed as a single word, phrase or brief description. For example: nausea, rash or no reaction. It is preferable that manifestation should be coded with a terminology, where possible. The values entered here may be used to display on an application screen as part of a list of adverse reactions, as recommended in the UK NHS CUI guidelines.  Terminologies commonly used include, but are not limited to, SNOMED CT or ICD10.",
         "alias": [
           "Symptoms",
           "Signs"
@@ -1504,10 +1541,16 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Manifestation"
+            }
+          ],
           "strength": "example",
           "description": "Clinical symptoms and/or signs that are observed or associated with an Adverse Reaction Event.",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/manifestation-codes"
+            "reference": "http://hl7.org/fhir/ValueSet/clinical-findings"
           }
         },
         "mapping": [
@@ -1526,7 +1569,7 @@
         "path": "AllergyIntolerance.reaction.description",
         "short": "Description of the event as a whole",
         "definition": "Text description about the reaction as a whole, including details of the manifestation if required.",
-        "comments": "Use the description to provide any details of a particular event of the occurred reaction such as circumstances, reaction specifics, what happened before/after. Information, related to the event, but not describing a particular care should be captured in the comment field. For example: at the age of four, the patient was given penicillin for strep throat and subsequently developed severe hives.",
+        "comment": "Use the description to provide any details of a particular event of the occurred reaction such as circumstances, reaction specifics, what happened before/after. Information, related to the event, but not describing a particular care should be captured in the comment field. For example: at the age of four, the patient was given penicillin for strep throat and subsequently developed severe hives.",
         "alias": [
           "Narrative",
           "Text"
@@ -1573,7 +1616,7 @@
         "path": "AllergyIntolerance.reaction.severity",
         "short": "mild | moderate | severe (of event as a whole)",
         "definition": "Clinical assessment of the severity of the reaction event as a whole, potentially considering multiple different manifestations.",
-        "comments": "It is acknowledged that this assessment is very subjective. There may be some some specific practice domains where objective scales have been applied. Objective scales can be included in this model as extensions.",
+        "comment": "It is acknowledged that this assessment is very subjective. There may be some some specific practice domains where objective scales have been applied. Objective scales can be included in this model as extensions.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1582,6 +1625,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AllergyIntoleranceSeverity"
+            }
+          ],
           "strength": "required",
           "description": "Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations.",
           "valueSetReference": {
@@ -1600,7 +1649,7 @@
         "path": "AllergyIntolerance.reaction.exposureRoute",
         "short": "How the subject was exposed to the substance",
         "definition": "Identification of the route by which the subject was exposed to the substance.",
-        "comments": "Coding of the route of exposure with a terminology should be used wherever possible.",
+        "comment": "Coding of the route of exposure with a terminology should be used wherever possible.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1609,6 +1658,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "RouteOfAdministration"
+            }
+          ],
           "strength": "example",
           "description": "A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.",
           "valueSetReference": {
@@ -1627,7 +1682,7 @@
         "path": "AllergyIntolerance.reaction.note",
         "short": "Text about event not captured in other fields",
         "definition": "Additional text about the adverse reaction event not captured in other fields.",
-        "comments": "Use this field to record information indirectly related to a particular event and not captured in the description. For example: Clinical records are no longer available, recorded based on information provided to the patient by her mother and her mother is deceased.",
+        "comment": "Use this field to record information indirectly related to a particular event and not captured in the description. For example: Clinical records are no longer available, recorded based on information provided to the patient by her mother and her mother is deceased.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1688,7 +1743,13 @@
       {
         "id": "AllergyIntolerance:shr-allergy-NoKnownAllergy.verificationStatus",
         "path": "AllergyIntolerance.verificationStatus",
-        "fixedCode": "unconfirmed"
+        "fixedCode": "unconfirmed",
+        "binding": {
+          "strength": "required",
+          "valueSetReference": {
+            "reference": "http://standardhealthrecord.org/shr/allergy/vs/AllergyVerificationStatusVS"
+          }
+        }
       },
       {
         "id": "AllergyIntolerance:shr-allergy-NoKnownAllergy.type",
@@ -1699,9 +1760,12 @@
         "id": "AllergyIntolerance:shr-allergy-NoKnownAllergy.category",
         "path": "AllergyIntolerance.category",
         "slicing": {
-          "id": "48",
+          "id": "46",
           "discriminator": [
-            "value"
+            {
+              "type": "value",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -1779,7 +1843,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-allergy-AllergenIrritantVS"
+            "reference": "http://standardhealthrecord.org/shr/allergy/vs/AllergenIrritantVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-allergy-NoKnownDrugAllergy.json b/lib/resources/standard_health_record/StructureDefinition-shr-allergy-NoKnownDrugAllergy.json
old mode 100755
new mode 100644
index 3a0d703..32b7e04
--- a/lib/resources/standard_health_record/StructureDefinition-shr-allergy-NoKnownDrugAllergy.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-allergy-NoKnownDrugAllergy.json
@@ -12,8 +12,10 @@
       "value": "shr.allergy.NoKnownDrugAllergy"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR NoKnownDrugAllergy Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.808Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,10 +27,9 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.948Z",
   "description": "The subject has no known allergies to any medications.",
   "purpose": "To record a clinical assessment of a propensity, or potential risk to an individual, of an adverse reaction upon future exposure to the specified substance, or class of substance.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "rim",
@@ -58,7 +59,7 @@
         "path": "AllergyIntolerance",
         "short": "SHR NoKnownDrugAllergy Profile",
         "definition": "The subject has no known allergies to any medications.",
-        "comments": "Substances include, but are not limited to: a therapeutic substance administered correctly at an appropriate dosage for the individual; food; material derived from plants or animals; or venom from insect stings.",
+        "comment": "Substances include, but are not limited to: a therapeutic substance administered correctly at an appropriate dosage for the individual; food; material derived from plants or animals; or venom from insect stings.",
         "alias": [
           "Allergy",
           "Intolerance",
@@ -134,7 +135,7 @@
         "path": "AllergyIntolerance.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -173,7 +174,7 @@
         "path": "AllergyIntolerance.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -194,7 +195,7 @@
         "path": "AllergyIntolerance.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -214,6 +215,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -228,7 +237,7 @@
         "path": "AllergyIntolerance.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -262,7 +271,7 @@
         "path": "AllergyIntolerance.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -291,16 +300,19 @@
         "id": "AllergyIntolerance:shr-allergy-NoKnownDrugAllergy.extension",
         "path": "AllergyIntolerance.extension",
         "slicing": {
-          "id": "53",
+          "id": "51",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -329,6 +341,7 @@
         "path": "AllergyIntolerance.extension",
         "sliceName": "abatement",
         "definition": "The end, remission or resolution.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -360,16 +373,19 @@
         "id": "AllergyIntolerance:shr-allergy-NoKnownDrugAllergy.modifierExtension",
         "path": "AllergyIntolerance.modifierExtension",
         "slicing": {
-          "id": "54",
+          "id": "52",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -399,6 +415,7 @@
         "path": "AllergyIntolerance.modifierExtension",
         "sliceName": "nonoccurrencemodifier",
         "definition": "When true, indicates either that the event or action documented in the entry did not occur, or the the thing documented is absent or does not exist.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -459,7 +476,10 @@
         "slicing": {
           "id": "10",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -559,7 +579,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -639,7 +658,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -828,6 +846,7 @@
         "path": "AllergyIntolerance.clinicalStatus",
         "short": "active | inactive | resolved",
         "definition": "The clinical status of the allergy or intolerance.",
+        "comment": "This element is labeled as a modifier because the status contains the codes inactive and resolved that mark the AllergyIntolerance as not currently valid.",
         "min": 0,
         "max": "1",
         "type": [
@@ -835,9 +854,19 @@
             "code": "code"
           }
         ],
+        "condition": [
+          "ait-1",
+          "ait-2"
+        ],
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AllergyIntoleranceClinicalStatus"
+            }
+          ],
           "strength": "required",
           "description": "The clinical status of the allergy or intolerance.",
           "valueSetReference": {
@@ -845,6 +874,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "rim",
+            "map": "Observation ACT\n.inboundRelationship[typeCode=COMP].source[classCode=OBS, code=\"clinicalStatus\", moodCode=EVN].value"
+          },
           {
             "identity": "w5",
             "map": "status"
@@ -856,7 +889,7 @@
         "path": "AllergyIntolerance.verificationStatus",
         "short": "unconfirmed | confirmed | refuted | entered-in-error",
         "definition": "Assertion about certainty associated with the propensity, or potential risk, of a reaction to the identified substance (including pharmaceutical product).",
-        "comments": "Decision support would typically raise alerts for 'confirmed' and 'unconfirmed' and ignore a 'refuted' reaction. In particular, 'refuted' may be useful for reconciliation of the Adverse Reaction List.",
+        "comment": "This element is labeled as a modifier because the status contains the codes refuted and entered-in-error that mark the AllergyIntolerance as not currently valid.",
         "min": 1,
         "max": "1",
         "type": [
@@ -865,16 +898,23 @@
           }
         ],
         "fixedCode": "unconfirmed",
+        "condition": [
+          "ait-1",
+          "ait-2"
+        ],
         "isModifier": true,
         "isSummary": true,
         "binding": {
           "strength": "required",
-          "description": "Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/allergy-verification-status"
+            "reference": "http://standardhealthrecord.org/shr/allergy/vs/AllergyVerificationStatusVS"
           }
         },
         "mapping": [
+          {
+            "identity": "rim",
+            "map": "Observation ACT\n.inboundRelationship[typeCode=COMP].source[classCode=OBS, code=\"verificationStatus\", moodCode=EVN].value"
+          },
           {
             "identity": "w5",
             "map": "status"
@@ -886,7 +926,7 @@
         "path": "AllergyIntolerance.type",
         "short": "allergy | intolerance - Underlying mechanism (if known)",
         "definition": "Identification of the underlying physiological mechanism for the reaction risk.",
-        "comments": "Allergic (typically immune-mediated) reactions have been traditionally regarded as an indicator for potential escalation to significant future risk. Contemporary knowledge suggests that some reactions previously thought to be immune-mediated are, in fact, non-immune, but in some cases can still pose a life threatening risk. It is acknowledged that many clinicians may not be in a position to distinguish the mechanism of a particular reaction. Often the term \"allergy\" is used rather generically and may overlap with the use of \"intolerance\" - in practice the boundaries between these two concepts may not be well-defined or understood. This data element is included nevertheless, because many legacy systems have captured this attribute. Immunologic testing may provide supporting evidence for the basis of the reaction and the causative substance, but no tests are 100% sensitive or specific for sensitivity to a particular substance. If, as is commonly the case, it is unclear whether the reaction is due to an allergy or an intolerance, then the type element should be omitted from the resource.",
+        "comment": "Allergic (typically immune-mediated) reactions have been traditionally regarded as an indicator for potential escalation to significant future risk. Contemporary knowledge suggests that some reactions previously thought to be immune-mediated are, in fact, non-immune, but in some cases can still pose a life threatening risk. It is acknowledged that many clinicians may not be in a position to distinguish the mechanism of a particular reaction. Often the term \"allergy\" is used rather generically and may overlap with the use of \"intolerance\" - in practice the boundaries between these two concepts may not be well-defined or understood. This data element is included nevertheless, because many legacy systems have captured this attribute. Immunologic testing may provide supporting evidence for the basis of the reaction and the causative substance, but no tests are 100% sensitive or specific for sensitivity to a particular substance. If, as is commonly the case, it is unclear whether the reaction is due to an allergy or an intolerance, then the type element should be omitted from the resource.",
         "alias": [
           "Category",
           "Class"
@@ -901,6 +941,12 @@
         "fixedCode": "allergy",
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AllergyIntoleranceType"
+            }
+          ],
           "strength": "required",
           "description": "Identification of the underlying physiological mechanism for a Reaction Risk.",
           "valueSetReference": {
@@ -925,9 +971,9 @@
       {
         "id": "AllergyIntolerance:shr-allergy-NoKnownDrugAllergy.category",
         "path": "AllergyIntolerance.category",
-        "short": "food | medication | biologic | environment",
+        "short": "food | medication | environment | biologic",
         "definition": "Category of the identified substance.",
-        "comments": "This data element has been included because it is currently being captured in some clinical systems. This data can be derived from the substance where coding systems are used, and is effectively redundant in that situation.  When searching on category, consider the implications of AllergyIntolerance resources without a category.  For example, when searching on category = medication, medication allergies that don't have a category valued will not be returned.  Refer to [search](search.html) for more information on how to search category with a :missing modifier to get allergies that don't have a category.",
+        "comment": "This data element has been included because it is currently being captured in some clinical systems. This data can be derived from the substance where coding systems are used, and is effectively redundant in that situation.  When searching on category, consider the implications of AllergyIntolerance resources without a category.  For example, when searching on category = medication, medication allergies that don't have a category valued will not be returned.  Refer to [search](search.html) for more information on how to search category with a :missing modifier to get allergies that don't have a category.  Additionally, category should be used with caution because category can be subjective based on the sender.",
         "alias": [
           "Category",
           "Type",
@@ -944,6 +990,12 @@
         "fixedCode": "drug",
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AllergyIntoleranceCategory"
+            }
+          ],
           "strength": "required",
           "description": "Category of an identified substance.",
           "valueSetReference": {
@@ -970,7 +1022,7 @@
         "path": "AllergyIntolerance.criticality",
         "short": "low | high | unable-to-assess",
         "definition": "Estimate of the potential clinical harm, or seriousness, of the reaction to the identified substance.",
-        "comments": "The default criticality value for any propensity to an adverse reaction should be 'Low Risk', indicating at the very least a relative contraindication to deliberate or voluntary exposure to the substance. 'High Risk' is flagged if the clinician has identified a propensity for a more serious or potentially life-threatening reaction, such as anaphylaxis, and implies an absolute contraindication to deliberate or voluntary exposure to the substance. If this element is missing, the criticality is unknown (though it may be known elsewhere).",
+        "comment": "The default criticality value for any propensity to an adverse reaction should be 'Low Risk', indicating at the very least a relative contraindication to deliberate or voluntary exposure to the substance. 'High Risk' is flagged if the clinician has identified a propensity for a more serious or potentially life-threatening reaction, such as anaphylaxis, and implies an absolute contraindication to deliberate or voluntary exposure to the substance. If this element is missing, the criticality is unknown (though it may be known elsewhere).\n\nSystems that capture a severity at the condition level are actually representing the concept of criticality whereas the severity documented at the reaction level is representing the true reaction severity.  Existing systems that are capturing both condition criticality and reaction severity may use the term \"severity\" to represent both.  Criticality is the worst it could be in the future (i.e. situation-agnostic) whereas severity is situation-dependent.",
         "alias": [
           "Severity",
           "Seriousness",
@@ -986,6 +1038,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AllergyIntoleranceCriticality"
+            }
+          ],
           "strength": "required",
           "description": "Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.",
           "valueSetReference": {
@@ -1010,9 +1068,9 @@
       {
         "id": "AllergyIntolerance:shr-allergy-NoKnownDrugAllergy.code",
         "path": "AllergyIntolerance.code",
-        "short": "Allergy or intolerance code",
+        "short": "Code that identifies the allergy or intolerance",
         "definition": "Code for an allergy or intolerance statement (either a positive or a negated/excluded statement).  This may be a code for a substance or pharmaceutical product that is considered to be responsible for the adverse reaction risk (e.g., \"Latex\"), an allergy or intolerance condition (e.g., \"Latex allergy\"), or a negated/excluded code for a specific substance or class (e.g., \"No latex allergy\") or a general or categorical negated statement (e.g.,  \"No known allergy\", \"No known drug allergies\").",
-        "comments": "It is strongly recommended that this element be populated using a terminology, where possible. For example, some terminologies used include RxNorm, SNOMED CT, DM+D, NDFRT, ICD-9, IDC-10, UNI, ATC and CPT. Plain text should only be used if there is no appropriate terminology available. Additional details can be specified in the text.\r\rWhen a substance or product code is specified for the 'code' element, the \"default\" semantic context is that this is a positive statement of an allergy or intolerance (depending on the value of the 'type' element, if present) condition to the specified substance/product.  In the corresponding SNOMED CT allergy model, the specified substance/product is the target (destination) of the \"Causative agent\" relationship.\r\rThe 'substanceExposureRisk' extension is available as a structured and more flexible alternative to the 'code' element for making positive or negative allergy or intolerance statements.  This extension provides the capability to make \"no known allergy\" (or \"no risk of adverse reaction\") statements regarding any coded substance/product (including cases when a pre-coordinated \"no allergy to x\" concept for that substance/product does not exist).  If the 'substanceExposureRisk' extension is present, the AllergyIntolerance.code element SHALL be omitted.",
+        "comment": "It is strongly recommended that this element be populated using a terminology, where possible. For example, some terminologies used include RxNorm, SNOMED CT, DM+D, NDFRT, ICD-9, IDC-10, UNI, ATC and CPT. Plain text should only be used if there is no appropriate terminology available. Additional details can be specified in the text.\r\rWhen a substance or product code is specified for the 'code' element, the \"default\" semantic context is that this is a positive statement of an allergy or intolerance (depending on the value of the 'type' element, if present) condition to the specified substance/product.  In the corresponding SNOMED CT allergy model, the specified substance/product is the target (destination) of the \"Causative agent\" relationship.\r\rThe 'substanceExposureRisk' extension is available as a structured and more flexible alternative to the 'code' element for making positive or negative allergy or intolerance statements.  This extension provides the capability to make \"no known allergy\" (or \"no risk of adverse reaction\") statements regarding any coded substance/product (including cases when a pre-coordinated \"no allergy to x\" concept for that substance/product does not exist).  If the 'substanceExposureRisk' extension is present, the AllergyIntolerance.code element SHALL be omitted.",
         "alias": [
           "Code"
         ],
@@ -1028,7 +1086,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-allergy-AllergenIrritantVS"
+            "reference": "http://standardhealthrecord.org/shr/allergy/vs/AllergenIrritantVS"
           }
         },
         "mapping": [
@@ -1176,7 +1234,7 @@
         "path": "AllergyIntolerance.asserter",
         "short": "Source of the information about the allergy",
         "definition": "The source of the information about the allergy that is recorded.",
-        "comments": "The recorder takes repsonsibility for the content, but can reference the source from where they got it.",
+        "comment": "The recorder takes repsonsibility for the content, but can reference the source from where they got it.",
         "alias": [
           "Source",
           "Informant"
@@ -1218,7 +1276,7 @@
         "path": "AllergyIntolerance.lastOccurrence",
         "short": "Date(/time) of last known occurrence of a reaction",
         "definition": "Represents the date and/or time of the last known occurrence of a reaction event.",
-        "comments": "This date may be replicated by one of the Onset of Reaction dates. Where a textual representation of the date of last occurrence is required e.g. 'In Childhood, '10 years ago' the Comment element should be used.",
+        "comment": "This date may be replicated by one of the Onset of Reaction dates. Where a textual representation of the date of last occurrence is required e.g. 'In Childhood, '10 years ago' the Comment element should be used.",
         "min": 0,
         "max": "0",
         "type": [
@@ -1238,7 +1296,7 @@
         "path": "AllergyIntolerance.note",
         "short": "Additional text not captured in other fields",
         "definition": "Additional narrative about the propensity for the Adverse Reaction, not captured in other fields.",
-        "comments": "For example: including reason for flagging a seriousness of 'High Risk'; and instructions related to future exposure or administration of the substance, such as administration within an Intensive Care Unit or under corticosteroid cover. The notes should be related to an allergy or intolerance as a condition in general and not related to any particular episode of it. For episode notes and descriptions, use AllergyIntolerance.event.description and  AllergyIntolerance.event.notes.",
+        "comment": "For example: including reason for flagging a seriousness of 'High Risk'; and instructions related to future exposure or administration of the substance, such as administration within an Intensive Care Unit or under corticosteroid cover. The notes should be related to an allergy or intolerance as a condition in general and not related to any particular episode of it. For episode notes and descriptions, use AllergyIntolerance.event.description and  AllergyIntolerance.event.notes.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1314,7 +1372,7 @@
         "path": "AllergyIntolerance.reaction.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1343,7 +1401,7 @@
         "path": "AllergyIntolerance.reaction.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1375,7 +1433,7 @@
         "path": "AllergyIntolerance.reaction.substance",
         "short": "Specific substance or pharmaceutical product considered to be responsible for event",
         "definition": "Identification of the specific substance (or pharmaceutical product) considered to be responsible for the Adverse Reaction event. Note: the substance for a specific reaction may be different from the substance identified as the cause of the risk, but it must be consistent with it. For instance, it may be a more specific substance (e.g. a brand medication) or a composite product that includes the identified substance. It must be clinically safe to only process the 'code' and ignore the 'reaction.substance'.",
-        "comments": "Coding of the specific substance (or pharmaceutical product) with a terminology capable of triggering decision support should be used wherever possible.  The 'code' element allows for the use of a specific substance or pharmaceutical product, or a group or class of substances. In the case of an allergy or intolerance to a class of substances, (for example, \"penicillins\"), the 'reaction.substance' element could be used to code the specific substance that was identifed as having caused the reaction (for example, \"amoxycillin\"). Duplication of the value in the 'code' and 'reaction.substance' elements is acceptable when a specific substance has been recorded in 'code'.",
+        "comment": "Coding of the specific substance (or pharmaceutical product) with a terminology capable of triggering decision support should be used wherever possible.  The 'code' element allows for the use of a specific substance or pharmaceutical product, or a group or class of substances. In the case of an allergy or intolerance to a class of substances, (for example, \"penicillins\"), the 'reaction.substance' element could be used to code the specific substance that was identifed as having caused the reaction (for example, \"amoxycillin\"). Duplication of the value in the 'code' and 'reaction.substance' elements is acceptable when a specific substance has been recorded in 'code'.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1384,6 +1442,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "SubstanceCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes defining the type of the substance (including pharmaceutical products).",
           "valueSetReference": {
@@ -1397,42 +1461,12 @@
           }
         ]
       },
-      {
-        "id": "AllergyIntolerance:shr-allergy-NoKnownDrugAllergy.reaction.certainty",
-        "path": "AllergyIntolerance.reaction.certainty",
-        "short": "unlikely | likely | confirmed | unknown",
-        "definition": "Statement about the degree of clinical certainty that the specific substance was the cause of the manifestation in this reaction event.",
-        "comments": "When certainty is missing, it means no information exists (although it could be in narrative).  By contrast, the unknown code is used when there is an explicit assertion that certainty is not known, such as when a patient eats a meal and it is unknown which food caused the reaction.",
-        "alias": [
-          "Cause"
-        ],
-        "min": 0,
-        "max": "1",
-        "type": [
-          {
-            "code": "code"
-          }
-        ],
-        "binding": {
-          "strength": "required",
-          "description": "Statement about the degree of clinical certainty that a specific substance was the cause of the manifestation in an reaction event.",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/reaction-event-certainty"
-          }
-        },
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "uncertaintyCode"
-          }
-        ]
-      },
       {
         "id": "AllergyIntolerance:shr-allergy-NoKnownDrugAllergy.reaction.manifestation",
         "path": "AllergyIntolerance.reaction.manifestation",
         "short": "Clinical symptoms/signs associated with the Event",
         "definition": "Clinical symptoms and/or signs that are observed or associated with the adverse reaction event.",
-        "comments": "Manifestation can be expressed as a single word, phrase or brief description. For example: nausea, rash or no reaction. It is preferable that manifestation should be coded with a terminology, where possible. The values entered here may be used to display on an application screen as part of a list of adverse reactions, as recommended in the UK NHS CUI guidelines.  Terminologies commonly used include, but are not limited to, SNOMED CT or ICD10.",
+        "comment": "Manifestation can be expressed as a single word, phrase or brief description. For example: nausea, rash or no reaction. It is preferable that manifestation should be coded with a terminology, where possible. The values entered here may be used to display on an application screen as part of a list of adverse reactions, as recommended in the UK NHS CUI guidelines.  Terminologies commonly used include, but are not limited to, SNOMED CT or ICD10.",
         "alias": [
           "Symptoms",
           "Signs"
@@ -1445,10 +1479,16 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Manifestation"
+            }
+          ],
           "strength": "example",
           "description": "Clinical symptoms and/or signs that are observed or associated with an Adverse Reaction Event.",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/manifestation-codes"
+            "reference": "http://hl7.org/fhir/ValueSet/clinical-findings"
           }
         },
         "mapping": [
@@ -1467,7 +1507,7 @@
         "path": "AllergyIntolerance.reaction.description",
         "short": "Description of the event as a whole",
         "definition": "Text description about the reaction as a whole, including details of the manifestation if required.",
-        "comments": "Use the description to provide any details of a particular event of the occurred reaction such as circumstances, reaction specifics, what happened before/after. Information, related to the event, but not describing a particular care should be captured in the comment field. For example: at the age of four, the patient was given penicillin for strep throat and subsequently developed severe hives.",
+        "comment": "Use the description to provide any details of a particular event of the occurred reaction such as circumstances, reaction specifics, what happened before/after. Information, related to the event, but not describing a particular care should be captured in the comment field. For example: at the age of four, the patient was given penicillin for strep throat and subsequently developed severe hives.",
         "alias": [
           "Narrative",
           "Text"
@@ -1514,7 +1554,7 @@
         "path": "AllergyIntolerance.reaction.severity",
         "short": "mild | moderate | severe (of event as a whole)",
         "definition": "Clinical assessment of the severity of the reaction event as a whole, potentially considering multiple different manifestations.",
-        "comments": "It is acknowledged that this assessment is very subjective. There may be some some specific practice domains where objective scales have been applied. Objective scales can be included in this model as extensions.",
+        "comment": "It is acknowledged that this assessment is very subjective. There may be some some specific practice domains where objective scales have been applied. Objective scales can be included in this model as extensions.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1523,6 +1563,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AllergyIntoleranceSeverity"
+            }
+          ],
           "strength": "required",
           "description": "Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations.",
           "valueSetReference": {
@@ -1541,7 +1587,7 @@
         "path": "AllergyIntolerance.reaction.exposureRoute",
         "short": "How the subject was exposed to the substance",
         "definition": "Identification of the route by which the subject was exposed to the substance.",
-        "comments": "Coding of the route of exposure with a terminology should be used wherever possible.",
+        "comment": "Coding of the route of exposure with a terminology should be used wherever possible.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1550,6 +1596,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "RouteOfAdministration"
+            }
+          ],
           "strength": "example",
           "description": "A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.",
           "valueSetReference": {
@@ -1568,7 +1620,7 @@
         "path": "AllergyIntolerance.reaction.note",
         "short": "Text about event not captured in other fields",
         "definition": "Additional text about the adverse reaction event not captured in other fields.",
-        "comments": "Use this field to record information indirectly related to a particular event and not captured in the description. For example: Clinical records are no longer available, recorded based on information provided to the patient by her mother and her mother is deceased.",
+        "comment": "Use this field to record information indirectly related to a particular event and not captured in the description. For example: Clinical records are no longer available, recorded based on information provided to the patient by her mother and her mother is deceased.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1629,7 +1681,13 @@
       {
         "id": "AllergyIntolerance:shr-allergy-NoKnownDrugAllergy.verificationStatus",
         "path": "AllergyIntolerance.verificationStatus",
-        "fixedCode": "unconfirmed"
+        "fixedCode": "unconfirmed",
+        "binding": {
+          "strength": "required",
+          "valueSetReference": {
+            "reference": "http://standardhealthrecord.org/shr/allergy/vs/AllergyVerificationStatusVS"
+          }
+        }
       },
       {
         "id": "AllergyIntolerance:shr-allergy-NoKnownDrugAllergy.type",
@@ -1663,7 +1721,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-allergy-AllergenIrritantVS"
+            "reference": "http://standardhealthrecord.org/shr/allergy/vs/AllergenIrritantVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-allergy-NoKnownEnvironmentalAllergy.json b/lib/resources/standard_health_record/StructureDefinition-shr-allergy-NoKnownEnvironmentalAllergy.json
old mode 100755
new mode 100644
index 7ee3d5b..25b7d3a
--- a/lib/resources/standard_health_record/StructureDefinition-shr-allergy-NoKnownEnvironmentalAllergy.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-allergy-NoKnownEnvironmentalAllergy.json
@@ -12,8 +12,10 @@
       "value": "shr.allergy.NoKnownEnvironmentalAllergy"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR NoKnownEnvironmentalAllergy Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.823Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,10 +27,9 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.952Z",
   "description": "The subject has no known allergies to any environmental factors.",
   "purpose": "To record a clinical assessment of a propensity, or potential risk to an individual, of an adverse reaction upon future exposure to the specified substance, or class of substance.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "rim",
@@ -58,7 +59,7 @@
         "path": "AllergyIntolerance",
         "short": "SHR NoKnownEnvironmentalAllergy Profile",
         "definition": "The subject has no known allergies to any environmental factors.",
-        "comments": "Substances include, but are not limited to: a therapeutic substance administered correctly at an appropriate dosage for the individual; food; material derived from plants or animals; or venom from insect stings.",
+        "comment": "Substances include, but are not limited to: a therapeutic substance administered correctly at an appropriate dosage for the individual; food; material derived from plants or animals; or venom from insect stings.",
         "alias": [
           "Allergy",
           "Intolerance",
@@ -134,7 +135,7 @@
         "path": "AllergyIntolerance.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -173,7 +174,7 @@
         "path": "AllergyIntolerance.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -194,7 +195,7 @@
         "path": "AllergyIntolerance.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -214,6 +215,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -228,7 +237,7 @@
         "path": "AllergyIntolerance.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -262,7 +271,7 @@
         "path": "AllergyIntolerance.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -291,16 +300,19 @@
         "id": "AllergyIntolerance:shr-allergy-NoKnownEnvironmentalAllergy.extension",
         "path": "AllergyIntolerance.extension",
         "slicing": {
-          "id": "55",
+          "id": "53",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -329,6 +341,7 @@
         "path": "AllergyIntolerance.extension",
         "sliceName": "abatement",
         "definition": "The end, remission or resolution.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -360,16 +373,19 @@
         "id": "AllergyIntolerance:shr-allergy-NoKnownEnvironmentalAllergy.modifierExtension",
         "path": "AllergyIntolerance.modifierExtension",
         "slicing": {
-          "id": "56",
+          "id": "54",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -399,6 +415,7 @@
         "path": "AllergyIntolerance.modifierExtension",
         "sliceName": "nonoccurrencemodifier",
         "definition": "When true, indicates either that the event or action documented in the entry did not occur, or the the thing documented is absent or does not exist.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -459,7 +476,10 @@
         "slicing": {
           "id": "10",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -559,7 +579,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -639,7 +658,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -828,6 +846,7 @@
         "path": "AllergyIntolerance.clinicalStatus",
         "short": "active | inactive | resolved",
         "definition": "The clinical status of the allergy or intolerance.",
+        "comment": "This element is labeled as a modifier because the status contains the codes inactive and resolved that mark the AllergyIntolerance as not currently valid.",
         "min": 0,
         "max": "1",
         "type": [
@@ -835,9 +854,19 @@
             "code": "code"
           }
         ],
+        "condition": [
+          "ait-1",
+          "ait-2"
+        ],
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AllergyIntoleranceClinicalStatus"
+            }
+          ],
           "strength": "required",
           "description": "The clinical status of the allergy or intolerance.",
           "valueSetReference": {
@@ -845,6 +874,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "rim",
+            "map": "Observation ACT\n.inboundRelationship[typeCode=COMP].source[classCode=OBS, code=\"clinicalStatus\", moodCode=EVN].value"
+          },
           {
             "identity": "w5",
             "map": "status"
@@ -856,7 +889,7 @@
         "path": "AllergyIntolerance.verificationStatus",
         "short": "unconfirmed | confirmed | refuted | entered-in-error",
         "definition": "Assertion about certainty associated with the propensity, or potential risk, of a reaction to the identified substance (including pharmaceutical product).",
-        "comments": "Decision support would typically raise alerts for 'confirmed' and 'unconfirmed' and ignore a 'refuted' reaction. In particular, 'refuted' may be useful for reconciliation of the Adverse Reaction List.",
+        "comment": "This element is labeled as a modifier because the status contains the codes refuted and entered-in-error that mark the AllergyIntolerance as not currently valid.",
         "min": 1,
         "max": "1",
         "type": [
@@ -865,16 +898,23 @@
           }
         ],
         "fixedCode": "unconfirmed",
+        "condition": [
+          "ait-1",
+          "ait-2"
+        ],
         "isModifier": true,
         "isSummary": true,
         "binding": {
           "strength": "required",
-          "description": "Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/allergy-verification-status"
+            "reference": "http://standardhealthrecord.org/shr/allergy/vs/AllergyVerificationStatusVS"
           }
         },
         "mapping": [
+          {
+            "identity": "rim",
+            "map": "Observation ACT\n.inboundRelationship[typeCode=COMP].source[classCode=OBS, code=\"verificationStatus\", moodCode=EVN].value"
+          },
           {
             "identity": "w5",
             "map": "status"
@@ -886,7 +926,7 @@
         "path": "AllergyIntolerance.type",
         "short": "allergy | intolerance - Underlying mechanism (if known)",
         "definition": "Identification of the underlying physiological mechanism for the reaction risk.",
-        "comments": "Allergic (typically immune-mediated) reactions have been traditionally regarded as an indicator for potential escalation to significant future risk. Contemporary knowledge suggests that some reactions previously thought to be immune-mediated are, in fact, non-immune, but in some cases can still pose a life threatening risk. It is acknowledged that many clinicians may not be in a position to distinguish the mechanism of a particular reaction. Often the term \"allergy\" is used rather generically and may overlap with the use of \"intolerance\" - in practice the boundaries between these two concepts may not be well-defined or understood. This data element is included nevertheless, because many legacy systems have captured this attribute. Immunologic testing may provide supporting evidence for the basis of the reaction and the causative substance, but no tests are 100% sensitive or specific for sensitivity to a particular substance. If, as is commonly the case, it is unclear whether the reaction is due to an allergy or an intolerance, then the type element should be omitted from the resource.",
+        "comment": "Allergic (typically immune-mediated) reactions have been traditionally regarded as an indicator for potential escalation to significant future risk. Contemporary knowledge suggests that some reactions previously thought to be immune-mediated are, in fact, non-immune, but in some cases can still pose a life threatening risk. It is acknowledged that many clinicians may not be in a position to distinguish the mechanism of a particular reaction. Often the term \"allergy\" is used rather generically and may overlap with the use of \"intolerance\" - in practice the boundaries between these two concepts may not be well-defined or understood. This data element is included nevertheless, because many legacy systems have captured this attribute. Immunologic testing may provide supporting evidence for the basis of the reaction and the causative substance, but no tests are 100% sensitive or specific for sensitivity to a particular substance. If, as is commonly the case, it is unclear whether the reaction is due to an allergy or an intolerance, then the type element should be omitted from the resource.",
         "alias": [
           "Category",
           "Class"
@@ -901,6 +941,12 @@
         "fixedCode": "allergy",
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AllergyIntoleranceType"
+            }
+          ],
           "strength": "required",
           "description": "Identification of the underlying physiological mechanism for a Reaction Risk.",
           "valueSetReference": {
@@ -925,9 +971,9 @@
       {
         "id": "AllergyIntolerance:shr-allergy-NoKnownEnvironmentalAllergy.category",
         "path": "AllergyIntolerance.category",
-        "short": "food | medication | biologic | environment",
+        "short": "food | medication | environment | biologic",
         "definition": "Category of the identified substance.",
-        "comments": "This data element has been included because it is currently being captured in some clinical systems. This data can be derived from the substance where coding systems are used, and is effectively redundant in that situation.  When searching on category, consider the implications of AllergyIntolerance resources without a category.  For example, when searching on category = medication, medication allergies that don't have a category valued will not be returned.  Refer to [search](search.html) for more information on how to search category with a :missing modifier to get allergies that don't have a category.",
+        "comment": "This data element has been included because it is currently being captured in some clinical systems. This data can be derived from the substance where coding systems are used, and is effectively redundant in that situation.  When searching on category, consider the implications of AllergyIntolerance resources without a category.  For example, when searching on category = medication, medication allergies that don't have a category valued will not be returned.  Refer to [search](search.html) for more information on how to search category with a :missing modifier to get allergies that don't have a category.  Additionally, category should be used with caution because category can be subjective based on the sender.",
         "alias": [
           "Category",
           "Type",
@@ -944,6 +990,12 @@
         "fixedCode": "environment",
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AllergyIntoleranceCategory"
+            }
+          ],
           "strength": "required",
           "description": "Category of an identified substance.",
           "valueSetReference": {
@@ -970,7 +1022,7 @@
         "path": "AllergyIntolerance.criticality",
         "short": "low | high | unable-to-assess",
         "definition": "Estimate of the potential clinical harm, or seriousness, of the reaction to the identified substance.",
-        "comments": "The default criticality value for any propensity to an adverse reaction should be 'Low Risk', indicating at the very least a relative contraindication to deliberate or voluntary exposure to the substance. 'High Risk' is flagged if the clinician has identified a propensity for a more serious or potentially life-threatening reaction, such as anaphylaxis, and implies an absolute contraindication to deliberate or voluntary exposure to the substance. If this element is missing, the criticality is unknown (though it may be known elsewhere).",
+        "comment": "The default criticality value for any propensity to an adverse reaction should be 'Low Risk', indicating at the very least a relative contraindication to deliberate or voluntary exposure to the substance. 'High Risk' is flagged if the clinician has identified a propensity for a more serious or potentially life-threatening reaction, such as anaphylaxis, and implies an absolute contraindication to deliberate or voluntary exposure to the substance. If this element is missing, the criticality is unknown (though it may be known elsewhere).\n\nSystems that capture a severity at the condition level are actually representing the concept of criticality whereas the severity documented at the reaction level is representing the true reaction severity.  Existing systems that are capturing both condition criticality and reaction severity may use the term \"severity\" to represent both.  Criticality is the worst it could be in the future (i.e. situation-agnostic) whereas severity is situation-dependent.",
         "alias": [
           "Severity",
           "Seriousness",
@@ -986,6 +1038,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AllergyIntoleranceCriticality"
+            }
+          ],
           "strength": "required",
           "description": "Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.",
           "valueSetReference": {
@@ -1010,9 +1068,9 @@
       {
         "id": "AllergyIntolerance:shr-allergy-NoKnownEnvironmentalAllergy.code",
         "path": "AllergyIntolerance.code",
-        "short": "Allergy or intolerance code",
+        "short": "Code that identifies the allergy or intolerance",
         "definition": "Code for an allergy or intolerance statement (either a positive or a negated/excluded statement).  This may be a code for a substance or pharmaceutical product that is considered to be responsible for the adverse reaction risk (e.g., \"Latex\"), an allergy or intolerance condition (e.g., \"Latex allergy\"), or a negated/excluded code for a specific substance or class (e.g., \"No latex allergy\") or a general or categorical negated statement (e.g.,  \"No known allergy\", \"No known drug allergies\").",
-        "comments": "It is strongly recommended that this element be populated using a terminology, where possible. For example, some terminologies used include RxNorm, SNOMED CT, DM+D, NDFRT, ICD-9, IDC-10, UNI, ATC and CPT. Plain text should only be used if there is no appropriate terminology available. Additional details can be specified in the text.\r\rWhen a substance or product code is specified for the 'code' element, the \"default\" semantic context is that this is a positive statement of an allergy or intolerance (depending on the value of the 'type' element, if present) condition to the specified substance/product.  In the corresponding SNOMED CT allergy model, the specified substance/product is the target (destination) of the \"Causative agent\" relationship.\r\rThe 'substanceExposureRisk' extension is available as a structured and more flexible alternative to the 'code' element for making positive or negative allergy or intolerance statements.  This extension provides the capability to make \"no known allergy\" (or \"no risk of adverse reaction\") statements regarding any coded substance/product (including cases when a pre-coordinated \"no allergy to x\" concept for that substance/product does not exist).  If the 'substanceExposureRisk' extension is present, the AllergyIntolerance.code element SHALL be omitted.",
+        "comment": "It is strongly recommended that this element be populated using a terminology, where possible. For example, some terminologies used include RxNorm, SNOMED CT, DM+D, NDFRT, ICD-9, IDC-10, UNI, ATC and CPT. Plain text should only be used if there is no appropriate terminology available. Additional details can be specified in the text.\r\rWhen a substance or product code is specified for the 'code' element, the \"default\" semantic context is that this is a positive statement of an allergy or intolerance (depending on the value of the 'type' element, if present) condition to the specified substance/product.  In the corresponding SNOMED CT allergy model, the specified substance/product is the target (destination) of the \"Causative agent\" relationship.\r\rThe 'substanceExposureRisk' extension is available as a structured and more flexible alternative to the 'code' element for making positive or negative allergy or intolerance statements.  This extension provides the capability to make \"no known allergy\" (or \"no risk of adverse reaction\") statements regarding any coded substance/product (including cases when a pre-coordinated \"no allergy to x\" concept for that substance/product does not exist).  If the 'substanceExposureRisk' extension is present, the AllergyIntolerance.code element SHALL be omitted.",
         "alias": [
           "Code"
         ],
@@ -1028,7 +1086,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-allergy-AllergenIrritantVS"
+            "reference": "http://standardhealthrecord.org/shr/allergy/vs/AllergenIrritantVS"
           }
         },
         "mapping": [
@@ -1176,7 +1234,7 @@
         "path": "AllergyIntolerance.asserter",
         "short": "Source of the information about the allergy",
         "definition": "The source of the information about the allergy that is recorded.",
-        "comments": "The recorder takes repsonsibility for the content, but can reference the source from where they got it.",
+        "comment": "The recorder takes repsonsibility for the content, but can reference the source from where they got it.",
         "alias": [
           "Source",
           "Informant"
@@ -1218,7 +1276,7 @@
         "path": "AllergyIntolerance.lastOccurrence",
         "short": "Date(/time) of last known occurrence of a reaction",
         "definition": "Represents the date and/or time of the last known occurrence of a reaction event.",
-        "comments": "This date may be replicated by one of the Onset of Reaction dates. Where a textual representation of the date of last occurrence is required e.g. 'In Childhood, '10 years ago' the Comment element should be used.",
+        "comment": "This date may be replicated by one of the Onset of Reaction dates. Where a textual representation of the date of last occurrence is required e.g. 'In Childhood, '10 years ago' the Comment element should be used.",
         "min": 0,
         "max": "0",
         "type": [
@@ -1238,7 +1296,7 @@
         "path": "AllergyIntolerance.note",
         "short": "Additional text not captured in other fields",
         "definition": "Additional narrative about the propensity for the Adverse Reaction, not captured in other fields.",
-        "comments": "For example: including reason for flagging a seriousness of 'High Risk'; and instructions related to future exposure or administration of the substance, such as administration within an Intensive Care Unit or under corticosteroid cover. The notes should be related to an allergy or intolerance as a condition in general and not related to any particular episode of it. For episode notes and descriptions, use AllergyIntolerance.event.description and  AllergyIntolerance.event.notes.",
+        "comment": "For example: including reason for flagging a seriousness of 'High Risk'; and instructions related to future exposure or administration of the substance, such as administration within an Intensive Care Unit or under corticosteroid cover. The notes should be related to an allergy or intolerance as a condition in general and not related to any particular episode of it. For episode notes and descriptions, use AllergyIntolerance.event.description and  AllergyIntolerance.event.notes.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1314,7 +1372,7 @@
         "path": "AllergyIntolerance.reaction.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1343,7 +1401,7 @@
         "path": "AllergyIntolerance.reaction.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1375,7 +1433,7 @@
         "path": "AllergyIntolerance.reaction.substance",
         "short": "Specific substance or pharmaceutical product considered to be responsible for event",
         "definition": "Identification of the specific substance (or pharmaceutical product) considered to be responsible for the Adverse Reaction event. Note: the substance for a specific reaction may be different from the substance identified as the cause of the risk, but it must be consistent with it. For instance, it may be a more specific substance (e.g. a brand medication) or a composite product that includes the identified substance. It must be clinically safe to only process the 'code' and ignore the 'reaction.substance'.",
-        "comments": "Coding of the specific substance (or pharmaceutical product) with a terminology capable of triggering decision support should be used wherever possible.  The 'code' element allows for the use of a specific substance or pharmaceutical product, or a group or class of substances. In the case of an allergy or intolerance to a class of substances, (for example, \"penicillins\"), the 'reaction.substance' element could be used to code the specific substance that was identifed as having caused the reaction (for example, \"amoxycillin\"). Duplication of the value in the 'code' and 'reaction.substance' elements is acceptable when a specific substance has been recorded in 'code'.",
+        "comment": "Coding of the specific substance (or pharmaceutical product) with a terminology capable of triggering decision support should be used wherever possible.  The 'code' element allows for the use of a specific substance or pharmaceutical product, or a group or class of substances. In the case of an allergy or intolerance to a class of substances, (for example, \"penicillins\"), the 'reaction.substance' element could be used to code the specific substance that was identifed as having caused the reaction (for example, \"amoxycillin\"). Duplication of the value in the 'code' and 'reaction.substance' elements is acceptable when a specific substance has been recorded in 'code'.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1384,6 +1442,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "SubstanceCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes defining the type of the substance (including pharmaceutical products).",
           "valueSetReference": {
@@ -1397,42 +1461,12 @@
           }
         ]
       },
-      {
-        "id": "AllergyIntolerance:shr-allergy-NoKnownEnvironmentalAllergy.reaction.certainty",
-        "path": "AllergyIntolerance.reaction.certainty",
-        "short": "unlikely | likely | confirmed | unknown",
-        "definition": "Statement about the degree of clinical certainty that the specific substance was the cause of the manifestation in this reaction event.",
-        "comments": "When certainty is missing, it means no information exists (although it could be in narrative).  By contrast, the unknown code is used when there is an explicit assertion that certainty is not known, such as when a patient eats a meal and it is unknown which food caused the reaction.",
-        "alias": [
-          "Cause"
-        ],
-        "min": 0,
-        "max": "1",
-        "type": [
-          {
-            "code": "code"
-          }
-        ],
-        "binding": {
-          "strength": "required",
-          "description": "Statement about the degree of clinical certainty that a specific substance was the cause of the manifestation in an reaction event.",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/reaction-event-certainty"
-          }
-        },
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "uncertaintyCode"
-          }
-        ]
-      },
       {
         "id": "AllergyIntolerance:shr-allergy-NoKnownEnvironmentalAllergy.reaction.manifestation",
         "path": "AllergyIntolerance.reaction.manifestation",
         "short": "Clinical symptoms/signs associated with the Event",
         "definition": "Clinical symptoms and/or signs that are observed or associated with the adverse reaction event.",
-        "comments": "Manifestation can be expressed as a single word, phrase or brief description. For example: nausea, rash or no reaction. It is preferable that manifestation should be coded with a terminology, where possible. The values entered here may be used to display on an application screen as part of a list of adverse reactions, as recommended in the UK NHS CUI guidelines.  Terminologies commonly used include, but are not limited to, SNOMED CT or ICD10.",
+        "comment": "Manifestation can be expressed as a single word, phrase or brief description. For example: nausea, rash or no reaction. It is preferable that manifestation should be coded with a terminology, where possible. The values entered here may be used to display on an application screen as part of a list of adverse reactions, as recommended in the UK NHS CUI guidelines.  Terminologies commonly used include, but are not limited to, SNOMED CT or ICD10.",
         "alias": [
           "Symptoms",
           "Signs"
@@ -1445,10 +1479,16 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Manifestation"
+            }
+          ],
           "strength": "example",
           "description": "Clinical symptoms and/or signs that are observed or associated with an Adverse Reaction Event.",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/manifestation-codes"
+            "reference": "http://hl7.org/fhir/ValueSet/clinical-findings"
           }
         },
         "mapping": [
@@ -1467,7 +1507,7 @@
         "path": "AllergyIntolerance.reaction.description",
         "short": "Description of the event as a whole",
         "definition": "Text description about the reaction as a whole, including details of the manifestation if required.",
-        "comments": "Use the description to provide any details of a particular event of the occurred reaction such as circumstances, reaction specifics, what happened before/after. Information, related to the event, but not describing a particular care should be captured in the comment field. For example: at the age of four, the patient was given penicillin for strep throat and subsequently developed severe hives.",
+        "comment": "Use the description to provide any details of a particular event of the occurred reaction such as circumstances, reaction specifics, what happened before/after. Information, related to the event, but not describing a particular care should be captured in the comment field. For example: at the age of four, the patient was given penicillin for strep throat and subsequently developed severe hives.",
         "alias": [
           "Narrative",
           "Text"
@@ -1514,7 +1554,7 @@
         "path": "AllergyIntolerance.reaction.severity",
         "short": "mild | moderate | severe (of event as a whole)",
         "definition": "Clinical assessment of the severity of the reaction event as a whole, potentially considering multiple different manifestations.",
-        "comments": "It is acknowledged that this assessment is very subjective. There may be some some specific practice domains where objective scales have been applied. Objective scales can be included in this model as extensions.",
+        "comment": "It is acknowledged that this assessment is very subjective. There may be some some specific practice domains where objective scales have been applied. Objective scales can be included in this model as extensions.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1523,6 +1563,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AllergyIntoleranceSeverity"
+            }
+          ],
           "strength": "required",
           "description": "Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations.",
           "valueSetReference": {
@@ -1541,7 +1587,7 @@
         "path": "AllergyIntolerance.reaction.exposureRoute",
         "short": "How the subject was exposed to the substance",
         "definition": "Identification of the route by which the subject was exposed to the substance.",
-        "comments": "Coding of the route of exposure with a terminology should be used wherever possible.",
+        "comment": "Coding of the route of exposure with a terminology should be used wherever possible.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1550,6 +1596,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "RouteOfAdministration"
+            }
+          ],
           "strength": "example",
           "description": "A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.",
           "valueSetReference": {
@@ -1568,7 +1620,7 @@
         "path": "AllergyIntolerance.reaction.note",
         "short": "Text about event not captured in other fields",
         "definition": "Additional text about the adverse reaction event not captured in other fields.",
-        "comments": "Use this field to record information indirectly related to a particular event and not captured in the description. For example: Clinical records are no longer available, recorded based on information provided to the patient by her mother and her mother is deceased.",
+        "comment": "Use this field to record information indirectly related to a particular event and not captured in the description. For example: Clinical records are no longer available, recorded based on information provided to the patient by her mother and her mother is deceased.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1629,7 +1681,13 @@
       {
         "id": "AllergyIntolerance:shr-allergy-NoKnownEnvironmentalAllergy.verificationStatus",
         "path": "AllergyIntolerance.verificationStatus",
-        "fixedCode": "unconfirmed"
+        "fixedCode": "unconfirmed",
+        "binding": {
+          "strength": "required",
+          "valueSetReference": {
+            "reference": "http://standardhealthrecord.org/shr/allergy/vs/AllergyVerificationStatusVS"
+          }
+        }
       },
       {
         "id": "AllergyIntolerance:shr-allergy-NoKnownEnvironmentalAllergy.type",
@@ -1663,7 +1721,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-allergy-AllergenIrritantVS"
+            "reference": "http://standardhealthrecord.org/shr/allergy/vs/AllergenIrritantVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-allergy-NoKnownFoodAllergy.json b/lib/resources/standard_health_record/StructureDefinition-shr-allergy-NoKnownFoodAllergy.json
old mode 100755
new mode 100644
index 21a9bb9..7ec7317
--- a/lib/resources/standard_health_record/StructureDefinition-shr-allergy-NoKnownFoodAllergy.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-allergy-NoKnownFoodAllergy.json
@@ -12,8 +12,10 @@
       "value": "shr.allergy.NoKnownFoodAllergy"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR NoKnownFoodAllergy Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.792Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,10 +27,9 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.943Z",
   "description": "The subject has no known allergies to any foods.",
   "purpose": "To record a clinical assessment of a propensity, or potential risk to an individual, of an adverse reaction upon future exposure to the specified substance, or class of substance.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "rim",
@@ -58,7 +59,7 @@
         "path": "AllergyIntolerance",
         "short": "SHR NoKnownFoodAllergy Profile",
         "definition": "The subject has no known allergies to any foods.",
-        "comments": "Substances include, but are not limited to: a therapeutic substance administered correctly at an appropriate dosage for the individual; food; material derived from plants or animals; or venom from insect stings.",
+        "comment": "Substances include, but are not limited to: a therapeutic substance administered correctly at an appropriate dosage for the individual; food; material derived from plants or animals; or venom from insect stings.",
         "alias": [
           "Allergy",
           "Intolerance",
@@ -134,7 +135,7 @@
         "path": "AllergyIntolerance.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -173,7 +174,7 @@
         "path": "AllergyIntolerance.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -194,7 +195,7 @@
         "path": "AllergyIntolerance.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -214,6 +215,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -228,7 +237,7 @@
         "path": "AllergyIntolerance.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -262,7 +271,7 @@
         "path": "AllergyIntolerance.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -291,16 +300,19 @@
         "id": "AllergyIntolerance:shr-allergy-NoKnownFoodAllergy.extension",
         "path": "AllergyIntolerance.extension",
         "slicing": {
-          "id": "51",
+          "id": "49",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -329,6 +341,7 @@
         "path": "AllergyIntolerance.extension",
         "sliceName": "abatement",
         "definition": "The end, remission or resolution.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -360,16 +373,19 @@
         "id": "AllergyIntolerance:shr-allergy-NoKnownFoodAllergy.modifierExtension",
         "path": "AllergyIntolerance.modifierExtension",
         "slicing": {
-          "id": "52",
+          "id": "50",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -399,6 +415,7 @@
         "path": "AllergyIntolerance.modifierExtension",
         "sliceName": "nonoccurrencemodifier",
         "definition": "When true, indicates either that the event or action documented in the entry did not occur, or the the thing documented is absent or does not exist.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -459,7 +476,10 @@
         "slicing": {
           "id": "10",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -559,7 +579,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -639,7 +658,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -828,6 +846,7 @@
         "path": "AllergyIntolerance.clinicalStatus",
         "short": "active | inactive | resolved",
         "definition": "The clinical status of the allergy or intolerance.",
+        "comment": "This element is labeled as a modifier because the status contains the codes inactive and resolved that mark the AllergyIntolerance as not currently valid.",
         "min": 0,
         "max": "1",
         "type": [
@@ -835,9 +854,19 @@
             "code": "code"
           }
         ],
+        "condition": [
+          "ait-1",
+          "ait-2"
+        ],
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AllergyIntoleranceClinicalStatus"
+            }
+          ],
           "strength": "required",
           "description": "The clinical status of the allergy or intolerance.",
           "valueSetReference": {
@@ -845,6 +874,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "rim",
+            "map": "Observation ACT\n.inboundRelationship[typeCode=COMP].source[classCode=OBS, code=\"clinicalStatus\", moodCode=EVN].value"
+          },
           {
             "identity": "w5",
             "map": "status"
@@ -856,7 +889,7 @@
         "path": "AllergyIntolerance.verificationStatus",
         "short": "unconfirmed | confirmed | refuted | entered-in-error",
         "definition": "Assertion about certainty associated with the propensity, or potential risk, of a reaction to the identified substance (including pharmaceutical product).",
-        "comments": "Decision support would typically raise alerts for 'confirmed' and 'unconfirmed' and ignore a 'refuted' reaction. In particular, 'refuted' may be useful for reconciliation of the Adverse Reaction List.",
+        "comment": "This element is labeled as a modifier because the status contains the codes refuted and entered-in-error that mark the AllergyIntolerance as not currently valid.",
         "min": 1,
         "max": "1",
         "type": [
@@ -865,16 +898,23 @@
           }
         ],
         "fixedCode": "unconfirmed",
+        "condition": [
+          "ait-1",
+          "ait-2"
+        ],
         "isModifier": true,
         "isSummary": true,
         "binding": {
           "strength": "required",
-          "description": "Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/allergy-verification-status"
+            "reference": "http://standardhealthrecord.org/shr/allergy/vs/AllergyVerificationStatusVS"
           }
         },
         "mapping": [
+          {
+            "identity": "rim",
+            "map": "Observation ACT\n.inboundRelationship[typeCode=COMP].source[classCode=OBS, code=\"verificationStatus\", moodCode=EVN].value"
+          },
           {
             "identity": "w5",
             "map": "status"
@@ -886,7 +926,7 @@
         "path": "AllergyIntolerance.type",
         "short": "allergy | intolerance - Underlying mechanism (if known)",
         "definition": "Identification of the underlying physiological mechanism for the reaction risk.",
-        "comments": "Allergic (typically immune-mediated) reactions have been traditionally regarded as an indicator for potential escalation to significant future risk. Contemporary knowledge suggests that some reactions previously thought to be immune-mediated are, in fact, non-immune, but in some cases can still pose a life threatening risk. It is acknowledged that many clinicians may not be in a position to distinguish the mechanism of a particular reaction. Often the term \"allergy\" is used rather generically and may overlap with the use of \"intolerance\" - in practice the boundaries between these two concepts may not be well-defined or understood. This data element is included nevertheless, because many legacy systems have captured this attribute. Immunologic testing may provide supporting evidence for the basis of the reaction and the causative substance, but no tests are 100% sensitive or specific for sensitivity to a particular substance. If, as is commonly the case, it is unclear whether the reaction is due to an allergy or an intolerance, then the type element should be omitted from the resource.",
+        "comment": "Allergic (typically immune-mediated) reactions have been traditionally regarded as an indicator for potential escalation to significant future risk. Contemporary knowledge suggests that some reactions previously thought to be immune-mediated are, in fact, non-immune, but in some cases can still pose a life threatening risk. It is acknowledged that many clinicians may not be in a position to distinguish the mechanism of a particular reaction. Often the term \"allergy\" is used rather generically and may overlap with the use of \"intolerance\" - in practice the boundaries between these two concepts may not be well-defined or understood. This data element is included nevertheless, because many legacy systems have captured this attribute. Immunologic testing may provide supporting evidence for the basis of the reaction and the causative substance, but no tests are 100% sensitive or specific for sensitivity to a particular substance. If, as is commonly the case, it is unclear whether the reaction is due to an allergy or an intolerance, then the type element should be omitted from the resource.",
         "alias": [
           "Category",
           "Class"
@@ -901,6 +941,12 @@
         "fixedCode": "allergy",
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AllergyIntoleranceType"
+            }
+          ],
           "strength": "required",
           "description": "Identification of the underlying physiological mechanism for a Reaction Risk.",
           "valueSetReference": {
@@ -925,9 +971,9 @@
       {
         "id": "AllergyIntolerance:shr-allergy-NoKnownFoodAllergy.category",
         "path": "AllergyIntolerance.category",
-        "short": "food | medication | biologic | environment",
+        "short": "food | medication | environment | biologic",
         "definition": "Category of the identified substance.",
-        "comments": "This data element has been included because it is currently being captured in some clinical systems. This data can be derived from the substance where coding systems are used, and is effectively redundant in that situation.  When searching on category, consider the implications of AllergyIntolerance resources without a category.  For example, when searching on category = medication, medication allergies that don't have a category valued will not be returned.  Refer to [search](search.html) for more information on how to search category with a :missing modifier to get allergies that don't have a category.",
+        "comment": "This data element has been included because it is currently being captured in some clinical systems. This data can be derived from the substance where coding systems are used, and is effectively redundant in that situation.  When searching on category, consider the implications of AllergyIntolerance resources without a category.  For example, when searching on category = medication, medication allergies that don't have a category valued will not be returned.  Refer to [search](search.html) for more information on how to search category with a :missing modifier to get allergies that don't have a category.  Additionally, category should be used with caution because category can be subjective based on the sender.",
         "alias": [
           "Category",
           "Type",
@@ -944,6 +990,12 @@
         "fixedCode": "food",
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AllergyIntoleranceCategory"
+            }
+          ],
           "strength": "required",
           "description": "Category of an identified substance.",
           "valueSetReference": {
@@ -970,7 +1022,7 @@
         "path": "AllergyIntolerance.criticality",
         "short": "low | high | unable-to-assess",
         "definition": "Estimate of the potential clinical harm, or seriousness, of the reaction to the identified substance.",
-        "comments": "The default criticality value for any propensity to an adverse reaction should be 'Low Risk', indicating at the very least a relative contraindication to deliberate or voluntary exposure to the substance. 'High Risk' is flagged if the clinician has identified a propensity for a more serious or potentially life-threatening reaction, such as anaphylaxis, and implies an absolute contraindication to deliberate or voluntary exposure to the substance. If this element is missing, the criticality is unknown (though it may be known elsewhere).",
+        "comment": "The default criticality value for any propensity to an adverse reaction should be 'Low Risk', indicating at the very least a relative contraindication to deliberate or voluntary exposure to the substance. 'High Risk' is flagged if the clinician has identified a propensity for a more serious or potentially life-threatening reaction, such as anaphylaxis, and implies an absolute contraindication to deliberate or voluntary exposure to the substance. If this element is missing, the criticality is unknown (though it may be known elsewhere).\n\nSystems that capture a severity at the condition level are actually representing the concept of criticality whereas the severity documented at the reaction level is representing the true reaction severity.  Existing systems that are capturing both condition criticality and reaction severity may use the term \"severity\" to represent both.  Criticality is the worst it could be in the future (i.e. situation-agnostic) whereas severity is situation-dependent.",
         "alias": [
           "Severity",
           "Seriousness",
@@ -986,6 +1038,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AllergyIntoleranceCriticality"
+            }
+          ],
           "strength": "required",
           "description": "Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.",
           "valueSetReference": {
@@ -1010,9 +1068,9 @@
       {
         "id": "AllergyIntolerance:shr-allergy-NoKnownFoodAllergy.code",
         "path": "AllergyIntolerance.code",
-        "short": "Allergy or intolerance code",
+        "short": "Code that identifies the allergy or intolerance",
         "definition": "Code for an allergy or intolerance statement (either a positive or a negated/excluded statement).  This may be a code for a substance or pharmaceutical product that is considered to be responsible for the adverse reaction risk (e.g., \"Latex\"), an allergy or intolerance condition (e.g., \"Latex allergy\"), or a negated/excluded code for a specific substance or class (e.g., \"No latex allergy\") or a general or categorical negated statement (e.g.,  \"No known allergy\", \"No known drug allergies\").",
-        "comments": "It is strongly recommended that this element be populated using a terminology, where possible. For example, some terminologies used include RxNorm, SNOMED CT, DM+D, NDFRT, ICD-9, IDC-10, UNI, ATC and CPT. Plain text should only be used if there is no appropriate terminology available. Additional details can be specified in the text.\r\rWhen a substance or product code is specified for the 'code' element, the \"default\" semantic context is that this is a positive statement of an allergy or intolerance (depending on the value of the 'type' element, if present) condition to the specified substance/product.  In the corresponding SNOMED CT allergy model, the specified substance/product is the target (destination) of the \"Causative agent\" relationship.\r\rThe 'substanceExposureRisk' extension is available as a structured and more flexible alternative to the 'code' element for making positive or negative allergy or intolerance statements.  This extension provides the capability to make \"no known allergy\" (or \"no risk of adverse reaction\") statements regarding any coded substance/product (including cases when a pre-coordinated \"no allergy to x\" concept for that substance/product does not exist).  If the 'substanceExposureRisk' extension is present, the AllergyIntolerance.code element SHALL be omitted.",
+        "comment": "It is strongly recommended that this element be populated using a terminology, where possible. For example, some terminologies used include RxNorm, SNOMED CT, DM+D, NDFRT, ICD-9, IDC-10, UNI, ATC and CPT. Plain text should only be used if there is no appropriate terminology available. Additional details can be specified in the text.\r\rWhen a substance or product code is specified for the 'code' element, the \"default\" semantic context is that this is a positive statement of an allergy or intolerance (depending on the value of the 'type' element, if present) condition to the specified substance/product.  In the corresponding SNOMED CT allergy model, the specified substance/product is the target (destination) of the \"Causative agent\" relationship.\r\rThe 'substanceExposureRisk' extension is available as a structured and more flexible alternative to the 'code' element for making positive or negative allergy or intolerance statements.  This extension provides the capability to make \"no known allergy\" (or \"no risk of adverse reaction\") statements regarding any coded substance/product (including cases when a pre-coordinated \"no allergy to x\" concept for that substance/product does not exist).  If the 'substanceExposureRisk' extension is present, the AllergyIntolerance.code element SHALL be omitted.",
         "alias": [
           "Code"
         ],
@@ -1028,7 +1086,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-allergy-AllergenIrritantVS"
+            "reference": "http://standardhealthrecord.org/shr/allergy/vs/AllergenIrritantVS"
           }
         },
         "mapping": [
@@ -1176,7 +1234,7 @@
         "path": "AllergyIntolerance.asserter",
         "short": "Source of the information about the allergy",
         "definition": "The source of the information about the allergy that is recorded.",
-        "comments": "The recorder takes repsonsibility for the content, but can reference the source from where they got it.",
+        "comment": "The recorder takes repsonsibility for the content, but can reference the source from where they got it.",
         "alias": [
           "Source",
           "Informant"
@@ -1218,7 +1276,7 @@
         "path": "AllergyIntolerance.lastOccurrence",
         "short": "Date(/time) of last known occurrence of a reaction",
         "definition": "Represents the date and/or time of the last known occurrence of a reaction event.",
-        "comments": "This date may be replicated by one of the Onset of Reaction dates. Where a textual representation of the date of last occurrence is required e.g. 'In Childhood, '10 years ago' the Comment element should be used.",
+        "comment": "This date may be replicated by one of the Onset of Reaction dates. Where a textual representation of the date of last occurrence is required e.g. 'In Childhood, '10 years ago' the Comment element should be used.",
         "min": 0,
         "max": "0",
         "type": [
@@ -1238,7 +1296,7 @@
         "path": "AllergyIntolerance.note",
         "short": "Additional text not captured in other fields",
         "definition": "Additional narrative about the propensity for the Adverse Reaction, not captured in other fields.",
-        "comments": "For example: including reason for flagging a seriousness of 'High Risk'; and instructions related to future exposure or administration of the substance, such as administration within an Intensive Care Unit or under corticosteroid cover. The notes should be related to an allergy or intolerance as a condition in general and not related to any particular episode of it. For episode notes and descriptions, use AllergyIntolerance.event.description and  AllergyIntolerance.event.notes.",
+        "comment": "For example: including reason for flagging a seriousness of 'High Risk'; and instructions related to future exposure or administration of the substance, such as administration within an Intensive Care Unit or under corticosteroid cover. The notes should be related to an allergy or intolerance as a condition in general and not related to any particular episode of it. For episode notes and descriptions, use AllergyIntolerance.event.description and  AllergyIntolerance.event.notes.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1314,7 +1372,7 @@
         "path": "AllergyIntolerance.reaction.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1343,7 +1401,7 @@
         "path": "AllergyIntolerance.reaction.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1375,7 +1433,7 @@
         "path": "AllergyIntolerance.reaction.substance",
         "short": "Specific substance or pharmaceutical product considered to be responsible for event",
         "definition": "Identification of the specific substance (or pharmaceutical product) considered to be responsible for the Adverse Reaction event. Note: the substance for a specific reaction may be different from the substance identified as the cause of the risk, but it must be consistent with it. For instance, it may be a more specific substance (e.g. a brand medication) or a composite product that includes the identified substance. It must be clinically safe to only process the 'code' and ignore the 'reaction.substance'.",
-        "comments": "Coding of the specific substance (or pharmaceutical product) with a terminology capable of triggering decision support should be used wherever possible.  The 'code' element allows for the use of a specific substance or pharmaceutical product, or a group or class of substances. In the case of an allergy or intolerance to a class of substances, (for example, \"penicillins\"), the 'reaction.substance' element could be used to code the specific substance that was identifed as having caused the reaction (for example, \"amoxycillin\"). Duplication of the value in the 'code' and 'reaction.substance' elements is acceptable when a specific substance has been recorded in 'code'.",
+        "comment": "Coding of the specific substance (or pharmaceutical product) with a terminology capable of triggering decision support should be used wherever possible.  The 'code' element allows for the use of a specific substance or pharmaceutical product, or a group or class of substances. In the case of an allergy or intolerance to a class of substances, (for example, \"penicillins\"), the 'reaction.substance' element could be used to code the specific substance that was identifed as having caused the reaction (for example, \"amoxycillin\"). Duplication of the value in the 'code' and 'reaction.substance' elements is acceptable when a specific substance has been recorded in 'code'.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1384,6 +1442,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "SubstanceCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes defining the type of the substance (including pharmaceutical products).",
           "valueSetReference": {
@@ -1397,42 +1461,12 @@
           }
         ]
       },
-      {
-        "id": "AllergyIntolerance:shr-allergy-NoKnownFoodAllergy.reaction.certainty",
-        "path": "AllergyIntolerance.reaction.certainty",
-        "short": "unlikely | likely | confirmed | unknown",
-        "definition": "Statement about the degree of clinical certainty that the specific substance was the cause of the manifestation in this reaction event.",
-        "comments": "When certainty is missing, it means no information exists (although it could be in narrative).  By contrast, the unknown code is used when there is an explicit assertion that certainty is not known, such as when a patient eats a meal and it is unknown which food caused the reaction.",
-        "alias": [
-          "Cause"
-        ],
-        "min": 0,
-        "max": "1",
-        "type": [
-          {
-            "code": "code"
-          }
-        ],
-        "binding": {
-          "strength": "required",
-          "description": "Statement about the degree of clinical certainty that a specific substance was the cause of the manifestation in an reaction event.",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/reaction-event-certainty"
-          }
-        },
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "uncertaintyCode"
-          }
-        ]
-      },
       {
         "id": "AllergyIntolerance:shr-allergy-NoKnownFoodAllergy.reaction.manifestation",
         "path": "AllergyIntolerance.reaction.manifestation",
         "short": "Clinical symptoms/signs associated with the Event",
         "definition": "Clinical symptoms and/or signs that are observed or associated with the adverse reaction event.",
-        "comments": "Manifestation can be expressed as a single word, phrase or brief description. For example: nausea, rash or no reaction. It is preferable that manifestation should be coded with a terminology, where possible. The values entered here may be used to display on an application screen as part of a list of adverse reactions, as recommended in the UK NHS CUI guidelines.  Terminologies commonly used include, but are not limited to, SNOMED CT or ICD10.",
+        "comment": "Manifestation can be expressed as a single word, phrase or brief description. For example: nausea, rash or no reaction. It is preferable that manifestation should be coded with a terminology, where possible. The values entered here may be used to display on an application screen as part of a list of adverse reactions, as recommended in the UK NHS CUI guidelines.  Terminologies commonly used include, but are not limited to, SNOMED CT or ICD10.",
         "alias": [
           "Symptoms",
           "Signs"
@@ -1445,10 +1479,16 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Manifestation"
+            }
+          ],
           "strength": "example",
           "description": "Clinical symptoms and/or signs that are observed or associated with an Adverse Reaction Event.",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/manifestation-codes"
+            "reference": "http://hl7.org/fhir/ValueSet/clinical-findings"
           }
         },
         "mapping": [
@@ -1467,7 +1507,7 @@
         "path": "AllergyIntolerance.reaction.description",
         "short": "Description of the event as a whole",
         "definition": "Text description about the reaction as a whole, including details of the manifestation if required.",
-        "comments": "Use the description to provide any details of a particular event of the occurred reaction such as circumstances, reaction specifics, what happened before/after. Information, related to the event, but not describing a particular care should be captured in the comment field. For example: at the age of four, the patient was given penicillin for strep throat and subsequently developed severe hives.",
+        "comment": "Use the description to provide any details of a particular event of the occurred reaction such as circumstances, reaction specifics, what happened before/after. Information, related to the event, but not describing a particular care should be captured in the comment field. For example: at the age of four, the patient was given penicillin for strep throat and subsequently developed severe hives.",
         "alias": [
           "Narrative",
           "Text"
@@ -1514,7 +1554,7 @@
         "path": "AllergyIntolerance.reaction.severity",
         "short": "mild | moderate | severe (of event as a whole)",
         "definition": "Clinical assessment of the severity of the reaction event as a whole, potentially considering multiple different manifestations.",
-        "comments": "It is acknowledged that this assessment is very subjective. There may be some some specific practice domains where objective scales have been applied. Objective scales can be included in this model as extensions.",
+        "comment": "It is acknowledged that this assessment is very subjective. There may be some some specific practice domains where objective scales have been applied. Objective scales can be included in this model as extensions.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1523,6 +1563,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AllergyIntoleranceSeverity"
+            }
+          ],
           "strength": "required",
           "description": "Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations.",
           "valueSetReference": {
@@ -1541,7 +1587,7 @@
         "path": "AllergyIntolerance.reaction.exposureRoute",
         "short": "How the subject was exposed to the substance",
         "definition": "Identification of the route by which the subject was exposed to the substance.",
-        "comments": "Coding of the route of exposure with a terminology should be used wherever possible.",
+        "comment": "Coding of the route of exposure with a terminology should be used wherever possible.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1550,6 +1596,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "RouteOfAdministration"
+            }
+          ],
           "strength": "example",
           "description": "A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.",
           "valueSetReference": {
@@ -1568,7 +1620,7 @@
         "path": "AllergyIntolerance.reaction.note",
         "short": "Text about event not captured in other fields",
         "definition": "Additional text about the adverse reaction event not captured in other fields.",
-        "comments": "Use this field to record information indirectly related to a particular event and not captured in the description. For example: Clinical records are no longer available, recorded based on information provided to the patient by her mother and her mother is deceased.",
+        "comment": "Use this field to record information indirectly related to a particular event and not captured in the description. For example: Clinical records are no longer available, recorded based on information provided to the patient by her mother and her mother is deceased.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1629,7 +1681,13 @@
       {
         "id": "AllergyIntolerance:shr-allergy-NoKnownFoodAllergy.verificationStatus",
         "path": "AllergyIntolerance.verificationStatus",
-        "fixedCode": "unconfirmed"
+        "fixedCode": "unconfirmed",
+        "binding": {
+          "strength": "required",
+          "valueSetReference": {
+            "reference": "http://standardhealthrecord.org/shr/allergy/vs/AllergyVerificationStatusVS"
+          }
+        }
       },
       {
         "id": "AllergyIntolerance:shr-allergy-NoKnownFoodAllergy.type",
@@ -1663,7 +1721,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-allergy-AllergenIrritantVS"
+            "reference": "http://standardhealthrecord.org/shr/allergy/vs/AllergenIrritantVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-base-ActionCode-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-base-ActionCode-extension.json
old mode 100755
new mode 100644
index 61deaa2..9b17d51
--- a/lib/resources/standard_health_record/StructureDefinition-shr-base-ActionCode-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-base-ActionCode-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.base.ActionCode"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ActionCode Extension",
   "title": "SHR ActionCode Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.348Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.280Z",
   "description": "The code for the action, such as an intervention or test, to be carried out.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-base-AssociatedEncounter-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-base-AssociatedEncounter-extension.json
old mode 100755
new mode 100644
index 57e4cc8..7251af2
--- a/lib/resources/standard_health_record/StructureDefinition-shr-base-AssociatedEncounter-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-base-AssociatedEncounter-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.base.AssociatedEncounter"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR AssociatedEncounter Extension",
   "title": "SHR AssociatedEncounter Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.579Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.857Z",
   "description": "The encounter or episode of care that led to creation of this entry.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-base-Author-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-base-Author-extension.json
old mode 100755
new mode 100644
index 83f317d..f0e262b
--- a/lib/resources/standard_health_record/StructureDefinition-shr-base-Author-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-base-Author-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.base.Author"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Author Extension",
   "title": "SHR Author Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.579Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.857Z",
   "description": "The person or organization who created the entry and is responsible for (and may certify) its content.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-base-Entry.json b/lib/resources/standard_health_record/StructureDefinition-shr-base-Entry.json
old mode 100755
new mode 100644
index c575837..3711065
--- a/lib/resources/standard_health_record/StructureDefinition-shr-base-Entry.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-base-Entry.json
@@ -3,7 +3,7 @@
   "id": "shr-base-Entry",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR Entry Profile</b></p>\n  <p>An item inserted in an electronic record.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.base.Entry maps to DomainResource:\n  Narrative maps to text\n  EntryId maps to id\n  Version maps to meta.versionId\n  EntryType maps to meta.profile\n  LastUpdateDate maps to meta.lastUpdated\n  Language maps to language\n  TBD &quot;SecurityLabel&quot; maps to meta.security\n  TBD &quot;Tag&quot; maps to meta.tag\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR Entry Profile</b></p>\n  <p>An item inserted in an electronic record.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.base.Entry maps to DomainResource:\n  Narrative maps to text\n  EntryId maps to id\n  constrain meta to 1..1\n  Version maps to meta.versionId\n  EntryType maps to meta.profile\n  LastUpdateDate maps to meta.lastUpdated\n  Language maps to language\n  &lt;TBD &quot;SecurityLabel&quot;&gt; maps to meta.security\n  &lt;TBD &quot;Tag&quot;&gt; maps to meta.tag\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-Entry",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.base.Entry"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Entry Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.569Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.855Z",
   "description": "An item inserted in an electronic record.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "rim",
@@ -91,7 +92,7 @@
         "path": "DomainResource.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 1,
         "max": "1",
         "base": {
@@ -111,7 +112,7 @@
         "path": "DomainResource.meta",
         "short": "Metadata about the resource",
         "definition": "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.",
-        "min": 0,
+        "min": 1,
         "max": "1",
         "base": {
           "path": "Resource.meta",
@@ -125,12 +126,183 @@
         ],
         "isSummary": true
       },
+      {
+        "id": "DomainResource:shr-base-Entry.meta.id",
+        "path": "DomainResource.meta.id",
+        "representation": [
+          "xmlAttr"
+        ],
+        "short": "xml:id (or equivalent in JSON)",
+        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Element.id",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "DomainResource:shr-base-Entry.meta.extension",
+        "path": "DomainResource.meta.extension",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
+        "short": "Additional Content defined by implementations",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "Element.extension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "DomainResource:shr-base-Entry.meta.versionId",
+        "path": "DomainResource.meta.versionId",
+        "short": "Version specific identifier",
+        "definition": "The version specific identifier, as it appears in the version portion of the URL. This values changes when the resource is created, updated, or deleted.",
+        "comment": "The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "id"
+          }
+        ],
+        "isSummary": true
+      },
+      {
+        "id": "DomainResource:shr-base-Entry.meta.lastUpdated",
+        "path": "DomainResource.meta.lastUpdated",
+        "short": "When the resource version last changed",
+        "definition": "When the resource last changed - e.g. when the version changed.",
+        "comment": "This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant.",
+        "min": 1,
+        "max": "1",
+        "type": [
+          {
+            "code": "instant"
+          }
+        ],
+        "isSummary": true
+      },
+      {
+        "id": "DomainResource:shr-base-Entry.meta.profile",
+        "path": "DomainResource.meta.profile",
+        "short": "Profiles this resource claims to conform to",
+        "definition": "A list of profiles (references to [StructureDefinition](structuredefinition.html#) resources) that this resource claims to conform to. The URL is a reference to [StructureDefinition.url]().",
+        "comment": "It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time.  The list of profile URLs is a set.",
+        "min": 1,
+        "max": "*",
+        "type": [
+          {
+            "code": "uri"
+          }
+        ],
+        "isSummary": true
+      },
+      {
+        "id": "DomainResource:shr-base-Entry.meta.security",
+        "path": "DomainResource.meta.security",
+        "short": "Security Labels applied to this resource",
+        "definition": "Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.",
+        "comment": "The security labels can be updated without changing the stated version of the resource  The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Coding"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "SecurityLabels"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
+            }
+          ],
+          "strength": "extensible",
+          "description": "Security Labels from the Healthcare Privacy and Security Classification System.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/security-labels"
+          }
+        }
+      },
+      {
+        "id": "DomainResource:shr-base-Entry.meta.tag",
+        "path": "DomainResource.meta.tag",
+        "short": "Tags applied to this resource",
+        "definition": "Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.",
+        "comment": "The tags can be updated without changing the stated version of the resource.  The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Coding"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Tags"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes that represent various types of tags, commonly workflow-related; e.g. \"Needs review by Dr. Jones\"",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/common-tags"
+          }
+        }
+      },
       {
         "id": "DomainResource:shr-base-Entry.implicitRules",
         "path": "DomainResource.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -151,7 +323,7 @@
         "path": "DomainResource.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -171,6 +343,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -185,7 +365,7 @@
         "path": "DomainResource.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -215,7 +395,7 @@
         "path": "DomainResource.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -239,16 +419,18 @@
         "id": "DomainResource:shr-base-Entry.extension",
         "path": "DomainResource.extension",
         "slicing": {
-          "id": "18",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
-          "ordered": false,
+          "description": "Extensions are always sliced by (at least) url",
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -271,7 +453,18 @@
         "id": "DomainResource:shr-base-Entry.extension:shrid",
         "path": "DomainResource.extension",
         "sliceName": "shrid",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
         "definition": "A unique, persistent identifier for the Standard Health Record to which this entry belongs.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -298,7 +491,18 @@
         "id": "DomainResource:shr-base-Entry.extension:focalsubject",
         "path": "DomainResource.extension",
         "sliceName": "focalsubject",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
         "definition": "The person or thing that this entry refers to, usually the Person of Record. However, not all entries refer to the Person of Record. The entry could refer to a fetus, care giver, or relative (living or dead).",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -325,7 +529,18 @@
         "id": "DomainResource:shr-base-Entry.extension:informant",
         "path": "DomainResource.extension",
         "sliceName": "informant",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
         "definition": "The person or entity that provided the information in the entry, as distinct from the actor creating the entry, e.g. the subject (patient), medical professional, family member, device or software program.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -352,7 +567,18 @@
         "id": "DomainResource:shr-base-Entry.extension:author",
         "path": "DomainResource.extension",
         "sliceName": "author",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
         "definition": "The person or organization who created the entry and is responsible for (and may certify) its content.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -379,7 +605,18 @@
         "id": "DomainResource:shr-base-Entry.extension:associatedencounter",
         "path": "DomainResource.extension",
         "sliceName": "associatedencounter",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
         "definition": "The encounter or episode of care that led to creation of this entry.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -406,7 +643,18 @@
         "id": "DomainResource:shr-base-Entry.extension:originalcreationdate",
         "path": "DomainResource.extension",
         "sliceName": "originalcreationdate",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
         "definition": "The point in time when the information was recorded in the system of record.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -433,16 +681,18 @@
         "id": "DomainResource:shr-base-Entry.modifierExtension",
         "path": "DomainResource.modifierExtension",
         "slicing": {
-          "id": "19",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
-          "ordered": false,
+          "description": "Extensions are always sliced by (at least) url",
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -466,7 +716,18 @@
         "id": "DomainResource:shr-base-Entry.modifierExtension:subjectisthirdpartymodifier",
         "path": "DomainResource.modifierExtension",
         "sliceName": "subjectisthirdpartymodifier",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
         "definition": "If true, the subject of this entry is someone other than the Person of Record, for example, a family member.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -505,6 +766,24 @@
         "min": 1,
         "max": "1"
       },
+      {
+        "id": "DomainResource:shr-base-Entry.meta",
+        "path": "DomainResource.meta",
+        "min": 1,
+        "max": "1"
+      },
+      {
+        "id": "DomainResource:shr-base-Entry.meta.lastUpdated",
+        "path": "DomainResource.meta.lastUpdated",
+        "min": 1,
+        "max": "1"
+      },
+      {
+        "id": "DomainResource:shr-base-Entry.meta.profile",
+        "path": "DomainResource.meta.profile",
+        "min": 1,
+        "max": "*"
+      },
       {
         "id": "DomainResource:shr-base-Entry.text",
         "path": "DomainResource.text",
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-base-FocalSubject-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-base-FocalSubject-extension.json
old mode 100755
new mode 100644
index 3adc9b9..8fe14ec
--- a/lib/resources/standard_health_record/StructureDefinition-shr-base-FocalSubject-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-base-FocalSubject-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.base.FocalSubject"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR FocalSubject Extension",
   "title": "SHR FocalSubject Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.578Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.856Z",
   "description": "The person or thing that this entry refers to, usually the Person of Record. However, not all entries refer to the Person of Record. The entry could refer to a fetus, care giver, or relative (living or dead).",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-base-Informant-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-base-Informant-extension.json
old mode 100755
new mode 100644
index 91a3f14..935ed87
--- a/lib/resources/standard_health_record/StructureDefinition-shr-base-Informant-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-base-Informant-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.base.Informant"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Informant Extension",
   "title": "SHR Informant Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.578Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.856Z",
   "description": "The person or entity that provided the information in the entry, as distinct from the actor creating the entry, e.g. the subject (patient), medical professional, family member, device or software program.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-base-Language-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-base-Language-extension.json
old mode 100755
new mode 100644
index 4a19e83..1801b9e
--- a/lib/resources/standard_health_record/StructureDefinition-shr-base-Language-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-base-Language-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.base.Language"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Language Extension",
   "title": "SHR Language Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.514Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.830Z",
   "description": "A human language, spoken or written.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-base-Narrative.json b/lib/resources/standard_health_record/StructureDefinition-shr-base-Narrative.json
old mode 100755
new mode 100644
index 40ecc79..f007269
--- a/lib/resources/standard_health_record/StructureDefinition-shr-base-Narrative.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-base-Narrative.json
@@ -12,8 +12,10 @@
       "value": "shr.base.Narrative"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Narrative Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.581Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.859Z",
   "description": "A human-readable narrative, potentially including images, that contains a summary of the resource, and may be used to represent the content of the resource to a human.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "rim",
@@ -103,9 +104,19 @@
       {
         "id": "Narrative:shr-base-Narrative.extension",
         "path": "Narrative.extension",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -142,6 +153,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "NarrativeStatus"
+            }
+          ],
           "strength": "required",
           "description": "The status of a resource narrative",
           "valueSetReference": {
@@ -160,7 +177,7 @@
         "path": "Narrative.div",
         "short": "Limited xhtml content",
         "definition": "The actual narrative content, a stripped down version of XHTML.",
-        "comments": "The contents of the html element are an XHTML fragment containing only the basic html formatting elements described in chapters 7-11 and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained stylesheets. The XHTML content may not contain a head, a body, external stylesheet references, scripts, forms, base/link/xlink, frames, iframes and objects.",
+        "comment": "The contents of the html element are an XHTML fragment containing only the basic html formatting elements described in chapters 7-11 and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained stylesheets. The XHTML content may not contain a head, a body, external stylesheet references, scripts, forms, base/link/xlink, frames, iframes and objects.",
         "min": 1,
         "max": "1",
         "type": [
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-base-NonOccurrenceModifier-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-base-NonOccurrenceModifier-extension.json
old mode 100755
new mode 100644
index 7155380..e6d4e88
--- a/lib/resources/standard_health_record/StructureDefinition-shr-base-NonOccurrenceModifier-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-base-NonOccurrenceModifier-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.base.NonOccurrenceModifier"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR NonOccurrenceModifier Extension",
   "title": "SHR NonOccurrenceModifier Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.550Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.844Z",
   "description": "When true, indicates either that the event or action documented in the entry did not occur, or the the thing documented is absent or does not exist.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -107,7 +108,10 @@
         "slicing": {
           "id": "10",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -187,7 +191,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-base-OriginalCreationDate-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-base-OriginalCreationDate-extension.json
old mode 100755
new mode 100644
index b7b77c5..9a32494
--- a/lib/resources/standard_health_record/StructureDefinition-shr-base-OriginalCreationDate-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-base-OriginalCreationDate-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.base.OriginalCreationDate"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR OriginalCreationDate Extension",
   "title": "SHR OriginalCreationDate Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.580Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.857Z",
   "description": "The point in time when the information was recorded in the system of record.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-base-PatientInstructions-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-base-PatientInstructions-extension.json
old mode 100755
new mode 100644
index c1d2810..0708e2b
--- a/lib/resources/standard_health_record/StructureDefinition-shr-base-PatientInstructions-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-base-PatientInstructions-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.base.PatientInstructions"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR PatientInstructions Extension",
   "title": "SHR PatientInstructions Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.351Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.282Z",
   "description": "Information for the patient, such as, where to get the test, how to prepare for the test, etc.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-base-PerformerInstructions-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-base-PerformerInstructions-extension.json
old mode 100755
new mode 100644
index b93e60b..95b99eb
--- a/lib/resources/standard_health_record/StructureDefinition-shr-base-PerformerInstructions-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-base-PerformerInstructions-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.base.PerformerInstructions"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR PerformerInstructions Extension",
   "title": "SHR PerformerInstructions Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.608Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.377Z",
   "description": "Information for the performer of the test, if needed.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-base-RequestNotToPerformActionModifier-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-base-RequestNotToPerformActionModifier-extension.json
deleted file mode 100755
index 8b0cf1f..0000000
--- a/lib/resources/standard_health_record/StructureDefinition-shr-base-RequestNotToPerformActionModifier-extension.json
+++ /dev/null
@@ -1,404 +0,0 @@
-{
-  "resourceType": "StructureDefinition",
-  "id": "shr-base-RequestNotToPerformActionModifier-extension",
-  "text": {
-    "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR RequestNotToPerformActionModifier Extension</b></p>\n  <p>If true, the thing requested should not take place. For example, a request to NOT elevate the head of a bed using the code for elevating the bed, and setting RequestNotToPerformActionModifier to true. Other examples include do not ambulate, do not flush NG tube, do not take blood pressure on a certain arm, etc. If the Request.code and RequestAgainstModifier both contain negation, that will reinforce the prohibition, and should not be interpreted as a double negative that equals a positive.</p>\n</div>"
-  },
-  "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-RequestNotToPerformActionModifier-extension",
-  "identifier": [
-    {
-      "system": "http://standardhealthrecord.org",
-      "value": "shr.base.RequestNotToPerformActionModifier"
-    }
-  ],
-  "name": "SHR RequestNotToPerformActionModifier Extension",
-  "title": "SHR RequestNotToPerformActionModifier Extension",
-  "status": "draft",
-  "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
-  "contact": [
-    {
-      "telecom": [
-        {
-          "system": "url",
-          "value": "http://www.standardhealthrecord.org"
-        }
-      ]
-    }
-  ],
-  "date": "2017-03-21T00:21:36.377Z",
-  "description": "If true, the thing requested should not take place. For example, a request to NOT elevate the head of a bed using the code for elevating the bed, and setting RequestNotToPerformActionModifier to true. Other examples include do not ambulate, do not flush NG tube, do not take blood pressure on a certain arm, etc. If the Request.code and RequestAgainstModifier both contain negation, that will reinforce the prohibition, and should not be interpreted as a double negative that equals a positive.",
-  "fhirVersion": "1.8.0",
-  "kind": "complex-type",
-  "abstract": false,
-  "contextType": "resource",
-  "context": [
-    "*"
-  ],
-  "type": "Extension",
-  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Extension",
-  "derivation": "constraint",
-  "snapshot": {
-    "element": [
-      {
-        "id": "Extension:requestnottoperformactionmodifier",
-        "path": "Extension",
-        "short": "SHR RequestNotToPerformActionModifier Extension",
-        "definition": "If true, the thing requested should not take place. For example, a request to NOT elevate the head of a bed using the code for elevating the bed, and setting RequestNotToPerformActionModifier to true. Other examples include do not ambulate, do not flush NG tube, do not take blood pressure on a certain arm, etc. If the Request.code and RequestAgainstModifier both contain negation, that will reinforce the prohibition, and should not be interpreted as a double negative that equals a positive.",
-        "min": 0,
-        "max": "*",
-        "base": {
-          "path": "Extension",
-          "min": 0,
-          "max": "1"
-        },
-        "condition": [
-          "ele-1"
-        ],
-        "constraint": [
-          {
-            "key": "ele-1",
-            "severity": "error",
-            "human": "All FHIR elements must have a @value or children",
-            "expression": "children().count() > id.count()",
-            "xpath": "@value|f:*|h:div",
-            "source": "Element"
-          },
-          {
-            "key": "ext-1",
-            "severity": "error",
-            "human": "Must have either extensions or value[x], not both",
-            "expression": "extension.exists() != value.exists()",
-            "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
-            "source": "Extension"
-          }
-        ]
-      },
-      {
-        "id": "Extension:requestnottoperformactionmodifier.id",
-        "path": "Extension.id",
-        "representation": [
-          "xmlAttr"
-        ],
-        "short": "xml:id (or equivalent in JSON)",
-        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "Element.id",
-          "min": 0,
-          "max": "1"
-        },
-        "type": [
-          {
-            "code": "string"
-          }
-        ],
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "N/A"
-          }
-        ]
-      },
-      {
-        "id": "Extension:requestnottoperformactionmodifier.extension",
-        "path": "Extension.extension",
-        "slicing": {
-          "id": "215",
-          "discriminator": [
-            "url"
-          ],
-          "ordered": false,
-          "rules": "open"
-        },
-        "short": "Extension",
-        "definition": "An Extension",
-        "min": 0,
-        "max": "*",
-        "base": {
-          "path": "Element.extension",
-          "min": 0,
-          "max": "*"
-        },
-        "type": [
-          {
-            "code": "Extension"
-          }
-        ]
-      },
-      {
-        "id": "Extension:requestnottoperformactionmodifier.extension:boolean",
-        "path": "Extension.extension",
-        "sliceName": "boolean",
-        "definition": "If true, the thing requested should not take place. For example, a request to NOT elevate the head of a bed using the code for elevating the bed, and setting RequestNotToPerformActionModifier to true. Other examples include do not ambulate, do not flush NG tube, do not take blood pressure on a certain arm, etc. If the Request.code and RequestAgainstModifier both contain negation, that will reinforce the prohibition, and should not be interpreted as a double negative that equals a positive.",
-        "min": 1,
-        "max": "1",
-        "base": {
-          "path": "Extension.extension",
-          "min": 0,
-          "max": "1"
-        },
-        "type": [
-          {
-            "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/primitive-boolean-extension"
-          }
-        ],
-        "isModifier": false,
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "N/A"
-          }
-        ]
-      },
-      {
-        "id": "Extension:requestnottoperformactionmodifier.extension:reason",
-        "path": "Extension.extension",
-        "sliceName": "reason",
-        "definition": "The justification for an action or non-action, conclusion, opinion, etc.",
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "Extension.extension",
-          "min": 0,
-          "max": "1"
-        },
-        "type": [
-          {
-            "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-Reason-extension"
-          }
-        ],
-        "isModifier": false,
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "N/A"
-          }
-        ]
-      },
-      {
-        "id": "Extension:requestnottoperformactionmodifier.url",
-        "path": "Extension.url",
-        "representation": [
-          "xmlAttr"
-        ],
-        "short": "identifies the meaning of the extension",
-        "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
-        "min": 1,
-        "max": "1",
-        "base": {
-          "path": "Extension.url",
-          "min": 1,
-          "max": "1"
-        },
-        "type": [
-          {
-            "code": "uri"
-          }
-        ],
-        "fixedUri": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-RequestNotToPerformActionModifier-extension",
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "N/A"
-          }
-        ]
-      },
-      {
-        "id": "Extension:requestnottoperformactionmodifier.value[x]",
-        "path": "Extension.value[x]",
-        "short": "Value of extension",
-        "definition": "Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).",
-        "min": 0,
-        "max": "0",
-        "base": {
-          "path": "Extension.value[x]",
-          "min": 0,
-          "max": "1"
-        },
-        "type": [
-          {
-            "code": "base64Binary"
-          },
-          {
-            "code": "boolean"
-          },
-          {
-            "code": "code"
-          },
-          {
-            "code": "date"
-          },
-          {
-            "code": "dateTime"
-          },
-          {
-            "code": "decimal"
-          },
-          {
-            "code": "id"
-          },
-          {
-            "code": "instant"
-          },
-          {
-            "code": "integer"
-          },
-          {
-            "code": "markdown"
-          },
-          {
-            "code": "oid"
-          },
-          {
-            "code": "positiveInt"
-          },
-          {
-            "code": "string"
-          },
-          {
-            "code": "time"
-          },
-          {
-            "code": "unsignedInt"
-          },
-          {
-            "code": "uri"
-          },
-          {
-            "code": "Address"
-          },
-          {
-            "code": "Age"
-          },
-          {
-            "code": "Annotation"
-          },
-          {
-            "code": "Attachment"
-          },
-          {
-            "code": "CodeableConcept"
-          },
-          {
-            "code": "Coding"
-          },
-          {
-            "code": "ContactPoint"
-          },
-          {
-            "code": "Count"
-          },
-          {
-            "code": "Distance"
-          },
-          {
-            "code": "Duration"
-          },
-          {
-            "code": "HumanName"
-          },
-          {
-            "code": "Identifier"
-          },
-          {
-            "code": "Money"
-          },
-          {
-            "code": "Period"
-          },
-          {
-            "code": "Quantity"
-          },
-          {
-            "code": "Range"
-          },
-          {
-            "code": "Ratio"
-          },
-          {
-            "code": "Reference"
-          },
-          {
-            "code": "SampledData"
-          },
-          {
-            "code": "Signature"
-          },
-          {
-            "code": "Timing"
-          },
-          {
-            "code": "Meta"
-          }
-        ],
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "N/A"
-          }
-        ]
-      }
-    ]
-  },
-  "differential": {
-    "element": [
-      {
-        "id": "Extension:requestnottoperformactionmodifier",
-        "path": "Extension",
-        "short": "SHR RequestNotToPerformActionModifier Extension",
-        "definition": "If true, the thing requested should not take place. For example, a request to NOT elevate the head of a bed using the code for elevating the bed, and setting RequestNotToPerformActionModifier to true. Other examples include do not ambulate, do not flush NG tube, do not take blood pressure on a certain arm, etc. If the Request.code and RequestAgainstModifier both contain negation, that will reinforce the prohibition, and should not be interpreted as a double negative that equals a positive.",
-        "min": 0,
-        "max": "*"
-      },
-      {
-        "id": "Extension:requestnottoperformactionmodifier.extension:boolean",
-        "path": "Extension.extension",
-        "sliceName": "boolean",
-        "definition": "If true, the thing requested should not take place. For example, a request to NOT elevate the head of a bed using the code for elevating the bed, and setting RequestNotToPerformActionModifier to true. Other examples include do not ambulate, do not flush NG tube, do not take blood pressure on a certain arm, etc. If the Request.code and RequestAgainstModifier both contain negation, that will reinforce the prohibition, and should not be interpreted as a double negative that equals a positive.",
-        "min": 1,
-        "max": "1",
-        "type": [
-          {
-            "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/primitive-boolean-extension"
-          }
-        ]
-      },
-      {
-        "id": "Extension:requestnottoperformactionmodifier.extension:reason",
-        "path": "Extension.extension",
-        "sliceName": "reason",
-        "definition": "The justification for an action or non-action, conclusion, opinion, etc.",
-        "min": 0,
-        "max": "1",
-        "type": [
-          {
-            "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-Reason-extension"
-          }
-        ]
-      },
-      {
-        "id": "Extension:requestnottoperformactionmodifier.url",
-        "path": "Extension.url",
-        "type": [
-          {
-            "code": "uri"
-          }
-        ],
-        "fixedUri": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-RequestNotToPerformActionModifier-extension"
-      },
-      {
-        "id": "Extension:requestnottoperformactionmodifier.value[x]",
-        "path": "Extension.value[x]",
-        "min": 0,
-        "max": "0"
-      }
-    ]
-  }
-}
\ No newline at end of file
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-base-ShrId-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-base-ShrId-extension.json
old mode 100755
new mode 100644
index 4ea70f9..f2f1ebb
--- a/lib/resources/standard_health_record/StructureDefinition-shr-base-ShrId-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-base-ShrId-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.base.ShrId"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ShrId Extension",
   "title": "SHR ShrId Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.578Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.856Z",
   "description": "A unique, persistent identifier for the Standard Health Record to which this entry belongs.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-base-SubjectIsThirdPartyModifier-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-base-SubjectIsThirdPartyModifier-extension.json
old mode 100755
new mode 100644
index 71e5024..703f4cf
--- a/lib/resources/standard_health_record/StructureDefinition-shr-base-SubjectIsThirdPartyModifier-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-base-SubjectIsThirdPartyModifier-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.base.SubjectIsThirdPartyModifier"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR SubjectIsThirdPartyModifier Extension",
   "title": "SHR SubjectIsThirdPartyModifier Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.578Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.856Z",
   "description": "If true, the subject of this entry is someone other than the Person of Record, for example, a family member.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-AlcoholBingeFrequency-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-AlcoholBingeFrequency-extension.json
old mode 100755
new mode 100644
index cadf5c7..bc8f566
--- a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-AlcoholBingeFrequency-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-AlcoholBingeFrequency-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.behavior.AlcoholBingeFrequency"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR AlcoholBingeFrequency Extension",
   "title": "SHR AlcoholBingeFrequency Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.190Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.041Z",
   "description": "How often have you had 6 or more Units if female, or 8 or more if male, on a single occasion in the last year?.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -105,9 +106,12 @@
         "id": "Extension:alcoholbingefrequency.extension",
         "path": "Extension.extension",
         "slicing": {
-          "id": "88",
+          "id": "86",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -149,7 +153,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-SemiquantitativeFrequencyVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/SemiquantitativeFrequencyVS"
           }
         },
         "mapping": [
@@ -239,7 +243,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -301,7 +304,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -485,7 +487,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-SemiquantitativeFrequencyVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/SemiquantitativeFrequencyVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-AlcoholUse.json b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-AlcoholUse.json
old mode 100755
new mode 100644
index d9acba5..c419d64
--- a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-AlcoholUse.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-AlcoholUse.json
@@ -3,7 +3,7 @@
   "id": "shr-behavior-AlcoholUse",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR AlcoholUse Profile</b></p>\n  <p>The history of the subject&#039;s use of alcohol.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.behavior.AlcoholUse maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR AlcoholUse Profile</b></p>\n  <p>The history of the subject's use of alcohol.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.behavior.AlcoholUse maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-behavior-AlcoholUse",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.behavior.AlcoholUse"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR AlcoholUse Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.176Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.038Z",
   "description": "The history of the subject's use of alcohol.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR AlcoholUse Profile",
         "definition": "The history of the subject's use of alcohol.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-behavior-AlcoholUse.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "89",
+          "id": "87",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -398,6 +435,7 @@
         "path": "Observation.extension",
         "sliceName": "setting",
         "definition": "Description of the place or type of surroundings where something is positioned or where an event takes place.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -430,6 +468,7 @@
         "path": "Observation.extension",
         "sliceName": "location",
         "definition": "A position, site, or point in space where something can be found.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -462,6 +501,7 @@
         "path": "Observation.extension",
         "sliceName": "frequency",
         "definition": "How many occurrences of an event per unit of time.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -494,6 +534,7 @@
         "path": "Observation.extension",
         "sliceName": "substance",
         "definition": "Any matter of defined composition that has discrete existence, whose origin may be biological, mineral or chemical.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -575,7 +616,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -625,7 +665,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-behavior-SubstanceOfAbuseVS"
+            "reference": "http://standardhealthrecord.org/shr/behavior/vs/SubstanceOfAbuseVS"
           }
         },
         "mapping": [
@@ -640,6 +680,7 @@
         "path": "Observation.extension",
         "sliceName": "generalizedlikelihood",
         "definition": "Quantitative or qualitative measure of likelihood.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -672,6 +713,7 @@
         "path": "Observation.extension",
         "sliceName": "exposuresourceorvector",
         "definition": "Where the substance originated. Vectors include animals (e.g., tick, mosquito, cats, livestock) capable of transmitting an infectious agent among vertebrates. Sources could include food, contaminated drinking water, air, radon gas in the home, etc.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -704,6 +746,7 @@
         "path": "Observation.extension",
         "sliceName": "exposurereason",
         "definition": "Why the exposure occurred.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -736,6 +779,7 @@
         "path": "Observation.extension",
         "sliceName": "exposuremethod",
         "definition": "How the exposure occurred, e.g. cutaneous contact, injection, ingestion, sexual contact, inhalation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -768,6 +812,7 @@
         "path": "Observation.extension",
         "sliceName": "routeintobody",
         "definition": "The way a substance enters an organism after contact, particularly, the route of drug administration.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -800,6 +845,7 @@
         "path": "Observation.extension",
         "sliceName": "test",
         "definition": "A laboratory, radiologic, or other clinical test or measurement used to determine the presence, absence, or degree of a condition, or assess the function or health of an individual. This includes patient-generated data, such as pedometer readings.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -832,6 +878,7 @@
         "path": "Observation.extension",
         "sliceName": "assessmenttool",
         "definition": "The name of the formal assessment or screening tool used to assess the behavior.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -913,7 +960,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -955,7 +1001,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-behavior-AlcoholUseScreeningToolVS"
+            "reference": "http://standardhealthrecord.org/shr/behavior/vs/AlcoholUseScreeningToolVS"
           }
         },
         "mapping": [
@@ -970,6 +1016,7 @@
         "path": "Observation.extension",
         "sliceName": "alcoholbingefrequency",
         "definition": "How often have you had 6 or more Units if female, or 8 or more if male, on a single occasion in the last year?.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1001,16 +1048,19 @@
         "id": "Observation:shr-behavior-AlcoholUse.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "90",
+          "id": "88",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1040,6 +1090,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1070,8 +1121,8 @@
       {
         "id": "Observation:shr-behavior-AlcoholUse.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -1080,7 +1131,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -1095,6 +1151,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-behavior-AlcoholUse.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-behavior-AlcoholUse.status",
         "extension": [
@@ -1106,6 +1219,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -1117,6 +1231,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -1124,6 +1244,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -1142,17 +1270,20 @@
         "id": "Observation:shr-behavior-AlcoholUse.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "86",
+          "id": "84",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 1,
         "max": "*",
         "type": [
@@ -1162,8 +1293,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -1248,6 +1385,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -1266,6 +1406,12 @@
         },
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1273,6 +1419,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1281,6 +1435,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -1292,7 +1450,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -1316,6 +1474,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -1331,20 +1493,32 @@
         ]
       },
       {
-        "id": "Observation:shr-behavior-AlcoholUse.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-behavior-AlcoholUse.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -1364,8 +1538,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -1379,6 +1556,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -1398,7 +1579,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -1450,6 +1631,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -1468,17 +1653,20 @@
         "id": "Observation:shr-behavior-AlcoholUse.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "87",
+          "id": "85",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 1,
         "max": "1",
         "type": [
@@ -1492,6 +1680,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1499,6 +1695,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1523,7 +1723,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1536,6 +1736,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1543,6 +1749,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -1570,6 +1780,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1577,6 +1793,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1584,6 +1804,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1601,6 +1825,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -1616,8 +1844,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1626,6 +1853,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -1633,6 +1866,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -1640,6 +1877,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1648,7 +1889,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1659,6 +1900,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1681,7 +1928,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1691,6 +1938,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1698,6 +1949,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1706,7 +1961,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1720,6 +1975,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1727,6 +1986,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1735,7 +1998,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1804,7 +2067,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1833,7 +2096,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1915,30 +2178,82 @@
         ]
       },
       {
-        "id": "Observation:shr-behavior-AlcoholUse.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-behavior-AlcoholUse.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-behavior-AlcoholUse.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1994,8 +2309,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -2057,7 +2372,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -2086,7 +2401,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -2118,7 +2433,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -2128,6 +2443,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -2178,7 +2499,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -2241,7 +2562,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -2270,7 +2591,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -2312,6 +2633,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -2319,6 +2646,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -2338,8 +2669,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -2376,6 +2707,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -2383,6 +2718,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -2391,7 +2730,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -2404,6 +2743,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -2426,7 +2771,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -2439,6 +2784,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -2446,6 +2797,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -2453,6 +2808,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -2461,7 +2820,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -2593,7 +2952,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-behavior-SubstanceOfAbuseVS"
+            "reference": "http://standardhealthrecord.org/shr/behavior/vs/SubstanceOfAbuseVS"
           }
         }
       },
@@ -2711,7 +3070,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-behavior-AlcoholUseScreeningToolVS"
+            "reference": "http://standardhealthrecord.org/shr/behavior/vs/AlcoholUseScreeningToolVS"
           }
         }
       },
@@ -2751,9 +3110,12 @@
         "id": "Observation:shr-behavior-AlcoholUse.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "86",
+          "id": "84",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -2873,12 +3235,16 @@
         ]
       },
       {
-        "id": "Observation:shr-behavior-AlcoholUse.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-behavior-AlcoholUse.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
@@ -2927,9 +3293,12 @@
         "id": "Observation:shr-behavior-AlcoholUse.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "87",
+          "id": "85",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-AssessmentTool-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-AssessmentTool-extension.json
old mode 100755
new mode 100644
index f69f78b..462da7a
--- a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-AssessmentTool-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-AssessmentTool-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.behavior.AssessmentTool"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR AssessmentTool Extension",
   "title": "SHR AssessmentTool Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.002Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.997Z",
   "description": "The name of the formal assessment or screening tool used to assess the behavior.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-BehavioralObservation.json b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-BehavioralObservation.json
old mode 100755
new mode 100644
index fa4762e..26b4274
--- a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-BehavioralObservation.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-BehavioralObservation.json
@@ -3,7 +3,7 @@
   "id": "shr-behavior-BehavioralObservation",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR BehavioralObservation Profile</b></p>\n  <p>A statement about observable responses, actions, or activities of the subject. Can be used to assert or deny behaviors.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.behavior.BehavioralObservation maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR BehavioralObservation Profile</b></p>\n  <p>A statement about observable responses, actions, or activities of the subject. Can be used to assert or deny behaviors.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.behavior.BehavioralObservation maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-behavior-BehavioralObservation",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.behavior.BehavioralObservation"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR BehavioralObservation Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.986Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.995Z",
   "description": "A statement about observable responses, actions, or activities of the subject. Can be used to assert or deny behaviors.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR BehavioralObservation Profile",
         "definition": "A statement about observable responses, actions, or activities of the subject. Can be used to assert or deny behaviors.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-behavior-BehavioralObservation.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "70",
+          "id": "68",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -398,6 +435,7 @@
         "path": "Observation.extension",
         "sliceName": "assessmenttool",
         "definition": "The name of the formal assessment or screening tool used to assess the behavior.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -430,6 +468,7 @@
         "path": "Observation.extension",
         "sliceName": "readinesstochange",
         "definition": "How motivated the subject is to change the behavior, if the behavior is ongoing, and change would be beneficial.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -461,16 +500,19 @@
         "id": "Observation:shr-behavior-BehavioralObservation.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "71",
+          "id": "69",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -500,6 +542,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -530,8 +573,8 @@
       {
         "id": "Observation:shr-behavior-BehavioralObservation.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -540,7 +583,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -555,6 +603,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-behavior-BehavioralObservation.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-behavior-BehavioralObservation.status",
         "extension": [
@@ -566,6 +671,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -577,6 +683,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -584,6 +696,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -602,17 +722,20 @@
         "id": "Observation:shr-behavior-BehavioralObservation.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "69",
+          "id": "67",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 1,
         "max": "*",
         "type": [
@@ -622,8 +745,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -666,6 +795,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -676,6 +808,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -683,6 +821,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -691,6 +837,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -702,7 +852,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -726,6 +876,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -741,20 +895,32 @@
         ]
       },
       {
-        "id": "Observation:shr-behavior-BehavioralObservation.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-behavior-BehavioralObservation.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -774,8 +940,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -789,6 +958,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -808,7 +981,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -860,6 +1033,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -879,8 +1056,8 @@
         "path": "Observation.value[x]",
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 1,
         "max": "1",
         "type": [
@@ -894,6 +1071,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -901,6 +1086,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -909,7 +1098,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -922,6 +1111,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -929,6 +1124,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -956,6 +1155,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -963,6 +1168,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -970,6 +1179,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -987,6 +1200,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -1002,8 +1219,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1012,6 +1228,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -1019,6 +1241,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -1026,6 +1252,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1034,7 +1264,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1045,6 +1275,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1067,7 +1303,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1077,6 +1313,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1084,6 +1324,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1092,7 +1336,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1106,6 +1350,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1113,6 +1361,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1121,7 +1373,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1190,7 +1442,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1219,7 +1471,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1301,30 +1553,82 @@
         ]
       },
       {
-        "id": "Observation:shr-behavior-BehavioralObservation.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-behavior-BehavioralObservation.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-behavior-BehavioralObservation.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1380,8 +1684,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1443,7 +1747,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1472,7 +1776,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1504,7 +1808,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1514,6 +1818,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1564,7 +1874,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1627,7 +1937,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1656,7 +1966,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1698,6 +2008,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1705,6 +2021,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1724,8 +2044,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1762,6 +2082,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1769,6 +2093,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1777,7 +2105,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1790,6 +2118,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1812,7 +2146,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1825,6 +2159,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1832,6 +2172,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1839,6 +2183,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1847,7 +2195,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1957,9 +2305,12 @@
         "id": "Observation:shr-behavior-BehavioralObservation.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "69",
+          "id": "67",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -2029,12 +2380,16 @@
         ]
       },
       {
-        "id": "Observation:shr-behavior-BehavioralObservation.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-behavior-BehavioralObservation.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-DietAndNutrition.json b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-DietAndNutrition.json
old mode 100755
new mode 100644
index 04d9b6d..54264b9
--- a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-DietAndNutrition.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-DietAndNutrition.json
@@ -3,7 +3,7 @@
   "id": "shr-behavior-DietAndNutrition",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR DietAndNutrition Profile</b></p>\n  <p>The usual food and drink consumed by an individual.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.behavior.DietAndNutrition maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR DietAndNutrition Profile</b></p>\n  <p>The usual food and drink consumed by an individual.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.behavior.DietAndNutrition maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-behavior-DietAndNutrition",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.behavior.DietAndNutrition"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR DietAndNutrition Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.244Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.055Z",
   "description": "The usual food and drink consumed by an individual.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR DietAndNutrition Profile",
         "definition": "The usual food and drink consumed by an individual.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-behavior-DietAndNutrition.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "96",
+          "id": "94",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -398,6 +435,7 @@
         "path": "Observation.extension",
         "sliceName": "assessmenttool",
         "definition": "The name of the formal assessment or screening tool used to assess the behavior.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -430,6 +468,7 @@
         "path": "Observation.extension",
         "sliceName": "readinesstochange",
         "definition": "How motivated the subject is to change the behavior, if the behavior is ongoing, and change would be beneficial.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -462,6 +501,7 @@
         "path": "Observation.extension",
         "sliceName": "specialdietfollowed",
         "definition": "A type of nutritional plan followed by the subject.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -494,6 +534,7 @@
         "path": "Observation.extension",
         "sliceName": "hassufficientfood",
         "definition": "SHR HasSufficientFood Extension",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -526,6 +567,7 @@
         "path": "Observation.extension",
         "sliceName": "dietnutritionconcern",
         "definition": "An anxiety or worry about the diet or nutritional intake of the subject.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -558,6 +600,7 @@
         "path": "Observation.extension",
         "sliceName": "foodallergy",
         "definition": "An immune or biochemical adverse reaction to a food substance.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -589,16 +632,19 @@
         "id": "Observation:shr-behavior-DietAndNutrition.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "97",
+          "id": "95",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -628,6 +674,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -658,8 +705,8 @@
       {
         "id": "Observation:shr-behavior-DietAndNutrition.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -668,7 +715,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -683,6 +735,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-behavior-DietAndNutrition.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-behavior-DietAndNutrition.status",
         "extension": [
@@ -694,6 +803,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -705,6 +815,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -712,6 +828,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -730,17 +854,20 @@
         "id": "Observation:shr-behavior-DietAndNutrition.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "94",
+          "id": "92",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 1,
         "max": "*",
         "type": [
@@ -750,8 +877,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -794,6 +927,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -812,6 +948,12 @@
         },
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -819,6 +961,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -827,6 +977,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -838,7 +992,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -862,6 +1016,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -877,20 +1035,32 @@
         ]
       },
       {
-        "id": "Observation:shr-behavior-DietAndNutrition.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-behavior-DietAndNutrition.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -910,8 +1080,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -925,6 +1098,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -944,7 +1121,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -996,6 +1173,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -1014,17 +1195,20 @@
         "id": "Observation:shr-behavior-DietAndNutrition.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "95",
+          "id": "93",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 1,
         "max": "1",
         "type": [
@@ -1038,6 +1222,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1045,6 +1237,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1069,7 +1265,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1082,6 +1278,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1089,6 +1291,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -1116,6 +1322,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1123,6 +1335,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1130,6 +1346,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1147,6 +1367,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -1162,8 +1386,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1172,6 +1395,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -1179,6 +1408,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -1186,6 +1419,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1194,7 +1431,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1205,6 +1442,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1227,7 +1470,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1237,6 +1480,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1244,6 +1491,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1252,7 +1503,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1266,6 +1517,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1273,6 +1528,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1281,7 +1540,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1350,7 +1609,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1379,7 +1638,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1461,30 +1720,82 @@
         ]
       },
       {
-        "id": "Observation:shr-behavior-DietAndNutrition.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-behavior-DietAndNutrition.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-behavior-DietAndNutrition.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1540,8 +1851,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1603,7 +1914,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1632,7 +1943,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1664,7 +1975,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1674,6 +1985,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1724,7 +2041,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1787,7 +2104,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1816,7 +2133,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1858,6 +2175,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1865,6 +2188,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1884,8 +2211,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1922,6 +2249,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1929,6 +2260,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1937,7 +2272,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1950,6 +2285,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1972,7 +2313,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1985,6 +2326,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1992,6 +2339,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1999,6 +2350,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -2007,7 +2362,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -2181,9 +2536,12 @@
         "id": "Observation:shr-behavior-DietAndNutrition.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "94",
+          "id": "92",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -2261,12 +2619,16 @@
         ]
       },
       {
-        "id": "Observation:shr-behavior-DietAndNutrition.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-behavior-DietAndNutrition.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
@@ -2315,9 +2677,12 @@
         "id": "Observation:shr-behavior-DietAndNutrition.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "95",
+          "id": "93",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-DietNutritionConcern-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-DietNutritionConcern-extension.json
old mode 100755
new mode 100644
index 0b7e1b6..aaf7e98
--- a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-DietNutritionConcern-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-DietNutritionConcern-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.behavior.DietNutritionConcern"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR DietNutritionConcern Extension",
   "title": "SHR DietNutritionConcern Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.259Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.057Z",
   "description": "An anxiety or worry about the diet or nutritional intake of the subject.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -170,7 +170,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-behavior-DietNutritionConcernVS"
+            "reference": "http://standardhealthrecord.org/shr/behavior/vs/DietNutritionConcernVS"
           }
         },
         "mapping": [
@@ -221,7 +221,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-behavior-DietNutritionConcernVS"
+            "reference": "http://standardhealthrecord.org/shr/behavior/vs/DietNutritionConcernVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-ExerciseHoursPerWeek-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-ExerciseHoursPerWeek-extension.json
old mode 100755
new mode 100644
index 3ce633b..d21903b
--- a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-ExerciseHoursPerWeek-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-ExerciseHoursPerWeek-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.behavior.ExerciseHoursPerWeek"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ExerciseHoursPerWeek Extension",
   "title": "SHR ExerciseHoursPerWeek Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.346Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.073Z",
   "description": "Hours of moderate or vigorous activity per week.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-HasSufficientFood-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-HasSufficientFood-extension.json
old mode 100755
new mode 100644
index 0af1fc8..3028be3
--- a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-HasSufficientFood-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-HasSufficientFood-extension.json
@@ -3,7 +3,7 @@
   "id": "shr-behavior-HasSufficientFood-extension",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR HasSufficientFood Extension</b></p>\n  <p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR HasSufficientFood Extension</b></p>\n  <p/>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-behavior-HasSufficientFood-extension",
   "identifier": [
@@ -12,9 +12,11 @@
       "value": "shr.behavior.HasSufficientFood"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR HasSufficientFood Extension",
   "title": "SHR HasSufficientFood Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.259Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,8 +28,7 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.057Z",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -127,7 +128,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -169,7 +169,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeFrequencyVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeFrequencyVS"
           }
         },
         "mapping": [
@@ -220,7 +220,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeFrequencyVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeFrequencyVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-HoursSleepPerNight-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-HoursSleepPerNight-extension.json
old mode 100755
new mode 100644
index 840ff48..044c830
--- a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-HoursSleepPerNight-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-HoursSleepPerNight-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.behavior.HoursSleepPerNight"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR HoursSleepPerNight Extension",
   "title": "SHR HoursSleepPerNight Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.294Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.065Z",
   "description": "Typical hours spent sleeping per night.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-IntravenousDrugUse.json b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-IntravenousDrugUse.json
old mode 100755
new mode 100644
index 6eb250b..42ec86a
--- a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-IntravenousDrugUse.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-IntravenousDrugUse.json
@@ -3,7 +3,7 @@
   "id": "shr-behavior-IntravenousDrugUse",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR IntravenousDrugUse Profile</b></p>\n  <p>Records whether the subject injects recreational drugs.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.behavior.IntravenousDrugUse maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR IntravenousDrugUse Profile</b></p>\n  <p>Records whether the subject injects recreational drugs.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.behavior.IntravenousDrugUse maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-behavior-IntravenousDrugUse",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.behavior.IntravenousDrugUse"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR IntravenousDrugUse Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.063Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.013Z",
   "description": "Records whether the subject injects recreational drugs.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR IntravenousDrugUse Profile",
         "definition": "Records whether the subject injects recreational drugs.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-behavior-IntravenousDrugUse.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "77",
+          "id": "75",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -398,6 +435,7 @@
         "path": "Observation.extension",
         "sliceName": "setting",
         "definition": "Description of the place or type of surroundings where something is positioned or where an event takes place.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -430,6 +468,7 @@
         "path": "Observation.extension",
         "sliceName": "location",
         "definition": "A position, site, or point in space where something can be found.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -462,6 +501,7 @@
         "path": "Observation.extension",
         "sliceName": "frequency",
         "definition": "How many occurrences of an event per unit of time.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -494,6 +534,7 @@
         "path": "Observation.extension",
         "sliceName": "substance",
         "definition": "Any matter of defined composition that has discrete existence, whose origin may be biological, mineral or chemical.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -575,7 +616,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -617,7 +657,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-behavior-SubstanceOfAbuseVS"
+            "reference": "http://standardhealthrecord.org/shr/behavior/vs/SubstanceOfAbuseVS"
           }
         },
         "mapping": [
@@ -632,6 +672,7 @@
         "path": "Observation.extension",
         "sliceName": "generalizedlikelihood",
         "definition": "Quantitative or qualitative measure of likelihood.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -664,6 +705,7 @@
         "path": "Observation.extension",
         "sliceName": "exposuresourceorvector",
         "definition": "Where the substance originated. Vectors include animals (e.g., tick, mosquito, cats, livestock) capable of transmitting an infectious agent among vertebrates. Sources could include food, contaminated drinking water, air, radon gas in the home, etc.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -696,6 +738,7 @@
         "path": "Observation.extension",
         "sliceName": "exposurereason",
         "definition": "Why the exposure occurred.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -728,6 +771,7 @@
         "path": "Observation.extension",
         "sliceName": "exposuremethod",
         "definition": "How the exposure occurred, e.g. cutaneous contact, injection, ingestion, sexual contact, inhalation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -809,7 +853,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -868,6 +911,7 @@
         "path": "Observation.extension",
         "sliceName": "routeintobody",
         "definition": "The way a substance enters an organism after contact, particularly, the route of drug administration.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -949,7 +993,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -1014,6 +1057,7 @@
         "path": "Observation.extension",
         "sliceName": "test",
         "definition": "A laboratory, radiologic, or other clinical test or measurement used to determine the presence, absence, or degree of a condition, or assess the function or health of an individual. This includes patient-generated data, such as pedometer readings.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1045,16 +1089,19 @@
         "id": "Observation:shr-behavior-IntravenousDrugUse.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "78",
+          "id": "76",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1084,6 +1131,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1114,8 +1162,8 @@
       {
         "id": "Observation:shr-behavior-IntravenousDrugUse.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -1124,7 +1172,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -1139,6 +1192,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-behavior-IntravenousDrugUse.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-behavior-IntravenousDrugUse.status",
         "extension": [
@@ -1150,6 +1260,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -1161,6 +1272,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -1168,6 +1285,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -1186,17 +1311,20 @@
         "id": "Observation:shr-behavior-IntravenousDrugUse.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "75",
+          "id": "73",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 1,
         "max": "*",
         "type": [
@@ -1206,8 +1334,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -1292,6 +1426,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -1310,6 +1447,12 @@
         },
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1317,6 +1460,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1325,6 +1476,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -1336,7 +1491,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -1360,6 +1515,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -1375,20 +1534,32 @@
         ]
       },
       {
-        "id": "Observation:shr-behavior-IntravenousDrugUse.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-behavior-IntravenousDrugUse.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -1408,8 +1579,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -1423,6 +1597,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -1442,7 +1620,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -1494,6 +1672,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -1512,17 +1694,20 @@
         "id": "Observation:shr-behavior-IntravenousDrugUse.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "76",
+          "id": "74",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 1,
         "max": "1",
         "type": [
@@ -1536,6 +1721,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1543,6 +1736,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1564,7 +1761,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-ThreeValueLogicVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/ThreeValueLogicVS"
           }
         }
       },
@@ -1573,7 +1770,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1586,6 +1783,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1593,6 +1796,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -1620,6 +1827,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1627,6 +1840,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1634,6 +1851,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1651,6 +1872,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -1666,8 +1891,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1676,6 +1900,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -1683,6 +1913,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -1690,6 +1924,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1698,7 +1936,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1709,6 +1947,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1731,7 +1975,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1741,6 +1985,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1748,6 +1996,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1756,7 +2008,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1770,6 +2022,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1777,6 +2033,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1785,7 +2045,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1854,7 +2114,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1883,7 +2143,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1965,30 +2225,82 @@
         ]
       },
       {
-        "id": "Observation:shr-behavior-IntravenousDrugUse.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-behavior-IntravenousDrugUse.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-behavior-IntravenousDrugUse.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -2044,8 +2356,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -2107,7 +2419,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -2136,7 +2448,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -2168,7 +2480,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -2178,6 +2490,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -2228,7 +2546,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -2291,7 +2609,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -2320,7 +2638,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -2362,6 +2680,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -2369,6 +2693,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -2388,8 +2716,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -2426,6 +2754,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -2433,6 +2765,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -2441,7 +2777,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -2454,6 +2790,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -2476,7 +2818,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -2489,6 +2831,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -2496,6 +2844,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -2503,6 +2855,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -2511,7 +2867,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -2635,7 +2991,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-behavior-SubstanceOfAbuseVS"
+            "reference": "http://standardhealthrecord.org/shr/behavior/vs/SubstanceOfAbuseVS"
           }
         }
       },
@@ -2771,9 +3127,12 @@
         "id": "Observation:shr-behavior-IntravenousDrugUse.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "75",
+          "id": "73",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -2893,12 +3252,16 @@
         ]
       },
       {
-        "id": "Observation:shr-behavior-IntravenousDrugUse.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-behavior-IntravenousDrugUse.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
@@ -2947,9 +3310,12 @@
         "id": "Observation:shr-behavior-IntravenousDrugUse.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "76",
+          "id": "74",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -2975,7 +3341,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-ThreeValueLogicVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/ThreeValueLogicVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-NicotineUse.json b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-NicotineUse.json
old mode 100755
new mode 100644
index 1d58cc8..3ee5567
--- a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-NicotineUse.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-NicotineUse.json
@@ -3,7 +3,7 @@
   "id": "shr-behavior-NicotineUse",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR NicotineUse Profile</b></p>\n  <p>Records the history of a subject&#039;s use of nicotine.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.behavior.NicotineUse maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR NicotineUse Profile</b></p>\n  <p>Records the history of a subject's use of nicotine.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.behavior.NicotineUse maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-behavior-NicotineUse",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.behavior.NicotineUse"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR NicotineUse Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.140Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.030Z",
   "description": "Records the history of a subject's use of nicotine.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR NicotineUse Profile",
         "definition": "Records the history of a subject's use of nicotine.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-behavior-NicotineUse.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "84",
+          "id": "82",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -398,6 +435,7 @@
         "path": "Observation.extension",
         "sliceName": "setting",
         "definition": "Description of the place or type of surroundings where something is positioned or where an event takes place.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -430,6 +468,7 @@
         "path": "Observation.extension",
         "sliceName": "location",
         "definition": "A position, site, or point in space where something can be found.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -462,6 +501,7 @@
         "path": "Observation.extension",
         "sliceName": "frequency",
         "definition": "How many occurrences of an event per unit of time.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -494,6 +534,7 @@
         "path": "Observation.extension",
         "sliceName": "substance",
         "definition": "Any matter of defined composition that has discrete existence, whose origin may be biological, mineral or chemical.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -575,7 +616,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -625,7 +665,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-behavior-SubstanceOfAbuseVS"
+            "reference": "http://standardhealthrecord.org/shr/behavior/vs/SubstanceOfAbuseVS"
           }
         },
         "mapping": [
@@ -640,6 +680,7 @@
         "path": "Observation.extension",
         "sliceName": "generalizedlikelihood",
         "definition": "Quantitative or qualitative measure of likelihood.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -672,6 +713,7 @@
         "path": "Observation.extension",
         "sliceName": "exposuresourceorvector",
         "definition": "Where the substance originated. Vectors include animals (e.g., tick, mosquito, cats, livestock) capable of transmitting an infectious agent among vertebrates. Sources could include food, contaminated drinking water, air, radon gas in the home, etc.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -704,6 +746,7 @@
         "path": "Observation.extension",
         "sliceName": "exposurereason",
         "definition": "Why the exposure occurred.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -736,6 +779,7 @@
         "path": "Observation.extension",
         "sliceName": "exposuremethod",
         "definition": "How the exposure occurred, e.g. cutaneous contact, injection, ingestion, sexual contact, inhalation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -817,7 +861,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -868,6 +911,7 @@
         "path": "Observation.extension",
         "sliceName": "routeintobody",
         "definition": "The way a substance enters an organism after contact, particularly, the route of drug administration.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -949,7 +993,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -1006,6 +1049,7 @@
         "path": "Observation.extension",
         "sliceName": "test",
         "definition": "A laboratory, radiologic, or other clinical test or measurement used to determine the presence, absence, or degree of a condition, or assess the function or health of an individual. This includes patient-generated data, such as pedometer readings.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1037,16 +1081,19 @@
         "id": "Observation:shr-behavior-NicotineUse.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "85",
+          "id": "83",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1076,6 +1123,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1106,8 +1154,8 @@
       {
         "id": "Observation:shr-behavior-NicotineUse.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -1116,7 +1164,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -1131,6 +1184,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-behavior-NicotineUse.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-behavior-NicotineUse.status",
         "extension": [
@@ -1142,6 +1252,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -1153,6 +1264,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -1160,6 +1277,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -1178,17 +1303,20 @@
         "id": "Observation:shr-behavior-NicotineUse.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "82",
+          "id": "80",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 1,
         "max": "*",
         "type": [
@@ -1198,8 +1326,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -1284,6 +1418,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -1302,6 +1439,12 @@
         },
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1309,6 +1452,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1317,6 +1468,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -1328,7 +1483,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -1352,6 +1507,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -1367,20 +1526,32 @@
         ]
       },
       {
-        "id": "Observation:shr-behavior-NicotineUse.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-behavior-NicotineUse.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -1400,8 +1571,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -1415,6 +1589,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -1434,7 +1612,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -1486,6 +1664,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -1504,17 +1686,20 @@
         "id": "Observation:shr-behavior-NicotineUse.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "83",
+          "id": "81",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 1,
         "max": "1",
         "type": [
@@ -1528,6 +1713,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1535,6 +1728,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1565,7 +1762,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1578,6 +1775,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1585,6 +1788,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -1612,6 +1819,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1619,6 +1832,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1626,6 +1843,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1643,6 +1864,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -1658,8 +1883,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1668,6 +1892,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -1675,6 +1905,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -1682,6 +1916,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1690,7 +1928,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1701,6 +1939,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1723,7 +1967,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1733,6 +1977,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1740,6 +1988,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1748,7 +2000,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1762,6 +2014,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1769,6 +2025,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1777,7 +2037,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1846,7 +2106,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1875,7 +2135,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1957,30 +2217,82 @@
         ]
       },
       {
-        "id": "Observation:shr-behavior-NicotineUse.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-behavior-NicotineUse.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-behavior-NicotineUse.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -2036,8 +2348,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -2099,7 +2411,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -2128,7 +2440,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -2160,7 +2472,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -2170,6 +2482,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -2220,7 +2538,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -2283,7 +2601,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -2312,7 +2630,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -2354,6 +2672,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -2361,6 +2685,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -2380,8 +2708,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -2418,6 +2746,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -2425,6 +2757,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -2433,7 +2769,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -2446,6 +2782,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -2468,7 +2810,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -2481,6 +2823,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -2488,6 +2836,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -2495,6 +2847,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -2503,7 +2859,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -2635,7 +2991,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-behavior-SubstanceOfAbuseVS"
+            "reference": "http://standardhealthrecord.org/shr/behavior/vs/SubstanceOfAbuseVS"
           }
         }
       },
@@ -2755,9 +3111,12 @@
         "id": "Observation:shr-behavior-NicotineUse.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "82",
+          "id": "80",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -2877,12 +3236,16 @@
         ]
       },
       {
-        "id": "Observation:shr-behavior-NicotineUse.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-behavior-NicotineUse.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
@@ -2931,9 +3294,12 @@
         "id": "Observation:shr-behavior-NicotineUse.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "83",
+          "id": "81",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-ONCSmokingStatus.json b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-ONCSmokingStatus.json
old mode 100755
new mode 100644
index da7bf5e..899a007
--- a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-ONCSmokingStatus.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-ONCSmokingStatus.json
@@ -3,7 +3,7 @@
   "id": "shr-behavior-ONCSmokingStatus",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR ONCSmokingStatus Profile</b></p>\n  <p>Records the subject&#039;s use of tobacco.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.behavior.ONCSmokingStatus maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR ONCSmokingStatus Profile</b></p>\n  <p>Records the subject's use of tobacco.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.behavior.ONCSmokingStatus maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-behavior-ONCSmokingStatus",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.behavior.ONCSmokingStatus"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ONCSmokingStatus Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.101Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.022Z",
   "description": "Records the subject's use of tobacco.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR ONCSmokingStatus Profile",
         "definition": "Records the subject's use of tobacco.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-behavior-ONCSmokingStatus.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "80",
+          "id": "78",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -397,16 +434,19 @@
         "id": "Observation:shr-behavior-ONCSmokingStatus.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "81",
+          "id": "79",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -436,6 +476,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -466,8 +507,8 @@
       {
         "id": "Observation:shr-behavior-ONCSmokingStatus.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -476,7 +517,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -491,6 +537,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-behavior-ONCSmokingStatus.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-behavior-ONCSmokingStatus.status",
         "extension": [
@@ -502,6 +605,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -513,6 +617,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -520,6 +630,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -539,8 +657,8 @@
         "path": "Observation.category",
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 0,
         "max": "*",
         "type": [
@@ -550,8 +668,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -573,6 +697,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -591,6 +718,12 @@
         },
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -598,6 +731,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -606,6 +747,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -617,7 +762,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -641,6 +786,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -656,20 +805,32 @@
         ]
       },
       {
-        "id": "Observation:shr-behavior-ONCSmokingStatus.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-behavior-ONCSmokingStatus.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -689,8 +850,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -704,6 +868,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -723,7 +891,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -775,6 +943,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -793,17 +965,20 @@
         "id": "Observation:shr-behavior-ONCSmokingStatus.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "79",
+          "id": "77",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 1,
         "max": "1",
         "type": [
@@ -817,6 +992,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -824,6 +1007,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -854,7 +1041,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -867,6 +1054,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -874,6 +1067,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -901,6 +1098,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -908,6 +1111,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -915,6 +1122,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -932,6 +1143,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -947,8 +1162,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -957,6 +1171,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -964,6 +1184,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -971,6 +1195,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -979,7 +1207,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -990,6 +1218,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1012,7 +1246,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1022,6 +1256,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1029,6 +1267,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1037,7 +1279,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1051,6 +1293,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1058,6 +1304,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1066,7 +1316,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1135,7 +1385,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1164,7 +1414,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1246,30 +1496,82 @@
         ]
       },
       {
-        "id": "Observation:shr-behavior-ONCSmokingStatus.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-behavior-ONCSmokingStatus.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-behavior-ONCSmokingStatus.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1325,8 +1627,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1388,7 +1690,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1417,7 +1719,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1449,7 +1751,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1459,6 +1761,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1509,7 +1817,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1572,7 +1880,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1601,7 +1909,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1643,6 +1951,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1650,6 +1964,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1669,8 +1987,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1707,6 +2025,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1714,6 +2036,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1722,7 +2048,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1735,6 +2061,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1757,7 +2089,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1770,6 +2102,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1777,6 +2115,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1784,6 +2126,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1792,7 +2138,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1919,12 +2265,16 @@
         ]
       },
       {
-        "id": "Observation:shr-behavior-ONCSmokingStatus.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-behavior-ONCSmokingStatus.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
@@ -1973,9 +2323,12 @@
         "id": "Observation:shr-behavior-ONCSmokingStatus.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "79",
+          "id": "77",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-PhysicalActivityLevel.json b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-PhysicalActivityLevel.json
old mode 100755
new mode 100644
index 47757a6..90ded4f
--- a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-PhysicalActivityLevel.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-PhysicalActivityLevel.json
@@ -3,7 +3,7 @@
   "id": "shr-behavior-PhysicalActivityLevel",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR PhysicalActivityLevel Profile</b></p>\n  <p>The amount of exercise or other physical activity compared to others of the same age.  See BMC Medical Research Methodology 2012 12:20 1471-2288.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.behavior.PhysicalActivityLevel maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR PhysicalActivityLevel Profile</b></p>\n  <p>The amount of exercise or other physical activity compared to others of the same age.  See BMC Medical Research Methodology 2012 12:20 1471-2288.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.behavior.PhysicalActivityLevel maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-behavior-PhysicalActivityLevel",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.behavior.PhysicalActivityLevel"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR PhysicalActivityLevel Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.324Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.072Z",
   "description": "The amount of exercise or other physical activity compared to others of the same age.  See BMC Medical Research Methodology 2012 12:20 1471-2288.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR PhysicalActivityLevel Profile",
         "definition": "The amount of exercise or other physical activity compared to others of the same age.  See BMC Medical Research Methodology 2012 12:20 1471-2288.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-behavior-PhysicalActivityLevel.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "104",
+          "id": "102",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -398,6 +435,7 @@
         "path": "Observation.extension",
         "sliceName": "assessmenttool",
         "definition": "The name of the formal assessment or screening tool used to assess the behavior.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -430,6 +468,7 @@
         "path": "Observation.extension",
         "sliceName": "readinesstochange",
         "definition": "How motivated the subject is to change the behavior, if the behavior is ongoing, and change would be beneficial.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -462,6 +501,7 @@
         "path": "Observation.extension",
         "sliceName": "exercisehoursperweek",
         "definition": "Hours of moderate or vigorous activity per week.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -494,6 +534,7 @@
         "path": "Observation.extension",
         "sliceName": "physicalactivitylimitation",
         "definition": "Anything that limits physical activity, including health factors, logistical, monetary, or social restrictions.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -525,16 +566,19 @@
         "id": "Observation:shr-behavior-PhysicalActivityLevel.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "105",
+          "id": "103",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -564,6 +608,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -594,8 +639,8 @@
       {
         "id": "Observation:shr-behavior-PhysicalActivityLevel.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -604,7 +649,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -619,6 +669,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-behavior-PhysicalActivityLevel.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-behavior-PhysicalActivityLevel.status",
         "extension": [
@@ -630,6 +737,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -641,6 +749,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -648,6 +762,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -666,17 +788,20 @@
         "id": "Observation:shr-behavior-PhysicalActivityLevel.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "102",
+          "id": "100",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 1,
         "max": "*",
         "type": [
@@ -686,8 +811,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -730,6 +861,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -748,6 +882,12 @@
         },
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -755,6 +895,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -763,6 +911,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -774,7 +926,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -798,6 +950,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -813,20 +969,32 @@
         ]
       },
       {
-        "id": "Observation:shr-behavior-PhysicalActivityLevel.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-behavior-PhysicalActivityLevel.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -846,8 +1014,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -861,6 +1032,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -880,7 +1055,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -932,6 +1107,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -950,17 +1129,20 @@
         "id": "Observation:shr-behavior-PhysicalActivityLevel.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "103",
+          "id": "101",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 1,
         "max": "1",
         "type": [
@@ -974,6 +1156,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -981,6 +1171,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1002,7 +1196,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeValueScaleVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeValueScaleVS"
           }
         }
       },
@@ -1011,7 +1205,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1024,6 +1218,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1031,6 +1231,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -1058,6 +1262,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1065,6 +1275,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1072,6 +1286,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1089,6 +1307,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -1104,8 +1326,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1114,6 +1335,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -1121,6 +1348,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -1128,6 +1359,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1136,7 +1371,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1147,6 +1382,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1169,7 +1410,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1179,6 +1420,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1186,6 +1431,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1194,7 +1443,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1208,6 +1457,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1215,6 +1468,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1223,7 +1480,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1292,7 +1549,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1321,7 +1578,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1403,30 +1660,82 @@
         ]
       },
       {
-        "id": "Observation:shr-behavior-PhysicalActivityLevel.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-behavior-PhysicalActivityLevel.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-behavior-PhysicalActivityLevel.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1482,8 +1791,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1545,7 +1854,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1574,7 +1883,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1606,7 +1915,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1616,6 +1925,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1666,7 +1981,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1729,7 +2044,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1758,7 +2073,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1800,6 +2115,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1807,6 +2128,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1826,8 +2151,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1864,6 +2189,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1871,6 +2200,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1879,7 +2212,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1892,6 +2225,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1914,7 +2253,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1927,6 +2266,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1934,6 +2279,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1941,6 +2290,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1949,7 +2302,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -2091,9 +2444,12 @@
         "id": "Observation:shr-behavior-PhysicalActivityLevel.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "102",
+          "id": "100",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -2171,12 +2527,16 @@
         ]
       },
       {
-        "id": "Observation:shr-behavior-PhysicalActivityLevel.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-behavior-PhysicalActivityLevel.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
@@ -2225,9 +2585,12 @@
         "id": "Observation:shr-behavior-PhysicalActivityLevel.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "103",
+          "id": "101",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -2253,7 +2616,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeValueScaleVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeValueScaleVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-PhysicalActivityLimitation-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-PhysicalActivityLimitation-extension.json
old mode 100755
new mode 100644
index 12e9b4c..b5c91ea
--- a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-PhysicalActivityLimitation-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-PhysicalActivityLimitation-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.behavior.PhysicalActivityLimitation"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR PhysicalActivityLimitation Extension",
   "title": "SHR PhysicalActivityLimitation Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.346Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.073Z",
   "description": "Anything that limits physical activity, including health factors, logistical, monetary, or social restrictions.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -170,7 +170,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-behavior-PhysicalActivityLimitationVS"
+            "reference": "http://standardhealthrecord.org/shr/behavior/vs/PhysicalActivityLimitationVS"
           }
         },
         "mapping": [
@@ -221,7 +221,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-behavior-PhysicalActivityLimitationVS"
+            "reference": "http://standardhealthrecord.org/shr/behavior/vs/PhysicalActivityLimitationVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-ReadinessToChange-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-ReadinessToChange-extension.json
old mode 100755
new mode 100644
index 0f71403..12261ed
--- a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-ReadinessToChange-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-ReadinessToChange-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.behavior.ReadinessToChange"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ReadinessToChange Extension",
   "title": "SHR ReadinessToChange Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.002Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.997Z",
   "description": "How motivated the subject is to change the behavior, if the behavior is ongoing, and change would be beneficial.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -170,7 +170,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeLikelihoodVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeLikelihoodVS"
           }
         },
         "mapping": [
@@ -221,7 +221,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeLikelihoodVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeLikelihoodVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-ReligiousPractice.json b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-ReligiousPractice.json
old mode 100755
new mode 100644
index 0443b39..a6d6bb9
--- a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-ReligiousPractice.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-ReligiousPractice.json
@@ -3,7 +3,7 @@
   "id": "shr-behavior-ReligiousPractice",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR ReligiousPractice Profile</b></p>\n  <p>The religion practiced by the focal subject.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.behavior.ReligiousPractice maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to http://hl7.org/fhir/StructureDefinition/patient-religion  //????\n  ReligiousCongregation maps to http://hl7.org/fhir/StructureDefinition/patient-congregation\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR ReligiousPractice Profile</b></p>\n  <p>The religion practiced by the focal subject.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.behavior.ReligiousPractice maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to http://hl7.org/fhir/StructureDefinition/patient-religion  //????\n  ReligiousCongregation maps to http://hl7.org/fhir/StructureDefinition/patient-congregation\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-behavior-ReligiousPractice",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.behavior.ReligiousPractice"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ReligiousPractice Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.212Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.048Z",
   "description": "The religion practiced by the focal subject.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR ReligiousPractice Profile",
         "definition": "The religion practiced by the focal subject.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-behavior-ReligiousPractice.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "92",
+          "id": "90",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "religiouscongregation",
         "definition": "A group of place of religious practice.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "codeableconcept",
         "definition": "A set of codes drawn from different coding systems, representing the same concept.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -404,6 +441,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -436,6 +474,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -468,6 +507,7 @@
         "path": "Observation.extension",
         "sliceName": "assessmenttool",
         "definition": "The name of the formal assessment or screening tool used to assess the behavior.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -500,6 +540,7 @@
         "path": "Observation.extension",
         "sliceName": "readinesstochange",
         "definition": "How motivated the subject is to change the behavior, if the behavior is ongoing, and change would be beneficial.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -532,6 +573,7 @@
         "path": "Observation.extension",
         "sliceName": "religiouspracticestatus",
         "definition": "The extent to which the religious practice is actively followed.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -564,6 +606,7 @@
         "path": "Observation.extension",
         "sliceName": "religiousrestriction",
         "definition": "Any restriction on that derives from religion and may impact medical treatment, other than dietary (handled elsewhere).",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -595,16 +638,19 @@
         "id": "Observation:shr-behavior-ReligiousPractice.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "93",
+          "id": "91",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -634,6 +680,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -664,8 +711,8 @@
       {
         "id": "Observation:shr-behavior-ReligiousPractice.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -674,7 +721,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -689,6 +741,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-behavior-ReligiousPractice.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-behavior-ReligiousPractice.status",
         "extension": [
@@ -700,6 +809,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -711,6 +821,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -718,6 +834,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -736,17 +860,20 @@
         "id": "Observation:shr-behavior-ReligiousPractice.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "91",
+          "id": "89",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 1,
         "max": "*",
         "type": [
@@ -756,8 +883,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -800,6 +933,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -818,6 +954,12 @@
         },
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -825,6 +967,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -833,6 +983,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -844,7 +998,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -868,6 +1022,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -883,20 +1041,32 @@
         ]
       },
       {
-        "id": "Observation:shr-behavior-ReligiousPractice.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-behavior-ReligiousPractice.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -916,8 +1086,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -931,6 +1104,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -950,7 +1127,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -1002,6 +1179,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -1021,8 +1202,8 @@
         "path": "Observation.value[x]",
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1035,6 +1216,9 @@
           {
             "code": "string"
           },
+          {
+            "code": "boolean"
+          },
           {
             "code": "Range"
           },
@@ -1062,6 +1246,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1069,6 +1261,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1077,7 +1273,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1090,6 +1286,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1097,6 +1299,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -1124,6 +1330,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1131,6 +1343,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1138,6 +1354,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1155,6 +1375,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -1170,8 +1394,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1180,6 +1403,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -1187,6 +1416,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -1194,6 +1427,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1202,7 +1439,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1213,6 +1450,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1235,7 +1478,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1245,6 +1488,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1252,6 +1499,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1260,7 +1511,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1274,6 +1525,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1281,6 +1536,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1289,7 +1548,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1358,7 +1617,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1387,7 +1646,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1469,30 +1728,82 @@
         ]
       },
       {
-        "id": "Observation:shr-behavior-ReligiousPractice.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-behavior-ReligiousPractice.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-behavior-ReligiousPractice.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1548,8 +1859,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1611,7 +1922,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1640,7 +1951,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1672,7 +1983,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1682,6 +1993,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1732,7 +2049,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1795,7 +2112,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1824,7 +2141,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1866,6 +2183,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1873,6 +2196,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1892,8 +2219,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1930,6 +2257,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1937,6 +2268,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1945,7 +2280,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1958,6 +2293,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1980,7 +2321,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1993,6 +2334,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -2000,6 +2347,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -2007,6 +2358,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -2015,7 +2370,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -2195,9 +2550,12 @@
         "id": "Observation:shr-behavior-ReligiousPractice.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "91",
+          "id": "89",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -2275,12 +2633,16 @@
         ]
       },
       {
-        "id": "Observation:shr-behavior-ReligiousPractice.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-behavior-ReligiousPractice.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-ReligiousPracticeStatus-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-ReligiousPracticeStatus-extension.json
old mode 100755
new mode 100644
index b6b65ec..b0c5f9b
--- a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-ReligiousPracticeStatus-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-ReligiousPracticeStatus-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.behavior.ReligiousPracticeStatus"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ReligiousPracticeStatus Extension",
   "title": "SHR ReligiousPracticeStatus Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.225Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.049Z",
   "description": "The extent to which the religious practice is actively followed.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -170,7 +170,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-behavior-ReligiousPracticeStatusVS"
+            "reference": "http://standardhealthrecord.org/shr/behavior/vs/ReligiousPracticeStatusVS"
           }
         },
         "mapping": [
@@ -221,7 +221,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-behavior-ReligiousPracticeStatusVS"
+            "reference": "http://standardhealthrecord.org/shr/behavior/vs/ReligiousPracticeStatusVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-ReligiousRestriction-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-ReligiousRestriction-extension.json
old mode 100755
new mode 100644
index 67b61ea..577bc7b
--- a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-ReligiousRestriction-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-ReligiousRestriction-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.behavior.ReligiousRestriction"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ReligiousRestriction Extension",
   "title": "SHR ReligiousRestriction Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.225Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.049Z",
   "description": "Any restriction on that derives from religion and may impact medical treatment, other than dietary (handled elsewhere).",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -170,7 +170,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-behavior-ReligiousRestrictionVS"
+            "reference": "http://standardhealthrecord.org/shr/behavior/vs/ReligiousRestrictionVS"
           }
         },
         "mapping": [
@@ -221,7 +221,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-behavior-ReligiousRestrictionVS"
+            "reference": "http://standardhealthrecord.org/shr/behavior/vs/ReligiousRestrictionVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-SleepQuality.json b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-SleepQuality.json
old mode 100755
new mode 100644
index bb028bd..1d812ac
--- a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-SleepQuality.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-SleepQuality.json
@@ -3,7 +3,7 @@
   "id": "shr-behavior-SleepQuality",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR SleepQuality Profile</b></p>\n  <p>Self-reported sleep quality.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.behavior.SleepQuality maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR SleepQuality Profile</b></p>\n  <p>Self-reported sleep quality.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.behavior.SleepQuality maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-behavior-SleepQuality",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.behavior.SleepQuality"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR SleepQuality Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.279Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.063Z",
   "description": "Self-reported sleep quality.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR SleepQuality Profile",
         "definition": "Self-reported sleep quality.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-behavior-SleepQuality.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "100",
+          "id": "98",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -398,6 +435,7 @@
         "path": "Observation.extension",
         "sliceName": "assessmenttool",
         "definition": "The name of the formal assessment or screening tool used to assess the behavior.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -430,6 +468,7 @@
         "path": "Observation.extension",
         "sliceName": "readinesstochange",
         "definition": "How motivated the subject is to change the behavior, if the behavior is ongoing, and change would be beneficial.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -462,6 +501,7 @@
         "path": "Observation.extension",
         "sliceName": "troublefallingasleep",
         "definition": "How often the subject has trouble falling asleep.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -494,6 +534,7 @@
         "path": "Observation.extension",
         "sliceName": "troublestayingasleep",
         "definition": "How often the subject has trouble staying asleep.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -526,6 +567,7 @@
         "path": "Observation.extension",
         "sliceName": "wakefeelingrested",
         "definition": "How often the subject feels rested when they wake up.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -558,6 +600,7 @@
         "path": "Observation.extension",
         "sliceName": "hourssleeppernight",
         "definition": "Typical hours spent sleeping per night.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -590,6 +633,7 @@
         "path": "Observation.extension",
         "sliceName": "sleepqualityreason",
         "definition": "Reason for poor sleep quality.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -621,16 +665,19 @@
         "id": "Observation:shr-behavior-SleepQuality.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "101",
+          "id": "99",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -660,6 +707,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -690,8 +738,8 @@
       {
         "id": "Observation:shr-behavior-SleepQuality.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -700,7 +748,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -715,6 +768,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-behavior-SleepQuality.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-behavior-SleepQuality.status",
         "extension": [
@@ -726,6 +836,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -737,6 +848,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -744,6 +861,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -762,17 +887,20 @@
         "id": "Observation:shr-behavior-SleepQuality.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "98",
+          "id": "96",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 1,
         "max": "*",
         "type": [
@@ -782,8 +910,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -826,6 +960,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -844,6 +981,12 @@
         },
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -851,6 +994,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -859,6 +1010,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -870,7 +1025,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -894,6 +1049,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -909,20 +1068,32 @@
         ]
       },
       {
-        "id": "Observation:shr-behavior-SleepQuality.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-behavior-SleepQuality.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -942,8 +1113,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -957,6 +1131,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -976,7 +1154,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -1028,6 +1206,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -1046,17 +1228,20 @@
         "id": "Observation:shr-behavior-SleepQuality.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "99",
+          "id": "97",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 1,
         "max": "1",
         "type": [
@@ -1070,6 +1255,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1077,6 +1270,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1098,7 +1295,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-PerformanceGradingScaleVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/PerformanceGradingScaleVS"
           }
         }
       },
@@ -1107,7 +1304,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1120,6 +1317,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1127,6 +1330,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -1154,6 +1361,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1161,6 +1374,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1168,6 +1385,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1185,6 +1406,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -1200,8 +1425,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1210,6 +1434,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -1217,6 +1447,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -1224,6 +1458,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1232,7 +1470,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1243,6 +1481,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1265,7 +1509,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1275,6 +1519,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1282,6 +1530,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1290,7 +1542,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1304,6 +1556,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1311,6 +1567,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1319,7 +1579,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1388,7 +1648,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1417,7 +1677,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1499,30 +1759,82 @@
         ]
       },
       {
-        "id": "Observation:shr-behavior-SleepQuality.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-behavior-SleepQuality.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-behavior-SleepQuality.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1578,8 +1890,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1641,7 +1953,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1670,7 +1982,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1702,7 +2014,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1712,6 +2024,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1762,7 +2080,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1825,7 +2143,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1854,7 +2172,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1896,6 +2214,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1903,6 +2227,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1922,8 +2250,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1960,6 +2288,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1967,6 +2299,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1975,7 +2311,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1988,6 +2324,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -2010,7 +2352,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -2023,6 +2365,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -2030,6 +2378,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -2037,6 +2389,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -2045,7 +2401,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -2235,9 +2591,12 @@
         "id": "Observation:shr-behavior-SleepQuality.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "98",
+          "id": "96",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -2315,12 +2674,16 @@
         ]
       },
       {
-        "id": "Observation:shr-behavior-SleepQuality.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-behavior-SleepQuality.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
@@ -2369,9 +2732,12 @@
         "id": "Observation:shr-behavior-SleepQuality.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "99",
+          "id": "97",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -2397,7 +2763,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-PerformanceGradingScaleVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/PerformanceGradingScaleVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-SleepQualityReason-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-SleepQualityReason-extension.json
old mode 100755
new mode 100644
index 8ea37bc..11a7138
--- a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-SleepQualityReason-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-SleepQualityReason-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.behavior.SleepQualityReason"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR SleepQualityReason Extension",
   "title": "SHR SleepQualityReason Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.294Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.065Z",
   "description": "Reason for poor sleep quality.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -170,7 +170,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-behavior-SleepQualityReasonVS"
+            "reference": "http://standardhealthrecord.org/shr/behavior/vs/SleepQualityReasonVS"
           }
         },
         "mapping": [
@@ -221,7 +221,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-behavior-SleepQualityReasonVS"
+            "reference": "http://standardhealthrecord.org/shr/behavior/vs/SleepQualityReasonVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-SpecialDietFollowed-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-SpecialDietFollowed-extension.json
old mode 100755
new mode 100644
index 57ac878..15f4924
--- a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-SpecialDietFollowed-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-SpecialDietFollowed-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.behavior.SpecialDietFollowed"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR SpecialDietFollowed Extension",
   "title": "SHR SpecialDietFollowed Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.259Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.056Z",
   "description": "A type of nutritional plan followed by the subject.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -170,7 +170,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-behavior-SpecialDietFollowedVS"
+            "reference": "http://standardhealthrecord.org/shr/behavior/vs/SpecialDietFollowedVS"
           }
         },
         "mapping": [
@@ -221,7 +221,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-behavior-SpecialDietFollowedVS"
+            "reference": "http://standardhealthrecord.org/shr/behavior/vs/SpecialDietFollowedVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-SubstanceAbuseTreatment.json b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-SubstanceAbuseTreatment.json
old mode 100755
new mode 100644
index a997abe..4774d50
--- a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-SubstanceAbuseTreatment.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-SubstanceAbuseTreatment.json
@@ -3,7 +3,7 @@
   "id": "shr-behavior-SubstanceAbuseTreatment",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR SubstanceAbuseTreatment Profile</b></p>\n  <p>The treatment program used to address a substance abuse problem.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.behavior.SubstanceAbuseTreatment maps to Procedure:\n  ProcedureStatus maps to status\n  NonOccurrenceModifier maps to notPerformed\n  NonOccurrenceModifier.Reason maps to reasonNotPerformed\n  OccurrenceTime.dateTime maps to performed[x].dateTime\n  OccurrenceTime.TimePeriod maps to performed[x].Period\n  ProcedureParticipant maps to performer\n  ProcedureParticipant.PersonOfRecord maps to performer.actor\n  ProcedureParticipant.Practitioner maps to performer.actor\n  ProcedureParticipant.RelatedPerson maps to performer.actor\n  ProcedureParticipant.ParticipationType maps to performer.role\n  Facility maps to location\n  Reason maps to reasonCode\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR SubstanceAbuseTreatment Profile</b></p>\n  <p>The treatment program used to address a substance abuse problem.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.behavior.SubstanceAbuseTreatment maps to Procedure:\n  ProcedureStatus maps to status\n  NonOccurrenceModifier maps to notDone\n  NonOccurrenceModifier.Reason maps to notDoneReason\n  OccurrenceTime.dateTime maps to performed[x].dateTime\n  OccurrenceTime.TimePeriod maps to performed[x].Period\n  ProcedureParticipant maps to performer\n  ProcedureParticipant.PersonOfRecord maps to performer.actor\n  ProcedureParticipant.Practitioner maps to performer.actor\n  ProcedureParticipant.RelatedPerson maps to performer.actor\n  ProcedureParticipant.ParticipationType maps to performer.role\n  Facility maps to location\n  Reason maps to reasonCode\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-behavior-SubstanceAbuseTreatment",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.behavior.SubstanceAbuseTreatment"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR SubstanceAbuseTreatment Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.378Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.077Z",
   "description": "The treatment program used to address a substance abuse problem.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "rim",
@@ -95,9 +96,9 @@
           {
             "key": "pro-1",
             "severity": "error",
-            "human": "Reason not performed is only permitted if notPerformed indicator is true",
-            "expression": "reasonNotPerformed.empty() or notPerformed = true",
-            "xpath": "not(exists(f:reasonNotPerformed)) or f:notPerformed/@value=true()"
+            "human": "Reason not done is only permitted if notDone indicator is true",
+            "expression": "notDoneReason.empty() or notDone = true",
+            "xpath": "not(exists(f:notDoneReason)) or f:notDone/@value=true()"
           }
         ],
         "mapping": [
@@ -120,7 +121,7 @@
         "path": "Procedure.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -159,7 +160,7 @@
         "path": "Procedure.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -180,7 +181,7 @@
         "path": "Procedure.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -200,6 +201,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -214,7 +223,7 @@
         "path": "Procedure.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -248,7 +257,7 @@
         "path": "Procedure.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -277,16 +286,19 @@
         "id": "Procedure:shr-behavior-SubstanceAbuseTreatment.extension",
         "path": "Procedure.extension",
         "slicing": {
-          "id": "106",
+          "id": "104",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -315,6 +327,7 @@
         "path": "Procedure.extension",
         "sliceName": "codeableconcept",
         "definition": "A set of codes drawn from different coding systems, representing the same concept.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -338,7 +351,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-behavior-SubstanceAbuseTreatmentTypeVS"
+            "reference": "http://standardhealthrecord.org/shr/behavior/vs/SubstanceAbuseTreatmentTypeVS"
           }
         },
         "mapping": [
@@ -353,7 +366,7 @@
         "path": "Procedure.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -407,12 +420,106 @@
           }
         ]
       },
+      {
+        "id": "Procedure:shr-behavior-SubstanceAbuseTreatment.definition",
+        "path": "Procedure.definition",
+        "short": "Instantiates protocol or definition",
+        "definition": "A protocol, guideline, orderset or other definition that was adhered to in whole or in part by this procedure.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/PlanDefinition"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ActivityDefinition"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/HealthcareService"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=DEFN].target"
+          }
+        ]
+      },
+      {
+        "id": "Procedure:shr-behavior-SubstanceAbuseTreatment.basedOn",
+        "path": "Procedure.basedOn",
+        "short": "A request for this procedure",
+        "definition": "A reference to a resource that contains details of the request for this procedure.",
+        "alias": [
+          "fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target[classCode=(various e.g. PROC, OBS, PCPR, ACT,  moodCode=RQO].code"
+          }
+        ]
+      },
+      {
+        "id": "Procedure:shr-behavior-SubstanceAbuseTreatment.partOf",
+        "path": "Procedure.partOf",
+        "short": "Part of referenced event",
+        "definition": "A larger event of which this particular procedure is a component or step.",
+        "comment": "The MedicationAdministration has a partOf reference to Procedure, but this is not a circular reference.  For a surgical procedure, the anesthesia related medicationAdministration is part of the procedure.  For an IV medication administration,  the procedure to insert the IV port is part of the medication administration.",
+        "alias": [
+          "container"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Procedure"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Observation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationAdministration"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".inboundRelationship[typeCode=COMP].source[classCode=SBADM or PROC or OBS, moodCode=EVN]"
+          }
+        ]
+      },
       {
         "id": "Procedure:shr-behavior-SubstanceAbuseTreatment.status",
         "path": "Procedure.status",
-        "short": "in-progress | aborted | completed | entered-in-error | unknown",
+        "short": "preparation | in-progress | suspended | aborted | completed | entered-in-error | unknown",
         "definition": "A code specifying the state of the procedure. Generally this will be in-progress or completed state.",
-        "comments": "The unknown code is not to be used to convey other statuses.  The unknown code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the procedure.",
+        "comment": "The unknown code is not to be used to convey other statuses.  The unknown code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the procedure.\n\nThis element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "min": 1,
         "max": "1",
         "type": [
@@ -423,19 +530,89 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ProcedureStatus"
+            }
+          ],
           "strength": "required",
           "description": "A code specifying the state of the procedure.",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/procedure-status"
+            "reference": "http://hl7.org/fhir/ValueSet/event-status"
           }
         },
         "mapping": [
+          {
+            "identity": "rim",
+            "map": "statusCode"
+          },
           {
             "identity": "w5",
             "map": "status"
           }
         ]
       },
+      {
+        "id": "Procedure:shr-behavior-SubstanceAbuseTreatment.notDone",
+        "path": "Procedure.notDone",
+        "short": "True if procedure was not performed as scheduled",
+        "definition": "Set this to true if the record is saying that the procedure was NOT performed.",
+        "comment": "If true, it means the procedure did not occur as described.  Typically it would be accompanied by attributes describing the type of activity.  It might also be accompanied by body site information or time information (i.e. no procedure was done to the left arm or no procedure was done in this 2-year period).  Specifying additional information such as performer, outcome, etc. is generally inappropriate.  For example, it's not that useful to say \"There was no appendectomy done at 12:03pm June 6th by Dr. Smith with a successful outcome\" as it implies that there *could* have been an appendectomy done at any other time, by any other clinician or with any other outcome.\n\nThis element is labeled as a modifier because it indicates that a procedure didn't happen.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "boolean"
+          }
+        ],
+        "defaultValueBoolean": false,
+        "isModifier": true,
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".actionNegationInd"
+          }
+        ]
+      },
+      {
+        "id": "Procedure:shr-behavior-SubstanceAbuseTreatment.notDoneReason",
+        "path": "Procedure.notDoneReason",
+        "short": "Reason procedure was not performed",
+        "definition": "A code indicating why the procedure was not performed.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+          }
+        ],
+        "condition": [
+          "pro-1"
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ProcedureNegationReason"
+            }
+          ],
+          "strength": "example",
+          "description": "A code that identifies the reason a procedure was not performed.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/procedure-not-performed-reason"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".reason.Observation.value"
+          }
+        ]
+      },
       {
         "id": "Procedure:shr-behavior-SubstanceAbuseTreatment.category",
         "path": "Procedure.category",
@@ -450,6 +627,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ProcedureCategory"
+            }
+          ],
           "strength": "example",
           "description": "A code that classifies a procedure for searching, sorting and display purposes.",
           "valueSetReference": {
@@ -472,7 +655,11 @@
         "path": "Procedure.code",
         "short": "Identification of the procedure",
         "definition": "The specific procedure that is performed. Use text if the exact nature of the procedure cannot be coded (e.g. \"Laparoscopic Appendectomy\").",
-        "min": 1,
+        "requirements": "0..1 to account for primarily narrative only resources.",
+        "alias": [
+          "type"
+        ],
+        "min": 0,
         "max": "1",
         "type": [
           {
@@ -481,6 +668,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ProcedureCode"
+            }
+          ],
           "strength": "example",
           "description": "A code to identify a specific procedure .",
           "valueSetReference": {
@@ -507,6 +700,9 @@
         "path": "Procedure.subject",
         "short": "Who the procedure was performed on",
         "definition": "The person, animal or group on which the procedure was performed.",
+        "alias": [
+          "patient"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -536,16 +732,23 @@
         ]
       },
       {
-        "id": "Procedure:shr-behavior-SubstanceAbuseTreatment.encounter",
-        "path": "Procedure.encounter",
-        "short": "The encounter associated with the procedure",
+        "id": "Procedure:shr-behavior-SubstanceAbuseTreatment.context",
+        "path": "Procedure.context",
+        "short": "Encounter or episode associated with the procedure",
         "definition": "The encounter during which the procedure was performed.",
+        "alias": [
+          "encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "isSummary": true,
@@ -622,7 +825,7 @@
         "mapping": [
           {
             "identity": "rim",
-            "map": ".participation[typeCode=PFM]"
+            "map": ".participation[typeCode=PRF]"
           }
         ]
       },
@@ -658,7 +861,7 @@
         "path": "Procedure.performer.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -687,7 +890,7 @@
         "path": "Procedure.performer.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -714,12 +917,44 @@
           }
         ]
       },
+      {
+        "id": "Procedure:shr-behavior-SubstanceAbuseTreatment.performer.role",
+        "path": "Procedure.performer.role",
+        "short": "The role the actor was in",
+        "definition": "For example: surgeon, anaethetist, endoscopist.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "strength": "required",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/v3-ParticipationType"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "v2",
+            "map": "Some combination of STF-18 / PRA-3 / PRT-4 / ROL-3 / ORC-12 / OBR-16 / PV1-7 / PV1-8 / PV1-9 / PV1-17 / OBX-25"
+          },
+          {
+            "identity": "rim",
+            "map": ".functionCode"
+          }
+        ]
+      },
       {
         "id": "Procedure:shr-behavior-SubstanceAbuseTreatment.performer.actor",
         "path": "Procedure.performer.actor",
         "short": "The reference to the practitioner",
         "definition": "The practitioner who was involved in the procedure.",
-        "min": 0,
+        "requirements": "A reference to Device supports use cases, such as pacemakers.",
+        "min": 1,
         "max": "1",
         "type": [
           {
@@ -737,6 +972,10 @@
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-actor-RelatedPerson"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Device"
           }
         ],
         "isSummary": true,
@@ -756,33 +995,23 @@
         ]
       },
       {
-        "id": "Procedure:shr-behavior-SubstanceAbuseTreatment.performer.role",
-        "path": "Procedure.performer.role",
-        "short": "The role the actor was in",
-        "definition": "For example: surgeon, anaethetist, endoscopist.",
+        "id": "Procedure:shr-behavior-SubstanceAbuseTreatment.performer.onBehalfOf",
+        "path": "Procedure.performer.onBehalfOf",
+        "short": "Organization the device or practitioner was acting for",
+        "definition": "The organization the device or practitioner was acting on behalf of.",
+        "requirements": "Practitioners and Devices can be associated with multiple organizations.  This element indicates which organization they were acting on behalf of when performing the action.",
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "CodeableConcept",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
           }
         ],
-        "isSummary": true,
-        "binding": {
-          "strength": "required",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/v3-ParticipationType"
-          }
-        },
         "mapping": [
-          {
-            "identity": "v2",
-            "map": "Some combination of STF-18 / PRA-3 / PRT-4 / ROL-3 / ORC-12 / OBR-16 / PV1-7 / PV1-8 / PV1-9 / PV1-17 / OBX-25"
-          },
           {
             "identity": "rim",
-            "map": ".functionCode"
+            "map": ".scoper"
           }
         ]
       },
@@ -801,36 +1030,14 @@
           }
         ],
         "isSummary": true,
-        "mapping": [
-          {
-            "identity": "w5",
-            "map": "where"
-          }
-        ]
-      },
-      {
-        "id": "Procedure:shr-behavior-SubstanceAbuseTreatment.reasonReference",
-        "path": "Procedure.reasonReference",
-        "short": "Condition that is the reason the procedure performed",
-        "definition": "The condition that is the reason why the procedure was performed.",
-        "comments": "e.g. endoscopy for dilatation and biopsy, combination diagnosis and therapeutic.",
-        "min": 0,
-        "max": "*",
-        "type": [
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Condition"
-          }
-        ],
-        "isSummary": true,
         "mapping": [
           {
             "identity": "rim",
-            "map": ".reasonCode"
+            "map": ".participation[typeCode=LOC].role[classCode=SDLOC]"
           },
           {
             "identity": "w5",
-            "map": "why"
+            "map": "where"
           }
         ]
       },
@@ -849,6 +1056,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ProcedureReason"
+            }
+          ],
           "strength": "example",
           "description": "A code that identifies the reason a procedure is  required.",
           "valueSetReference": {
@@ -867,55 +1080,32 @@
         ]
       },
       {
-        "id": "Procedure:shr-behavior-SubstanceAbuseTreatment.notPerformed",
-        "path": "Procedure.notPerformed",
-        "short": "True if procedure was not performed as scheduled",
-        "definition": "Set this to true if the record is saying that the procedure was NOT performed.",
-        "comments": "If true, it means the procedure did not occur as described.  Typically it would be accompanied by attributes describing the type of activity.  It might also be accompanied by body site information or time information (i.e. no procedure was done to the left arm or no procedure was done in this 2-year period).  Specifying additional information such as performer, outcome, etc. is generally inappropriate.  For example, it's not that useful to say \"There was no appendectomy done at 12:03pm June 6th by Dr. Smith with a successful outcome\" as it implies that there *could* have been an appendectomy done at any other time, by any other clinician or with any other outcome.",
+        "id": "Procedure:shr-behavior-SubstanceAbuseTreatment.reasonReference",
+        "path": "Procedure.reasonReference",
+        "short": "Condition that is the reason the procedure performed",
+        "definition": "The condition that is the reason why the procedure was performed.",
+        "comment": "e.g. endoscopy for dilatation and biopsy, combination diagnosis and therapeutic.",
         "min": 0,
-        "max": "1",
+        "max": "*",
         "type": [
           {
-            "code": "boolean"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Condition"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Observation"
           }
         ],
-        "defaultValueBoolean": false,
-        "isModifier": true,
         "isSummary": true,
         "mapping": [
           {
             "identity": "rim",
-            "map": ".actionNegationInd"
-          }
-        ]
-      },
-      {
-        "id": "Procedure:shr-behavior-SubstanceAbuseTreatment.reasonNotPerformed",
-        "path": "Procedure.reasonNotPerformed",
-        "short": "Reason procedure was not performed",
-        "definition": "A code indicating why the procedure was not performed.",
-        "min": 0,
-        "max": "1",
-        "type": [
-          {
-            "code": "CodeableConcept",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
-          }
-        ],
-        "condition": [
-          "pro-1"
-        ],
-        "binding": {
-          "strength": "example",
-          "description": "A code that identifies the reason a procedure was not performed.",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/procedure-not-performed-reason"
-          }
-        },
-        "mapping": [
+            "map": ".reasonCode"
+          },
           {
-            "identity": "rim",
-            "map": ".reason.Observation.value"
+            "identity": "w5",
+            "map": "why"
           }
         ]
       },
@@ -933,6 +1123,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -955,7 +1151,7 @@
         "path": "Procedure.outcome",
         "short": "The result of procedure",
         "definition": "The outcome of the procedure - did it resolve reasons for the procedure being performed?",
-        "comments": "If outcome contains narrative text only, it can be captured using the CodeableConcept.text.",
+        "comment": "If outcome contains narrative text only, it can be captured using the CodeableConcept.text.",
         "min": 0,
         "max": "1",
         "type": [
@@ -965,6 +1161,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ProcedureOutcome"
+            }
+          ],
           "strength": "example",
           "description": "An outcome of a procedure - whether it was resolved or otherwise.",
           "valueSetReference": {
@@ -983,7 +1185,7 @@
         "path": "Procedure.report",
         "short": "Any report resulting from the procedure",
         "definition": "This could be a histology result, pathology report, surgical report, etc..",
-        "comments": "There could potentially be multiple reports - e.g. if this was a procedure which took multiple biopsies resulting in a number of anatomical pathology reports.",
+        "comment": "There could potentially be multiple reports - e.g. if this was a procedure which took multiple biopsies resulting in a number of anatomical pathology reports.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1004,7 +1206,7 @@
         "path": "Procedure.complication",
         "short": "Complication following the procedure",
         "definition": "Any complications that occurred during the procedure, or in the immediate post-performance period. These are generally tracked separately from the notes, which will typically describe the procedure itself rather than any 'post procedure' issues.",
-        "comments": "If complications are only expressed by the narrative text, they can be captured using the CodeableConcept.text.",
+        "comment": "If complications are only expressed by the narrative text, they can be captured using the CodeableConcept.text.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1013,6 +1215,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ProcedureComplication"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing complications that resulted from a procedure.",
           "valueSetReference": {
@@ -1022,7 +1230,28 @@
         "mapping": [
           {
             "identity": "rim",
-            "map": "Need specialization of OUT for this."
+            "map": ".outboundRelationship[typeCode=OUTC].target[classCode=OBS, code=\"complication\", moodCode=EVN].value"
+          }
+        ]
+      },
+      {
+        "id": "Procedure:shr-behavior-SubstanceAbuseTreatment.complicationDetail",
+        "path": "Procedure.complicationDetail",
+        "short": "A condition that is a result of the procedure",
+        "definition": "Any complications that occurred during the procedure, or in the immediate post-performance period.",
+        "requirements": "This is used to document a condition that is a result of the procedure, not the condition that was the reason for the procedure.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Condition"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=OUTC].target[classCode=OBS, code=\"complication\", moodCode=EVN].value"
           }
         ]
       },
@@ -1039,6 +1268,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ProcedureFollowUp"
+            }
+          ],
           "strength": "example",
           "description": "Specific follow up required for a procedure e.g. removal of sutures.",
           "valueSetReference": {
@@ -1053,34 +1288,8 @@
         ]
       },
       {
-        "id": "Procedure:shr-behavior-SubstanceAbuseTreatment.request",
-        "path": "Procedure.request",
-        "short": "A request for this procedure",
-        "definition": "A reference to a resource that contains details of the request for this procedure.",
-        "min": 0,
-        "max": "1",
-        "type": [
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
-          },
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DiagnosticRequest"
-          },
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
-          },
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
-          }
-        ]
-      },
-      {
-        "id": "Procedure:shr-behavior-SubstanceAbuseTreatment.notes",
-        "path": "Procedure.notes",
+        "id": "Procedure:shr-behavior-SubstanceAbuseTreatment.note",
+        "path": "Procedure.note",
         "short": "Additional information about the procedure",
         "definition": "Any other notes about the procedure.  E.g. the operative notes.",
         "min": 0,
@@ -1122,6 +1331,12 @@
             "xpath": "@value|f:*|h:div",
             "source": "Element"
           }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".participation[typeCode=DEV].role[classCode=MANU]"
+          }
         ]
       },
       {
@@ -1156,7 +1371,7 @@
         "path": "Procedure.focalDevice.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1185,7 +1400,7 @@
         "path": "Procedure.focalDevice.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1225,12 +1440,24 @@
           }
         ],
         "binding": {
-          "strength": "required",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "DeviceActionKind"
+            }
+          ],
+          "strength": "preferred",
           "description": "A kind of change that happened to the device during the procedure.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/device-action"
           }
-        }
+        },
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=\"procedure device action\"].value=:procedure device action codes"
+          }
+        ]
       },
       {
         "id": "Procedure:shr-behavior-SubstanceAbuseTreatment.focalDevice.manipulated",
@@ -1244,6 +1471,12 @@
             "code": "Reference",
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/Device"
           }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".participation[typeCode=DEV].role[classCode=SDLOC]"
+          }
         ]
       },
       {
@@ -1251,7 +1484,7 @@
         "path": "Procedure.usedReference",
         "short": "Items used during procedure",
         "definition": "Identifies medications, devices and any other substance used as part of the procedure.",
-        "comments": "For devices actually implanted or removed, use Procedure.device.",
+        "comment": "For devices actually implanted or removed, use Procedure.device.",
         "requirements": "Used for tracking contamination, etc.",
         "min": 0,
         "max": "*",
@@ -1268,6 +1501,12 @@
             "code": "Reference",
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/Substance"
           }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".participation[typeCode=DEV].role[classCode=MANU] or\n.participation[typeCode=CSM].role[classCode=ADMM] (for Medication or Substance)"
+          }
         ]
       },
       {
@@ -1275,7 +1514,7 @@
         "path": "Procedure.usedCode",
         "short": "Coded items used during the procedure",
         "definition": "Identifies coded items that were used as part of the procedure.",
-        "comments": "For devices actually implanted or removed, use Procedure.device.",
+        "comment": "For devices actually implanted or removed, use Procedure.device.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1284,29 +1523,22 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ProcedureUsed"
+            }
+          ],
           "strength": "example",
-          "description": "Codes describing items used during a procedure"
-        }
-      },
-      {
-        "id": "Procedure:shr-behavior-SubstanceAbuseTreatment.component",
-        "path": "Procedure.component",
-        "short": "Events related to the procedure",
-        "definition": "Identifies medication administrations, other procedures or observations that are related to this procedure.",
-        "min": 0,
-        "max": "*",
-        "type": [
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationAdministration"
-          },
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Procedure"
-          },
+          "description": "Codes describing items used during a procedure",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/device-kind"
+          }
+        },
+        "mapping": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Observation"
+            "identity": "rim",
+            "map": "participation[typeCode=Dev].role[classCode=MANU]"
           }
         ]
       }
@@ -1338,10 +1570,20 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-behavior-SubstanceAbuseTreatmentTypeVS"
+            "reference": "http://standardhealthrecord.org/shr/behavior/vs/SubstanceAbuseTreatmentTypeVS"
           }
         }
       },
+      {
+        "id": "Procedure:shr-behavior-SubstanceAbuseTreatment.notDoneReason",
+        "path": "Procedure.notDoneReason",
+        "type": [
+          {
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+          }
+        ]
+      },
       {
         "id": "Procedure:shr-behavior-SubstanceAbuseTreatment.performed[x]",
         "path": "Procedure.performed[x]",
@@ -1359,6 +1601,22 @@
         "id": "Procedure:shr-behavior-SubstanceAbuseTreatment.performer",
         "path": "Procedure.performer"
       },
+      {
+        "id": "Procedure:shr-behavior-SubstanceAbuseTreatment.performer.role",
+        "path": "Procedure.performer.role",
+        "type": [
+          {
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+          }
+        ],
+        "binding": {
+          "strength": "required",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/v3-ParticipationType"
+          }
+        }
+      },
       {
         "id": "Procedure:shr-behavior-SubstanceAbuseTreatment.performer.actor",
         "path": "Procedure.performer.actor",
@@ -1378,24 +1636,12 @@
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-actor-RelatedPerson"
-          }
-        ]
-      },
-      {
-        "id": "Procedure:shr-behavior-SubstanceAbuseTreatment.performer.role",
-        "path": "Procedure.performer.role",
-        "type": [
+          },
           {
-            "code": "CodeableConcept",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
-          }
-        ],
-        "binding": {
-          "strength": "required",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/v3-ParticipationType"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Device"
           }
-        }
+        ]
       },
       {
         "id": "Procedure:shr-behavior-SubstanceAbuseTreatment.location",
@@ -1416,18 +1662,6 @@
             "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
           }
         ]
-      },
-      {
-        "id": "Procedure:shr-behavior-SubstanceAbuseTreatment.reasonNotPerformed",
-        "path": "Procedure.reasonNotPerformed",
-        "min": 0,
-        "max": "1",
-        "type": [
-          {
-            "code": "CodeableConcept",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
-          }
-        ]
       }
     ]
   }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-SubstanceUse.json b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-SubstanceUse.json
old mode 100755
new mode 100644
index fb850c7..50fd227
--- a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-SubstanceUse.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-SubstanceUse.json
@@ -3,7 +3,7 @@
   "id": "shr-behavior-SubstanceUse",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR SubstanceUse Profile</b></p>\n  <p>Assertion concerning the past or current use of a substance (alcohol, recreational drugs, illegal drugs, or abuse of prescription medication) that could negatively impact the subject&#039;s health.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.behavior.SubstanceUse maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR SubstanceUse Profile</b></p>\n  <p>Assertion concerning the past or current use of a substance (alcohol, recreational drugs, illegal drugs, or abuse of prescription medication) that could negatively impact the subject's health.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.behavior.SubstanceUse maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-behavior-SubstanceUse",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.behavior.SubstanceUse"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR SubstanceUse Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.024Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.003Z",
   "description": "Assertion concerning the past or current use of a substance (alcohol, recreational drugs, illegal drugs, or abuse of prescription medication) that could negatively impact the subject's health.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR SubstanceUse Profile",
         "definition": "Assertion concerning the past or current use of a substance (alcohol, recreational drugs, illegal drugs, or abuse of prescription medication) that could negatively impact the subject's health.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-behavior-SubstanceUse.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "73",
+          "id": "71",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -398,6 +435,7 @@
         "path": "Observation.extension",
         "sliceName": "setting",
         "definition": "Description of the place or type of surroundings where something is positioned or where an event takes place.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -430,6 +468,7 @@
         "path": "Observation.extension",
         "sliceName": "location",
         "definition": "A position, site, or point in space where something can be found.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -462,6 +501,7 @@
         "path": "Observation.extension",
         "sliceName": "frequency",
         "definition": "How many occurrences of an event per unit of time.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -494,6 +534,7 @@
         "path": "Observation.extension",
         "sliceName": "substance",
         "definition": "Any matter of defined composition that has discrete existence, whose origin may be biological, mineral or chemical.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -575,7 +616,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -617,7 +657,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-behavior-SubstanceOfAbuseVS"
+            "reference": "http://standardhealthrecord.org/shr/behavior/vs/SubstanceOfAbuseVS"
           }
         },
         "mapping": [
@@ -632,6 +672,7 @@
         "path": "Observation.extension",
         "sliceName": "generalizedlikelihood",
         "definition": "Quantitative or qualitative measure of likelihood.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -664,6 +705,7 @@
         "path": "Observation.extension",
         "sliceName": "exposuresourceorvector",
         "definition": "Where the substance originated. Vectors include animals (e.g., tick, mosquito, cats, livestock) capable of transmitting an infectious agent among vertebrates. Sources could include food, contaminated drinking water, air, radon gas in the home, etc.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -696,6 +738,7 @@
         "path": "Observation.extension",
         "sliceName": "exposurereason",
         "definition": "Why the exposure occurred.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -728,6 +771,7 @@
         "path": "Observation.extension",
         "sliceName": "exposuremethod",
         "definition": "How the exposure occurred, e.g. cutaneous contact, injection, ingestion, sexual contact, inhalation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -760,6 +804,7 @@
         "path": "Observation.extension",
         "sliceName": "routeintobody",
         "definition": "The way a substance enters an organism after contact, particularly, the route of drug administration.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -792,6 +837,7 @@
         "path": "Observation.extension",
         "sliceName": "test",
         "definition": "A laboratory, radiologic, or other clinical test or measurement used to determine the presence, absence, or degree of a condition, or assess the function or health of an individual. This includes patient-generated data, such as pedometer readings.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -823,16 +869,19 @@
         "id": "Observation:shr-behavior-SubstanceUse.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "74",
+          "id": "72",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -862,6 +911,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -892,8 +942,8 @@
       {
         "id": "Observation:shr-behavior-SubstanceUse.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -902,7 +952,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -917,6 +972,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-behavior-SubstanceUse.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-behavior-SubstanceUse.status",
         "extension": [
@@ -928,6 +1040,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -939,6 +1052,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -946,6 +1065,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -964,17 +1091,20 @@
         "id": "Observation:shr-behavior-SubstanceUse.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "72",
+          "id": "70",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 1,
         "max": "*",
         "type": [
@@ -984,8 +1114,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -1070,6 +1206,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -1080,6 +1219,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1087,6 +1232,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1095,6 +1248,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -1106,7 +1263,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -1130,6 +1287,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -1145,20 +1306,32 @@
         ]
       },
       {
-        "id": "Observation:shr-behavior-SubstanceUse.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-behavior-SubstanceUse.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -1178,8 +1351,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -1193,6 +1369,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -1212,7 +1392,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -1264,6 +1444,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -1283,8 +1467,8 @@
         "path": "Observation.value[x]",
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 1,
         "max": "1",
         "type": [
@@ -1298,6 +1482,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1305,6 +1497,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1313,7 +1509,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1326,6 +1522,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1333,6 +1535,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -1360,6 +1566,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1367,6 +1579,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1374,6 +1590,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1391,6 +1611,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -1406,8 +1630,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1416,6 +1639,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -1423,6 +1652,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -1430,6 +1663,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1438,7 +1675,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1449,6 +1686,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1471,7 +1714,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1481,6 +1724,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1488,6 +1735,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1496,7 +1747,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1510,6 +1761,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1517,6 +1772,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1525,7 +1784,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1594,7 +1853,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1623,7 +1882,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1705,30 +1964,82 @@
         ]
       },
       {
-        "id": "Observation:shr-behavior-SubstanceUse.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-behavior-SubstanceUse.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-behavior-SubstanceUse.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1784,8 +2095,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1847,7 +2158,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1876,7 +2187,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1908,7 +2219,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1918,6 +2229,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1968,7 +2285,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -2031,7 +2348,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -2060,7 +2377,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -2102,6 +2419,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -2109,6 +2432,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -2128,8 +2455,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -2166,6 +2493,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -2173,6 +2504,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -2181,7 +2516,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -2194,6 +2529,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -2216,7 +2557,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -2229,6 +2570,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -2236,6 +2583,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -2243,6 +2594,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -2251,7 +2606,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -2375,7 +2730,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-behavior-SubstanceOfAbuseVS"
+            "reference": "http://standardhealthrecord.org/shr/behavior/vs/SubstanceOfAbuseVS"
           }
         }
       },
@@ -2495,9 +2850,12 @@
         "id": "Observation:shr-behavior-SubstanceUse.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "72",
+          "id": "70",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -2609,12 +2967,16 @@
         ]
       },
       {
-        "id": "Observation:shr-behavior-SubstanceUse.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-behavior-SubstanceUse.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-TroubleFallingAsleep-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-TroubleFallingAsleep-extension.json
old mode 100755
new mode 100644
index 95d0755..42287b3
--- a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-TroubleFallingAsleep-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-TroubleFallingAsleep-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.behavior.TroubleFallingAsleep"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR TroubleFallingAsleep Extension",
   "title": "SHR TroubleFallingAsleep Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.293Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.064Z",
   "description": "How often the subject has trouble falling asleep.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -170,7 +170,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeFrequencyVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeFrequencyVS"
           }
         },
         "mapping": [
@@ -221,7 +221,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeFrequencyVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeFrequencyVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-TroubleStayingAsleep-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-TroubleStayingAsleep-extension.json
old mode 100755
new mode 100644
index e9ac82e..e1e9249
--- a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-TroubleStayingAsleep-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-TroubleStayingAsleep-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.behavior.TroubleStayingAsleep"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR TroubleStayingAsleep Extension",
   "title": "SHR TroubleStayingAsleep Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.294Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.064Z",
   "description": "How often the subject has trouble staying asleep.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -170,7 +170,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeFrequencyVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeFrequencyVS"
           }
         },
         "mapping": [
@@ -221,7 +221,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeFrequencyVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeFrequencyVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-ViolentBehaviorRisk.json b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-ViolentBehaviorRisk.json
old mode 100755
new mode 100644
index eddf180..4d48335
--- a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-ViolentBehaviorRisk.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-ViolentBehaviorRisk.json
@@ -12,8 +12,10 @@
       "value": "shr.behavior.ViolentBehaviorRisk"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ViolentBehaviorRisk Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.401Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,10 +27,9 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.079Z",
   "description": "Risk or danger posed by the focal subject to others and/or his or herself due to violent behavior.",
   "purpose": "Need some way to safely (without breaking interoperability) allow implementers to exchange content not supported by the initial set of declared resources.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "rim",
@@ -114,7 +115,7 @@
         "path": "Basic.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -153,7 +154,7 @@
         "path": "Basic.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -174,7 +175,7 @@
         "path": "Basic.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -194,6 +195,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -208,7 +217,7 @@
         "path": "Basic.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -242,7 +251,7 @@
         "path": "Basic.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -271,16 +280,19 @@
         "id": "Basic:shr-behavior-ViolentBehaviorRisk.extension",
         "path": "Basic.extension",
         "slicing": {
-          "id": "109",
+          "id": "107",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -309,6 +321,7 @@
         "path": "Basic.extension",
         "sliceName": "violentrisktoothers",
         "definition": "Risk or danger posed by the focal subject to others.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -341,6 +354,7 @@
         "path": "Basic.extension",
         "sliceName": "violentrisktoself",
         "definition": "Risk or danger posed by the focal subject to his or herself.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -373,7 +387,7 @@
         "path": "Basic.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -427,8 +441,8 @@
         "path": "Basic.code",
         "short": "Kind of Resource",
         "definition": "Identifies the 'type' of resource - equivalent to the resource name for other resources.",
-        "comments": "Because resource references will only be able to indicate 'Basic', the type of reference will need to be specified in a Profile identified as part of the resource.  Refer to the resource notes section for information on appropriate terminologies for this code.",
-        "requirements": "Must be able to distinguish different types of \"basic\" resources.",
+        "comment": "Because resource references will only be able to indicate 'Basic', the type of reference will need to be specified in a Profile identified as part of the resource.  Refer to the resource notes section for information on appropriate terminologies for this code.\n\nThis element is labeled as a modifier because the it defines the meaning of the resource and cannot be ignored.",
+        "requirements": "Must be able to distinguish different types of Basic resources.",
         "min": 1,
         "max": "1",
         "type": [
@@ -447,6 +461,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BasicResourceType"
+            }
+          ],
           "strength": "example",
           "description": "Codes for identifying types of resources not yet defined by FHIR",
           "valueSetReference": {
@@ -469,7 +489,7 @@
         "path": "Basic.subject",
         "short": "Identifies the focus of this resource",
         "definition": "Identifies the patient, practitioner, device or any other resource that is the \"focus\" of this resource.",
-        "comments": "Optional as not all resources potential resources will have subjects.  Resources associated with multiple subjects can handle this via extension.",
+        "comment": "Optional as not all potential resources will have subjects.  Resources associated with multiple subjects can handle this via extension.",
         "requirements": "Needed for partitioning the resource by Patient.",
         "min": 0,
         "max": "1",
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-ViolentRiskToOthers-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-ViolentRiskToOthers-extension.json
old mode 100755
new mode 100644
index 99064c4..65f2fa3
--- a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-ViolentRiskToOthers-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-ViolentRiskToOthers-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.behavior.ViolentRiskToOthers"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ViolentRiskToOthers Extension",
   "title": "SHR ViolentRiskToOthers Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.401Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.079Z",
   "description": "Risk or danger posed by the focal subject to others.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -105,9 +106,12 @@
         "id": "Extension:violentrisktoothers.extension",
         "path": "Extension.extension",
         "slicing": {
-          "id": "107",
+          "id": "105",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -149,7 +153,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeValueScaleVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeValueScaleVS"
           }
         },
         "mapping": [
@@ -193,7 +197,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -377,7 +380,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeValueScaleVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeValueScaleVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-ViolentRiskToSelf-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-ViolentRiskToSelf-extension.json
old mode 100755
new mode 100644
index 6a4a075..c8018be
--- a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-ViolentRiskToSelf-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-ViolentRiskToSelf-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.behavior.ViolentRiskToSelf"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ViolentRiskToSelf Extension",
   "title": "SHR ViolentRiskToSelf Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.401Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.080Z",
   "description": "Risk or danger posed by the focal subject to his or herself.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -105,9 +106,12 @@
         "id": "Extension:violentrisktoself.extension",
         "path": "Extension.extension",
         "slicing": {
-          "id": "108",
+          "id": "106",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -149,7 +153,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeValueScaleVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeValueScaleVS"
           }
         },
         "mapping": [
@@ -193,7 +197,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -377,7 +380,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeValueScaleVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeValueScaleVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-WakeFeelingRested-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-WakeFeelingRested-extension.json
old mode 100755
new mode 100644
index f67d43d..8a47b0d
--- a/lib/resources/standard_health_record/StructureDefinition-shr-behavior-WakeFeelingRested-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-behavior-WakeFeelingRested-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.behavior.WakeFeelingRested"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR WakeFeelingRested Extension",
   "title": "SHR WakeFeelingRested Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.294Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.064Z",
   "description": "How often the subject feels rested when they wake up.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -170,7 +170,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeFrequencyVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeFrequencyVS"
           }
         },
         "mapping": [
@@ -221,7 +221,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeFrequencyVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeFrequencyVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-Address.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-Address.json
old mode 100755
new mode 100644
index a84b71e..071aca2
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-Address.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-Address.json
@@ -3,7 +3,7 @@
   "id": "shr-core-Address",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR Address Profile</b></p>\n  <p>An address expressed using postal conventions (as opposed to GPS or other location definition formats). This data type may be used to convey addresses for use in delivering mail as well as for visiting locations and which might not be valid for mail delivery. There are a variety of postal address formats defined around the world. (Source: HL7 FHIR).</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.core.Address maps to Address:\n  AddressLine maps to line\n  City maps to city\n  County maps to district\n  State maps to state\n  PostalCode maps to postalCode\n  Country maps to country\n  use is 0..0\n  type is 0..0\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR Address Profile</b></p>\n  <p>An address expressed using postal conventions (as opposed to GPS or other location definition formats). This data type may be used to convey addresses for use in delivering mail as well as for visiting locations and which might not be valid for mail delivery. There are a variety of postal address formats defined around the world. (Source: HL7 FHIR).</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.core.Address maps to Address:\n  AddressLine maps to line\n  City maps to city\n  County maps to district\n  State maps to state\n  PostalCode maps to postalCode\n  Country maps to country\n  constrain use to 0..0\n  constrain type to 0..0\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-Address",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.core.Address"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Address Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.424Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,10 +27,9 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.304Z",
   "description": "An address expressed using postal conventions (as opposed to GPS or other location definition formats). This data type may be used to convey addresses for use in delivering mail as well as for visiting locations and which might not be valid for mail delivery. There are a variety of postal address formats defined around the world. (Source: HL7 FHIR).",
   "purpose": "Need to be able to record postal addresses, along with notes about their use.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "v2",
@@ -63,7 +64,7 @@
         "path": "Address",
         "short": "SHR Address Profile",
         "definition": "An address expressed using postal conventions (as opposed to GPS or other location definition formats). This data type may be used to convey addresses for use in delivering mail as well as for visiting locations and which might not be valid for mail delivery. There are a variety of postal address formats defined around the world. (Source: HL7 FHIR).",
-        "comments": "Note: address is for postal addresses, not physical locations.",
+        "comment": "Note: address is for postal addresses, not physical locations.",
         "min": 0,
         "max": "*",
         "condition": [
@@ -128,9 +129,19 @@
       {
         "id": "Address:shr-core-Address.extension",
         "path": "Address.extension",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -159,7 +170,7 @@
         "path": "Address.use",
         "short": "home | work | temp | old - purpose of this address",
         "definition": "The purpose of this address.",
-        "comments": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary or old address etc.for a current/permanent one. Applications can assume that an address is current unless it explicitly says that it is temporary or old.",
+        "comment": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary or old address etc.for a current/permanent one. Applications can assume that an address is current unless it explicitly says that it is temporary or old.",
         "requirements": "Allows an appropriate address to be chosen from a list of many.",
         "min": 0,
         "max": "0",
@@ -177,6 +188,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AddressUse"
+            }
+          ],
           "strength": "required",
           "description": "The use of an address",
           "valueSetReference": {
@@ -218,6 +235,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AddressType"
+            }
+          ],
           "strength": "required",
           "description": "The type of an address (physical / postal)",
           "valueSetReference": {
@@ -244,7 +267,7 @@
         "path": "Address.text",
         "short": "Text representation of the address",
         "definition": "A full text representation of the address.",
-        "comments": "Can provide both a text representation and parts.",
+        "comment": "Can provide both a text representation and parts.",
         "requirements": "A renderable, unencoded form.",
         "min": 0,
         "max": "1",
@@ -288,6 +311,7 @@
             "code": "string"
           }
         ],
+        "orderMeaning": "The order in which lines should appear in an address label",
         "example": [
           {
             "label": "General",
@@ -360,7 +384,7 @@
         "path": "Address.district",
         "short": "District name (aka county)",
         "definition": "The name of the administrative area (county).",
-        "comments": "District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead.",
+        "comment": "District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead.",
         "alias": [
           "County"
         ],
@@ -471,7 +495,7 @@
         "path": "Address.country",
         "short": "Country (e.g. can be ISO 3166 2 or 3 letter code)",
         "definition": "Country - a nation as commonly understood or generally accepted.",
-        "comments": "ISO 3166 3 letter codes can be used in place of a full country name.",
+        "comment": "ISO 3166 3 letter codes can be used in place of a full country name.",
         "min": 1,
         "max": "1",
         "type": [
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-Age-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-Age-extension.json
old mode 100755
new mode 100644
index f6d3819..f5bbbd5
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-Age-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-Age-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.core.Age"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Age Extension",
   "title": "SHR Age Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.517Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.832Z",
   "description": "How long something has existed (quantitative).",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-Age.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-Age.json
old mode 100755
new mode 100644
index 63cb01e..cbc40d5
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-Age.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-Age.json
@@ -12,8 +12,10 @@
       "value": "shr.core.Age"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Age Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.418Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.299Z",
   "description": "How long something has existed (quantitative).",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "rim",
@@ -52,7 +53,7 @@
         "path": "Age",
         "short": "SHR Age Profile",
         "definition": "How long something has existed (quantitative).",
-        "comments": "The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.",
+        "comment": "The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.",
         "min": 0,
         "max": "*",
         "constraint": [
@@ -68,7 +69,7 @@
             "key": "age-1",
             "severity": "error",
             "human": "There SHALL be a code if there is a value and it SHALL be an expression of time.  If system is present, it SHALL be UCUM.  If value is present, it SHALL be positive.",
-            "expression": "(code or value.empty()) and (system.empty() or system = %ucum) and (value.empty() or value.toString().contains('.').not())",
+            "expression": "(code or value.empty()) and (system.empty() or system = %ucum) and (value.empty() or value > 0)",
             "xpath": "(f:code or not(f:value)) and (not(exists(f:system)) or f:system/@value='http://unitsofmeasure.org') and not(contains(f:value/@value, '-'))"
           }
         ],
@@ -117,9 +118,19 @@
       {
         "id": "Age:shr-core-Age.extension",
         "path": "Age.extension",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -148,7 +159,7 @@
         "path": "Age.value",
         "short": "Numerical value (with implicit precision)",
         "definition": "The value of the measured amount. The value includes an implicit precision in the presentation of the value.",
-        "comments": "The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).",
+        "comment": "The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).",
         "requirements": "Precision is handled implicitly in almost all cases of measurement.",
         "min": 1,
         "max": "1",
@@ -179,7 +190,7 @@
         "path": "Age.comparator",
         "short": "< | <= | >= | > - how to understand the value",
         "definition": "How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is \"<\" , then the real value is < stated value.",
-        "comments": "This is labeled as \"Is Modifier\" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value.",
+        "comment": "This is labeled as \"Is Modifier\" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value.",
         "requirements": "Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.",
         "min": 0,
         "max": "1",
@@ -197,6 +208,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "QuantityComparator"
+            }
+          ],
           "strength": "required",
           "description": "How the Quantity should be understood and represented.",
           "valueSetReference": {
@@ -216,6 +233,12 @@
       },
       {
         "id": "Age:shr-core-Age.unit",
+        "extension": [
+          {
+            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
+            "valueBoolean": true
+          }
+        ],
         "path": "Age.unit",
         "short": "Unit representation",
         "definition": "A human-readable form of the unit.",
@@ -282,7 +305,7 @@
         "path": "Age.code",
         "short": "Coded form of the unit",
         "definition": "A computer processable form of the unit in some unit representation system.",
-        "comments": "The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency.  The context of use may additionally require a code from a particular system.",
+        "comment": "The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency.  The context of use may additionally require a code from a particular system.",
         "requirements": "Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.",
         "min": 1,
         "max": "1",
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-AgeGroup-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-AgeGroup-extension.json
old mode 100755
new mode 100644
index 6201d67..07c6ebc
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-AgeGroup-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-AgeGroup-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.core.AgeGroup"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR AgeGroup Extension",
   "title": "SHR AgeGroup Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.518Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.832Z",
   "description": "Subgroups of populations based on age.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -170,7 +170,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-actor-AgeGroupVS"
+            "reference": "http://standardhealthrecord.org/shr/actor/vs/AgeGroupVS"
           }
         },
         "mapping": [
@@ -221,7 +221,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-actor-AgeGroupVS"
+            "reference": "http://standardhealthrecord.org/shr/actor/vs/AgeGroupVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-AgeRange-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-AgeRange-extension.json
old mode 100755
new mode 100644
index 0a58c96..1e53919
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-AgeRange-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-AgeRange-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.core.AgeRange"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR AgeRange Extension",
   "title": "SHR AgeRange Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.517Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.832Z",
   "description": "A quantitative range of ages. One of the two ages must be specified.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -107,7 +108,10 @@
         "slicing": {
           "id": "7",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -187,7 +191,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-Annotation.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-Annotation.json
old mode 100755
new mode 100644
index 2f82999..f2d3461
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-Annotation.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-Annotation.json
@@ -12,8 +12,10 @@
       "value": "shr.core.Annotation"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Annotation Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.438Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.313Z",
   "description": "A text note which also contains information about who made the statement and when.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "v2",
@@ -52,7 +53,7 @@
         "path": "Annotation",
         "short": "SHR Annotation Profile",
         "definition": "A text note which also contains information about who made the statement and when.",
-        "comments": "For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time.  This element may need to be included in narrative because of the potential for modifying information.  *Annotations SHOULD NOT* be used to communicate \"modifying\" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).",
+        "comment": "For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time.  This element may need to be included in narrative because of the potential for modifying information.  *Annotations SHOULD NOT* be used to communicate \"modifying\" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).",
         "min": 0,
         "max": "*",
         "condition": [
@@ -113,9 +114,19 @@
       {
         "id": "Annotation:shr-core-Annotation.extension",
         "path": "Annotation.extension",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-Area-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-Area-extension.json
old mode 100755
new mode 100644
index 33d5e72..6034d02
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-Area-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-Area-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.core.Area"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Area Extension",
   "title": "SHR Area Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.120Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.520Z",
   "description": "The extent of a 2-dimensional surface enclosed within a boundary.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-BodySite-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-BodySite-extension.json
old mode 100755
new mode 100644
index 2cf893b..33f270a
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-BodySite-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-BodySite-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.core.BodySite"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR BodySite Extension",
   "title": "SHR BodySite Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.624Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.884Z",
   "description": "Location on or in the body.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-BodySite.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-BodySite.json
old mode 100755
new mode 100644
index 4aaaedc..2f63bca
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-BodySite.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-BodySite.json
@@ -3,7 +3,7 @@
   "id": "shr-core-BodySite",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR BodySite Profile</b></p>\n  <p>Location on or in the body.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.core.BodySite maps to BodySite:\n  CodeableConcept maps to code\n  Laterality maps to modifier (slice on = coding.code)\n  Directionality maps to modifier\n  PortionTotality maps to modifier\n  Description maps to description\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR BodySite Profile</b></p>\n  <p>Location on or in the body.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.core.BodySite maps to BodySite:\n  CodeableConcept maps to code\n  Laterality maps to qualifier (slice on = coding.code)\n  Directionality maps to qualifier\n  PortionTotality maps to qualifier\n  Description maps to description\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-BodySite",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.core.BodySite"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR BodySite Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.434Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,10 +27,14 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.310Z",
   "description": "Location on or in the body.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "rim",
+      "uri": "http://hl7.org/v3",
+      "name": "RIM Mapping"
+    },
     {
       "identity": "openehr",
       "uri": "http://openehr.org",
@@ -43,11 +49,6 @@
       "identity": "v2",
       "uri": "http://hl7.org/v2",
       "name": "HL7 v2 Mapping"
-    },
-    {
-      "identity": "rim",
-      "uri": "http://hl7.org/v3",
-      "name": "RIM Mapping"
     }
   ],
   "kind": "resource",
@@ -106,9 +107,13 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "rim",
+            "map": "ActSIte"
+          },
           {
             "identity": "openehr",
-            "map": "Archetype ID   openEHR-EHR-CLUSTER.anatomical_location.v1      Concept name   Anatomical Location      Concept description   Record details about an anatomical location.      Keywords   location, site, anatomical      Copyright   © openEHR Foundation      Purpose   To record details about anatomical location.      Misuse   Not for specifiying unilateral/bilateral occurence - this is related to an evaluation which perhaps includes multiple locations.      Author   Author name: Heather Leslie Organisation: Ocean Informatics Email: heather.leslie@oceaninformatics.com Date of Origination: 2008-11-10       Translator   Norwegian Bokmål: Lars Bitsch-Larsen, Haukeland University Hospital of Bergen, Norway, MD, DEAA, MBA, spec in anesthesia, spec in tropical medicine. Arabic (Syria): Mona Saleh       Other contributors   Heather Leslie, Ocean Informatics, Australia (Editor) Ian McNicoll, freshEHR Clinical Informatics, United Kingdom (Editor) Dunmail Hodkinson, Black Pear Software Ltd, UK      References   Use cases: - 5LICS, midclavicular line - L forearm, 2cm anterior to the cubital fossa - Right iliac fossa - 5 cm below L tibial tuberosity - 2 cm medial to R nipple - 4 cm below R costal margin in midclavicular line - R femur - midline nose - medial aspect of R great toe nail."
+            "map": "Archetype ID   openEHR-EHR-CLUSTER.anatomical_location.v1      Concept name   Anatomical Location      Concept description   Record details about an anatomical location.      Keywords   location, site, anatomical      Copyright   © openEHR Foundation      Purpose   To record details about anatomical location.      Misuse   Not for specifiying unilateral/bilateral occurrence - this is related to an evaluation which perhaps includes multiple locations.      Author   Author name: Heather Leslie Organization: Ocean Informatics Email: heather.leslie@oceaninformatics.com Date of Origination: 2008-11-10       Translator   Norwegian Bokmål: Lars Bitsch-Larsen, Haukeland University Hospital of Bergen, Norway, MD, DEAA, MBA, spec in anesthesia, spec in tropical medicine. Arabic (Syria): Mona Saleh       Other contributors   Heather Leslie, Ocean Informatics, Australia (Editor) Ian McNicoll, freshEHR Clinical Informatics, United Kingdom (Editor) Dunmail Hodkinson, Black Pear Software Ltd, UK      References   Use cases: - 5LICS, midclavicular line - L forearm, 2cm anterior to the cubital fossa - Right iliac fossa - 5 cm below L tibial tuberosity - 2 cm medial to R nipple - 4 cm below R costal margin in midclavicular line - R femur - midline nose - medial aspect of R great toe nail."
           },
           {
             "identity": "w5",
@@ -121,7 +126,7 @@
         "path": "BodySite.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -160,7 +165,7 @@
         "path": "BodySite.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -181,7 +186,7 @@
         "path": "BodySite.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -201,6 +206,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -215,7 +228,7 @@
         "path": "BodySite.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -249,7 +262,7 @@
         "path": "BodySite.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -279,7 +292,7 @@
         "path": "BodySite.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -308,7 +321,7 @@
         "path": "BodySite.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -333,21 +346,6 @@
           }
         ]
       },
-      {
-        "id": "BodySite:shr-core-BodySite.patient",
-        "path": "BodySite.patient",
-        "short": "Patient",
-        "definition": "The person to which the body site belongs.",
-        "min": 1,
-        "max": "1",
-        "type": [
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient"
-          }
-        ],
-        "isSummary": true
-      },
       {
         "id": "BodySite:shr-core-BodySite.identifier",
         "path": "BodySite.identifier",
@@ -362,9 +360,45 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "rim",
+            "map": ".id"
+          },
           {
             "identity": "openehr",
             "map": "Specific location  Cluster Optional (0..1) Cardinality: Mandatory, repeating, unordered (1..*)"
+          },
+          {
+            "identity": "w5",
+            "map": "id"
+          }
+        ]
+      },
+      {
+        "id": "BodySite:shr-core-BodySite.active",
+        "path": "BodySite.active",
+        "short": "Whether this body site record is in active use",
+        "definition": "Whether this body site is in active use.",
+        "comment": "This element is labeled as a modifier because it may be used to mark that the resource was created in error.",
+        "requirements": "Need to be able to mark a body site entry as not to be used because it was created in error.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "boolean"
+          }
+        ],
+        "defaultValueBoolean": true,
+        "isModifier": true,
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "statusCode"
+          },
+          {
+            "identity": "w5",
+            "map": "status"
           }
         ]
       },
@@ -385,7 +419,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
           }
         },
         "mapping": [
@@ -393,25 +427,36 @@
             "identity": "v2",
             "map": "OBX-20"
           },
+          {
+            "identity": "rim",
+            "map": ".targetSiteCode"
+          },
           {
             "identity": "openehr",
             "map": "Name of location"
+          },
+          {
+            "identity": "w5",
+            "map": "what"
           }
         ]
       },
       {
-        "id": "BodySite:shr-core-BodySite.modifier",
-        "path": "BodySite.modifier",
+        "id": "BodySite:shr-core-BodySite.qualifier",
+        "path": "BodySite.qualifier",
         "slicing": {
-          "id": "192",
+          "id": "187",
           "discriminator": [
-            "coding.code"
+            {
+              "type": "value",
+              "path": "coding.code"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Modification to location code",
-        "definition": "Modifier to refine the anatomical location.  These include modifiers for laterality, relative location, directionality, number, and plane.",
+        "definition": "Qualifier to refine the anatomical location.  These include qualifiers for laterality, relative location, directionality, number, and plane.",
         "min": 0,
         "max": "*",
         "type": [
@@ -420,6 +465,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySiteQualifier"
+            }
+          ],
           "strength": "example",
           "description": "Concepts modifying the anatomic location",
           "valueSetReference": {
@@ -431,18 +482,26 @@
             "identity": "v2",
             "map": "No distinct element defined in V2.x. The IHE Radiology Technical Framework directs the use of OBR-15-specimen source to contain laterality for imaging studies."
           },
+          {
+            "identity": "rim",
+            "map": ".targetSiteCode"
+          },
           {
             "identity": "openehr",
             "map": "Combines Side, Numerical identifier, Anatomical plane,and Aspect"
+          },
+          {
+            "identity": "w5",
+            "map": "what"
           }
         ]
       },
       {
-        "id": "BodySite:shr-core-BodySite.modifier:shr-core-Laterality",
-        "path": "BodySite.modifier",
+        "id": "BodySite:shr-core-BodySite.qualifier:shr-core-Laterality",
+        "path": "BodySite.qualifier",
         "sliceName": "shr-core-Laterality",
         "short": "Modification to location code",
-        "definition": "Modifier to refine the anatomical location.  These include modifiers for laterality, relative location, directionality, number, and plane.",
+        "definition": "Qualifier to refine the anatomical location.  These include qualifiers for laterality, relative location, directionality, number, and plane.",
         "min": 0,
         "max": "1",
         "type": [
@@ -454,7 +513,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-LateralityVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/LateralityVS"
           }
         },
         "mapping": [
@@ -462,18 +521,26 @@
             "identity": "v2",
             "map": "No distinct element defined in V2.x. The IHE Radiology Technical Framework directs the use of OBR-15-specimen source to contain laterality for imaging studies."
           },
+          {
+            "identity": "rim",
+            "map": ".targetSiteCode"
+          },
           {
             "identity": "openehr",
             "map": "Combines Side, Numerical identifier, Anatomical plane,and Aspect"
+          },
+          {
+            "identity": "w5",
+            "map": "what"
           }
         ]
       },
       {
-        "id": "BodySite:shr-core-BodySite.modifier:shr-core-Directionality",
-        "path": "BodySite.modifier",
+        "id": "BodySite:shr-core-BodySite.qualifier:shr-core-Directionality",
+        "path": "BodySite.qualifier",
         "sliceName": "shr-core-Directionality",
         "short": "Modification to location code",
-        "definition": "Modifier to refine the anatomical location.  These include modifiers for laterality, relative location, directionality, number, and plane.",
+        "definition": "Qualifier to refine the anatomical location.  These include qualifiers for laterality, relative location, directionality, number, and plane.",
         "min": 0,
         "max": "1",
         "type": [
@@ -485,7 +552,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-DirectionalityVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/DirectionalityVS"
           }
         },
         "mapping": [
@@ -493,18 +560,26 @@
             "identity": "v2",
             "map": "No distinct element defined in V2.x. The IHE Radiology Technical Framework directs the use of OBR-15-specimen source to contain laterality for imaging studies."
           },
+          {
+            "identity": "rim",
+            "map": ".targetSiteCode"
+          },
           {
             "identity": "openehr",
             "map": "Combines Side, Numerical identifier, Anatomical plane,and Aspect"
+          },
+          {
+            "identity": "w5",
+            "map": "what"
           }
         ]
       },
       {
-        "id": "BodySite:shr-core-BodySite.modifier:shr-core-PortionTotality",
-        "path": "BodySite.modifier",
+        "id": "BodySite:shr-core-BodySite.qualifier:shr-core-PortionTotality",
+        "path": "BodySite.qualifier",
         "sliceName": "shr-core-PortionTotality",
         "short": "Modification to location code",
-        "definition": "Modifier to refine the anatomical location.  These include modifiers for laterality, relative location, directionality, number, and plane.",
+        "definition": "Qualifier to refine the anatomical location.  These include qualifiers for laterality, relative location, directionality, number, and plane.",
         "min": 0,
         "max": "1",
         "type": [
@@ -516,7 +591,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-PortionTotalityVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/PortionTotalityVS"
           }
         },
         "mapping": [
@@ -524,18 +599,26 @@
             "identity": "v2",
             "map": "No distinct element defined in V2.x. The IHE Radiology Technical Framework directs the use of OBR-15-specimen source to contain laterality for imaging studies."
           },
+          {
+            "identity": "rim",
+            "map": ".targetSiteCode"
+          },
           {
             "identity": "openehr",
             "map": "Combines Side, Numerical identifier, Anatomical plane,and Aspect"
+          },
+          {
+            "identity": "w5",
+            "map": "what"
           }
         ]
       },
       {
         "id": "BodySite:shr-core-BodySite.description",
         "path": "BodySite.description",
-        "short": "The Description of anatomical location",
-        "definition": "Description of anatomical location.",
-        "comments": "This Description  could include any visual markings used to orientate the viewer e.g. external reference points, special sutures, ink markings.",
+        "short": "Anatomical location description",
+        "definition": "A summary, charactarization or explanation of the anatomic location.",
+        "comment": "This description could include any visual markings used to orientate the viewer e.g. external reference points, special sutures, ink markings.",
         "min": 0,
         "max": "1",
         "type": [
@@ -545,9 +628,17 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "rim",
+            "map": ".text"
+          },
           {
             "identity": "openehr",
             "map": "Description of anatomical location/Visual markings/orientation"
+          },
+          {
+            "identity": "w5",
+            "map": "what"
           }
         ]
       },
@@ -564,9 +655,42 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "rim",
+            "map": "outboundRelationship[typeCode=COMP].target"
+          },
           {
             "identity": "openehr",
             "map": "Image"
+          },
+          {
+            "identity": "w5",
+            "map": "what"
+          }
+        ]
+      },
+      {
+        "id": "BodySite:shr-core-BodySite.patient",
+        "path": "BodySite.patient",
+        "short": "Who this is about",
+        "definition": "The person to which the body site belongs.",
+        "min": 1,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".scoper or .scoper.playsRole"
+          },
+          {
+            "identity": "w5",
+            "map": "who.focus"
           }
         ]
       }
@@ -594,25 +718,28 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
           }
         }
       },
       {
-        "id": "BodySite:shr-core-BodySite.modifier",
-        "path": "BodySite.modifier",
+        "id": "BodySite:shr-core-BodySite.qualifier",
+        "path": "BodySite.qualifier",
         "slicing": {
-          "id": "192",
+          "id": "187",
           "discriminator": [
-            "coding.code"
+            {
+              "type": "value",
+              "path": "coding.code"
+            }
           ],
           "ordered": false,
           "rules": "open"
         }
       },
       {
-        "id": "BodySite:shr-core-BodySite.modifier:shr-core-Laterality",
-        "path": "BodySite.modifier",
+        "id": "BodySite:shr-core-BodySite.qualifier:shr-core-Laterality",
+        "path": "BodySite.qualifier",
         "sliceName": "shr-core-Laterality",
         "min": 0,
         "max": "1",
@@ -625,13 +752,13 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-LateralityVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/LateralityVS"
           }
         }
       },
       {
-        "id": "BodySite:shr-core-BodySite.modifier:shr-core-Directionality",
-        "path": "BodySite.modifier",
+        "id": "BodySite:shr-core-BodySite.qualifier:shr-core-Directionality",
+        "path": "BodySite.qualifier",
         "sliceName": "shr-core-Directionality",
         "min": 0,
         "max": "1",
@@ -644,13 +771,13 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-DirectionalityVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/DirectionalityVS"
           }
         }
       },
       {
-        "id": "BodySite:shr-core-BodySite.modifier:shr-core-PortionTotality",
-        "path": "BodySite.modifier",
+        "id": "BodySite:shr-core-BodySite.qualifier:shr-core-PortionTotality",
+        "path": "BodySite.qualifier",
         "sliceName": "shr-core-PortionTotality",
         "min": 0,
         "max": "1",
@@ -663,7 +790,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-PortionTotalityVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/PortionTotalityVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-Circumference-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-Circumference-extension.json
old mode 100755
new mode 100644
index 8f8455d..a54599e
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-Circumference-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-Circumference-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.core.Circumference"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Circumference Extension",
   "title": "SHR Circumference Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.120Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.520Z",
   "description": "The length of such a boundary line of a figure, area, or object.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -105,9 +106,12 @@
         "id": "Extension:circumference.extension",
         "path": "Extension.extension",
         "slicing": {
-          "id": "264",
+          "id": "254",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -135,7 +139,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-ClockDirection-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-ClockDirection-extension.json
old mode 100755
new mode 100644
index 221e97f..c3c9f3b
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-ClockDirection-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-ClockDirection-extension.json
@@ -3,7 +3,7 @@
   "id": "shr-core-ClockDirection-extension",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR ClockDirection Extension</b></p>\n  <p>A direction indicated by an angle relative to 12 o&#039;clock.</p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR ClockDirection Extension</b></p>\n  <p>A direction indicated by an angle relative to 12 o'clock.</p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-ClockDirection-extension",
   "identifier": [
@@ -12,9 +12,11 @@
       "value": "shr.core.ClockDirection"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ClockDirection Extension",
   "title": "SHR ClockDirection Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.121Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.521Z",
   "description": "A direction indicated by an angle relative to 12 o'clock.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -170,7 +170,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-ClockDirectionVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/ClockDirectionVS"
           }
         },
         "mapping": [
@@ -221,7 +221,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-ClockDirectionVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/ClockDirectionVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-CodeableConcept-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-CodeableConcept-extension.json
old mode 100755
new mode 100644
index cd7d66c..32df3f7
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-CodeableConcept-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-CodeableConcept-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.core.CodeableConcept"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR CodeableConcept Extension",
   "title": "SHR CodeableConcept Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.190Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.041Z",
   "description": "A set of codes drawn from different coding systems, representing the same concept.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-CodeableConcept.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-CodeableConcept.json
old mode 100755
new mode 100644
index 7484302..afb3b7a
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-CodeableConcept.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-CodeableConcept.json
@@ -12,8 +12,10 @@
       "value": "shr.core.CodeableConcept"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR CodeableConcept Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.077Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,10 +27,9 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.014Z",
   "description": "A set of codes drawn from different coding systems, representing the same concept.",
   "purpose": "This is a common pattern in healthcare - a concept that may be defined by one or more codes from formal definitions including LOINC and SNOMED CT, and/or defined by the provision of text that captures a human sense of the concept.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "v2",
@@ -58,7 +59,7 @@
         "path": "CodeableConcept",
         "short": "SHR CodeableConcept Profile",
         "definition": "A set of codes drawn from different coding systems, representing the same concept.",
-        "comments": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.",
+        "comment": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.",
         "min": 0,
         "max": "*",
         "condition": [
@@ -123,9 +124,19 @@
       {
         "id": "CodeableConcept:shr-core-CodeableConcept.extension",
         "path": "CodeableConcept.extension",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -154,7 +165,7 @@
         "path": "CodeableConcept.coding",
         "short": "Code defined by a terminology system",
         "definition": "A reference to a code defined by a terminology system.",
-        "comments": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true.",
+        "comment": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.",
         "requirements": "Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings.",
         "min": 0,
         "max": "*",
@@ -182,12 +193,18 @@
       },
       {
         "id": "CodeableConcept:shr-core-CodeableConcept.text",
+        "extension": [
+          {
+            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
+            "valueBoolean": true
+          }
+        ],
         "path": "CodeableConcept.text",
         "short": "Plain text representation of the concept",
         "definition": "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.",
-        "comments": "Very often the text is the same as a displayName of one of the codings.",
+        "comment": "Very often the text is the same as a displayName of one of the codings.",
         "requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.",
-        "min": 1,
+        "min": 0,
         "max": "1",
         "type": [
           {
@@ -229,12 +246,6 @@
             "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-Coding"
           }
         ]
-      },
-      {
-        "id": "CodeableConcept:shr-core-CodeableConcept.text",
-        "path": "CodeableConcept.text",
-        "min": 1,
-        "max": "1"
       }
     ]
   }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-Coding.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-Coding.json
old mode 100755
new mode 100644
index e91d564..830ca8f
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-Coding.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-Coding.json
@@ -12,8 +12,10 @@
       "value": "shr.core.Coding"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Coding Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.405Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,10 +27,9 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.292Z",
   "description": "Coding of a concept, drawn from a controlled vocabulary. Includes the vocabulary and version, if applicable. May include a display text, and a descriptor expressing the intended interpretation of the code.",
   "purpose": "References to codes are very common in healthcare models.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "v2",
@@ -58,7 +59,7 @@
         "path": "Coding",
         "short": "SHR Coding Profile",
         "definition": "Coding of a concept, drawn from a controlled vocabulary. Includes the vocabulary and version, if applicable. May include a display text, and a descriptor expressing the intended interpretation of the code.",
-        "comments": "Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.",
+        "comment": "Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.",
         "min": 0,
         "max": "*",
         "condition": [
@@ -124,16 +125,18 @@
         "id": "Coding:shr-core-Coding.extension",
         "path": "Coding.extension",
         "slicing": {
-          "id": "190",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
-          "ordered": false,
+          "description": "Extensions are always sliced by (at least) url",
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -161,7 +164,18 @@
         "id": "Coding:shr-core-Coding.extension:codingqualifier",
         "path": "Coding.extension",
         "sliceName": "codingqualifier",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
         "definition": "A description of the purpose or origin of the code that assists in the interpretation of the code.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -194,7 +208,7 @@
         "path": "Coding.system",
         "short": "Identity of the terminology system",
         "definition": "The identification of the code system that defines the meaning of the symbol in the code.",
-        "comments": "The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.",
+        "comment": "The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.",
         "requirements": "Need to be unambiguous about the source of the definition of the symbol.",
         "min": 0,
         "max": "1",
@@ -224,7 +238,7 @@
         "path": "Coding.version",
         "short": "Version of the system - if relevant",
         "definition": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.",
-        "comments": "Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.",
+        "comment": "Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.",
         "min": 0,
         "max": "1",
         "type": [
@@ -279,6 +293,12 @@
       },
       {
         "id": "Coding:shr-core-Coding.display",
+        "extension": [
+          {
+            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
+            "valueBoolean": true
+          }
+        ],
         "path": "Coding.display",
         "short": "Representation defined by the system",
         "definition": "A representation of the meaning of the code in the system, following the rules of the system.",
@@ -311,7 +331,7 @@
         "path": "Coding.userSelected",
         "short": "If this coding was chosen directly by the user",
         "definition": "Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).",
-        "comments": "Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.",
+        "comment": "Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.",
         "requirements": "This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.",
         "min": 0,
         "max": "1",
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-CodingQualifier-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-CodingQualifier-extension.json
old mode 100755
new mode 100644
index d4a44c1..8852041
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-CodingQualifier-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-CodingQualifier-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.core.CodingQualifier"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR CodingQualifier Extension",
   "title": "SHR CodingQualifier Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.405Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.292Z",
   "description": "A description of the purpose or origin of the code that assists in the interpretation of the code.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -169,7 +169,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-CodingQualifierVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/CodingQualifierVS"
           }
         },
         "mapping": [
@@ -219,7 +219,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-CodingQualifierVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/CodingQualifierVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-Count-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-Count-extension.json
old mode 100755
new mode 100644
index 477981d..a1f7cbc
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-Count-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-Count-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.core.Count"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Count Extension",
   "title": "SHR Count Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.921Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.975Z",
   "description": "The number of non-null items in a referenced set of items or values.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-Country-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-Country-extension.json
old mode 100755
new mode 100644
index 1d72dd1..837dfee
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-Country-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-Country-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.core.Country"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Country Extension",
   "title": "SHR Country Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.469Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.328Z",
   "description": "Country - a nation as commonly understood or generally accepted, expressed in ISO 3166 Alpha-2 (2-letter) codes.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-Depth-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-Depth-extension.json
old mode 100755
new mode 100644
index 8030394..6f6e3f5
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-Depth-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-Depth-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.core.Depth"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Depth Extension",
   "title": "SHR Depth Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.120Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.520Z",
   "description": "The extent downward or inward; the perpendicular measurement from the surface downward to determine deepness.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-Details-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-Details-extension.json
old mode 100755
new mode 100644
index 8c2b61d..72cf5f5
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-Details-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-Details-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.core.Details"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Details Extension",
   "title": "SHR Details Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.029Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.229Z",
   "description": "Particulars considered individually and in relation to a whole.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-DollarAmount.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-DollarAmount.json
old mode 100755
new mode 100644
index 9962d12..64172d5
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-DollarAmount.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-DollarAmount.json
@@ -12,8 +12,10 @@
       "value": "shr.core.DollarAmount"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR DollarAmount Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.415Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,10 +27,9 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.297Z",
   "description": "An amount of money expressed in US dollars.",
   "purpose": "Need to able to capture all sorts of measured values, even if the measured value are not precisely quantified. Values include exact measures such as 3.51g, customary units such as 3 tablets, and currencies such as $100.32USD.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "v2",
@@ -53,7 +54,7 @@
         "path": "Quantity",
         "short": "SHR DollarAmount Profile",
         "definition": "An amount of money expressed in US dollars.",
-        "comments": "The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.",
+        "comment": "The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.",
         "min": 0,
         "max": "*",
         "condition": [
@@ -121,9 +122,19 @@
       {
         "id": "Quantity:shr-core-DollarAmount.extension",
         "path": "Quantity.extension",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -152,7 +163,7 @@
         "path": "Quantity.value",
         "short": "Numerical value (with implicit precision)",
         "definition": "The value of the measured amount. The value includes an implicit precision in the presentation of the value.",
-        "comments": "The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).",
+        "comment": "The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).",
         "requirements": "Precision is handled implicitly in almost all cases of measurement.",
         "min": 1,
         "max": "1",
@@ -178,7 +189,7 @@
         "path": "Quantity.comparator",
         "short": "< | <= | >= | > - how to understand the value",
         "definition": "How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is \"<\" , then the real value is < stated value.",
-        "comments": "This is labeled as \"Is Modifier\" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value.",
+        "comment": "This is labeled as \"Is Modifier\" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value.",
         "requirements": "Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.",
         "min": 0,
         "max": "1",
@@ -191,6 +202,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "QuantityComparator"
+            }
+          ],
           "strength": "required",
           "description": "How the Quantity should be understood and represented.",
           "valueSetReference": {
@@ -210,6 +227,12 @@
       },
       {
         "id": "Quantity:shr-core-DollarAmount.unit",
+        "extension": [
+          {
+            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
+            "valueBoolean": true
+          }
+        ],
         "path": "Quantity.unit",
         "short": "Unit representation",
         "definition": "A human-readable form of the unit.",
@@ -266,7 +289,7 @@
         "path": "Quantity.code",
         "short": "Coded form of the unit",
         "definition": "A computer processable form of the unit in some unit representation system.",
-        "comments": "The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency.  The context of use may additionally require a code from a particular system.",
+        "comment": "The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency.  The context of use may additionally require a code from a particular system.",
         "requirements": "Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.",
         "min": 1,
         "max": "1",
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-Duration-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-Duration-extension.json
old mode 100755
new mode 100644
index ab527c2..feb108f
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-Duration-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-Duration-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.core.Duration"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Duration Extension",
   "title": "SHR Duration Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.921Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.975Z",
   "description": "The length of time that something continues.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-Duration.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-Duration.json
old mode 100755
new mode 100644
index 08915ca..962ce4c
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-Duration.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-Duration.json
@@ -12,8 +12,10 @@
       "value": "shr.core.Duration"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Duration Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.417Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.299Z",
   "description": "The length of time that something continues.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "rim",
@@ -52,7 +53,7 @@
         "path": "Duration",
         "short": "SHR Duration Profile",
         "definition": "The length of time that something continues.",
-        "comments": "The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.",
+        "comment": "The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.",
         "min": 0,
         "max": "*",
         "constraint": [
@@ -68,7 +69,7 @@
             "key": "drt-1",
             "severity": "error",
             "human": "There SHALL be a code if there is a value and it SHALL be an expression of time.  If system is present, it SHALL be UCUM.",
-            "expression": "(code or value.empty()) and (system.empty() or system = %ucum)",
+            "expression": "code.exists() implies ((system = %ucum) and value.exists())",
             "xpath": "(f:code or not(f:value)) and (not(exists(f:system)) or f:system/@value='http://unitsofmeasure.org')"
           }
         ],
@@ -117,9 +118,19 @@
       {
         "id": "Duration:shr-core-Duration.extension",
         "path": "Duration.extension",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -148,7 +159,7 @@
         "path": "Duration.value",
         "short": "Numerical value (with implicit precision)",
         "definition": "The value of the measured amount. The value includes an implicit precision in the presentation of the value.",
-        "comments": "The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).",
+        "comment": "The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).",
         "requirements": "Precision is handled implicitly in almost all cases of measurement.",
         "min": 1,
         "max": "1",
@@ -179,7 +190,7 @@
         "path": "Duration.comparator",
         "short": "< | <= | >= | > - how to understand the value",
         "definition": "How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is \"<\" , then the real value is < stated value.",
-        "comments": "This is labeled as \"Is Modifier\" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value.",
+        "comment": "This is labeled as \"Is Modifier\" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value.",
         "requirements": "Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.",
         "min": 0,
         "max": "1",
@@ -197,6 +208,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "QuantityComparator"
+            }
+          ],
           "strength": "required",
           "description": "How the Quantity should be understood and represented.",
           "valueSetReference": {
@@ -216,6 +233,12 @@
       },
       {
         "id": "Duration:shr-core-Duration.unit",
+        "extension": [
+          {
+            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
+            "valueBoolean": true
+          }
+        ],
         "path": "Duration.unit",
         "short": "Unit representation",
         "definition": "A human-readable form of the unit.",
@@ -282,7 +305,7 @@
         "path": "Duration.code",
         "short": "Coded form of the unit",
         "definition": "A computer processable form of the unit in some unit representation system.",
-        "comments": "The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency.  The context of use may additionally require a code from a particular system.",
+        "comment": "The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency.  The context of use may additionally require a code from a particular system.",
         "requirements": "Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.",
         "min": 1,
         "max": "1",
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-EffectiveDate-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-EffectiveDate-extension.json
old mode 100755
new mode 100644
index 474bfaf..169c0dd
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-EffectiveDate-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-EffectiveDate-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.core.EffectiveDate"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR EffectiveDate Extension",
   "title": "SHR EffectiveDate Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.403Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.291Z",
   "description": "The date when something is to take effect.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-EffectiveTimePeriod-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-EffectiveTimePeriod-extension.json
old mode 100755
new mode 100644
index 9a60efe..b1ce32c
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-EffectiveTimePeriod-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-EffectiveTimePeriod-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.core.EffectiveTimePeriod"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR EffectiveTimePeriod Extension",
   "title": "SHR EffectiveTimePeriod Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.833Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.181Z",
   "description": "The date and time span for which something is active, valid, or in force.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-EffectiveTimePeriod.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-EffectiveTimePeriod.json
old mode 100755
new mode 100644
index c0d47c5..a897db7
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-EffectiveTimePeriod.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-EffectiveTimePeriod.json
@@ -12,8 +12,10 @@
       "value": "shr.core.EffectiveTimePeriod"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR EffectiveTimePeriod Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.419Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.300Z",
   "description": "The date and time span for which something is active, valid, or in force.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "v2",
@@ -52,7 +53,7 @@
         "path": "Period",
         "short": "SHR EffectiveTimePeriod Profile",
         "definition": "The date and time span for which something is active, valid, or in force.",
-        "comments": "This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. \"the patient was an inpatient of the hospital for this time range\") or one value from the range applies (e.g. \"give to the patient between these two times\"). If duration is required, specify the type as Interval|Duration.",
+        "comment": "This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. \"the patient was an inpatient of the hospital for this time range\") or one value from the range applies (e.g. \"give to the patient between these two times\"). If duration is required, specify the type as Interval|Duration.",
         "min": 0,
         "max": "*",
         "condition": [
@@ -120,9 +121,19 @@
       {
         "id": "Period:shr-core-EffectiveTimePeriod.extension",
         "path": "Period.extension",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -151,7 +162,7 @@
         "path": "Period.start",
         "short": "Starting time with inclusive boundary",
         "definition": "The start of the period. The boundary is inclusive.",
-        "comments": "If the low element is missing, the meaning is that the low boundary is not known.",
+        "comment": "If the low element is missing, the meaning is that the low boundary is not known.",
         "min": 1,
         "max": "1",
         "type": [
@@ -179,7 +190,7 @@
         "path": "Period.end",
         "short": "End time with inclusive boundary, if not ongoing",
         "definition": "The end of the period. If the end of the period is missing, it means that the period is ongoing. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.",
-        "comments": "The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.",
+        "comment": "The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.",
         "min": 0,
         "max": "1",
         "type": [
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-Explanation-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-Explanation-extension.json
old mode 100755
new mode 100644
index e921b5e..0617ebb
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-Explanation-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-Explanation-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.core.Explanation"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Explanation Extension",
   "title": "SHR Explanation Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.401Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.079Z",
   "description": "A set of statements describing a group of facts that clarifies the cause, context and/or consequence of those facts.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-Frequency-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-Frequency-extension.json
old mode 100755
new mode 100644
index 409e61e..e0b9e78
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-Frequency-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-Frequency-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.core.Frequency"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Frequency Extension",
   "title": "SHR Frequency Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.921Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.975Z",
   "description": "How many occurrences of an event per unit of time.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -105,9 +106,12 @@
         "id": "Extension:frequency.extension",
         "path": "Extension.extension",
         "slicing": {
-          "id": "62",
+          "id": "60",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -187,7 +191,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-GeneralizedAge-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-GeneralizedAge-extension.json
old mode 100755
new mode 100644
index d20cf30..f6ec065
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-GeneralizedAge-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-GeneralizedAge-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.core.GeneralizedAge"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR GeneralizedAge Extension",
   "title": "SHR GeneralizedAge Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.517Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.832Z",
   "description": "Qualitative or quantitative, exact or inexact description of age.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -113,7 +114,10 @@
         "slicing": {
           "id": "6",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -219,7 +223,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-GeneralizedDateTime-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-GeneralizedDateTime-extension.json
old mode 100755
new mode 100644
index 9773089..8df7c4c
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-GeneralizedDateTime-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-GeneralizedDateTime-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.core.GeneralizedDateTime"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR GeneralizedDateTime Extension",
   "title": "SHR GeneralizedDateTime Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.516Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.831Z",
   "description": "A point in time, specified qualitatively or quantitatively.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -113,7 +114,10 @@
         "slicing": {
           "id": "4",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -219,7 +223,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-GeneralizedLikelihood-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-GeneralizedLikelihood-extension.json
old mode 100755
new mode 100644
index e783e61..f88b1a9
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-GeneralizedLikelihood-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-GeneralizedLikelihood-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.core.GeneralizedLikelihood"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR GeneralizedLikelihood Extension",
   "title": "SHR GeneralizedLikelihood Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.594Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.864Z",
   "description": "Quantitative or qualitative measure of likelihood.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -111,9 +112,12 @@
         "id": "Extension:generalizedlikelihood.extension",
         "path": "Extension.extension",
         "slicing": {
-          "id": "20",
+          "id": "18",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -193,7 +197,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-GeneralizedTemporalContext-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-GeneralizedTemporalContext-extension.json
old mode 100755
new mode 100644
index 5771ca4..3f35db5
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-GeneralizedTemporalContext-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-GeneralizedTemporalContext-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.core.GeneralizedTemporalContext"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR GeneralizedTemporalContext Extension",
   "title": "SHR GeneralizedTemporalContext Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.595Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.865Z",
   "description": "A generalized indicator of a dateTime or an age when an event happened.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -111,9 +112,12 @@
         "id": "Extension:generalizedtemporalcontext.extension",
         "path": "Extension.extension",
         "slicing": {
-          "id": "22",
+          "id": "20",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -219,7 +223,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-GeopoliticalLocation.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-GeopoliticalLocation.json
old mode 100755
new mode 100644
index b1ffa22..2d43d16
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-GeopoliticalLocation.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-GeopoliticalLocation.json
@@ -3,7 +3,7 @@
   "id": "shr-core-GeopoliticalLocation",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR GeopoliticalLocation Profile</b></p>\n  <p>The countries of the world and major geopolitical subregions, such as US states.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.core.GeopoliticalLocation maps to Address:\n  AddressLine maps to line\n  City maps to city\n  County maps to district\n  State maps to state\n  PostalCode maps to postalCode\n  Country maps to country\n  use is 0..0\n  type is 0..0\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR GeopoliticalLocation Profile</b></p>\n  <p>The countries of the world and major geopolitical subregions, such as US states.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.core.GeopoliticalLocation maps to Address:\n  AddressLine maps to line\n  City maps to city\n  County maps to district\n  State maps to state\n  PostalCode maps to postalCode\n  Country maps to country\n  constrain use to 0..0\n  constrain type to 0..0\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-GeopoliticalLocation",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.core.GeopoliticalLocation"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR GeopoliticalLocation Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.426Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,10 +27,9 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.305Z",
   "description": "The countries of the world and major geopolitical subregions, such as US states.",
   "purpose": "Need to be able to record postal addresses, along with notes about their use.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "v2",
@@ -63,7 +64,7 @@
         "path": "Address",
         "short": "SHR GeopoliticalLocation Profile",
         "definition": "The countries of the world and major geopolitical subregions, such as US states.",
-        "comments": "Note: address is for postal addresses, not physical locations.",
+        "comment": "Note: address is for postal addresses, not physical locations.",
         "min": 0,
         "max": "*",
         "condition": [
@@ -128,9 +129,19 @@
       {
         "id": "Address:shr-core-GeopoliticalLocation.extension",
         "path": "Address.extension",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -159,7 +170,7 @@
         "path": "Address.use",
         "short": "home | work | temp | old - purpose of this address",
         "definition": "The purpose of this address.",
-        "comments": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary or old address etc.for a current/permanent one. Applications can assume that an address is current unless it explicitly says that it is temporary or old.",
+        "comment": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary or old address etc.for a current/permanent one. Applications can assume that an address is current unless it explicitly says that it is temporary or old.",
         "requirements": "Allows an appropriate address to be chosen from a list of many.",
         "min": 0,
         "max": "0",
@@ -177,6 +188,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AddressUse"
+            }
+          ],
           "strength": "required",
           "description": "The use of an address",
           "valueSetReference": {
@@ -218,6 +235,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AddressType"
+            }
+          ],
           "strength": "required",
           "description": "The type of an address (physical / postal)",
           "valueSetReference": {
@@ -244,7 +267,7 @@
         "path": "Address.text",
         "short": "Text representation of the address",
         "definition": "A full text representation of the address.",
-        "comments": "Can provide both a text representation and parts.",
+        "comment": "Can provide both a text representation and parts.",
         "requirements": "A renderable, unencoded form.",
         "min": 0,
         "max": "1",
@@ -288,6 +311,7 @@
             "code": "string"
           }
         ],
+        "orderMeaning": "The order in which lines should appear in an address label",
         "example": [
           {
             "label": "General",
@@ -360,7 +384,7 @@
         "path": "Address.district",
         "short": "District name (aka county)",
         "definition": "The name of the administrative area (county).",
-        "comments": "District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead.",
+        "comment": "District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead.",
         "alias": [
           "County"
         ],
@@ -471,7 +495,7 @@
         "path": "Address.country",
         "short": "Country (e.g. can be ISO 3166 2 or 3 letter code)",
         "definition": "Country - a nation as commonly understood or generally accepted.",
-        "comments": "ISO 3166 3 letter codes can be used in place of a full country name.",
+        "comment": "ISO 3166 3 letter codes can be used in place of a full country name.",
         "min": 1,
         "max": "1",
         "type": [
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-Geoposition.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-Geoposition.json
old mode 100755
new mode 100644
index dc3f293..28fab57
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-Geoposition.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-Geoposition.json
@@ -3,7 +3,7 @@
   "id": "shr-core-Geoposition",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR Geoposition Profile</b></p>\n  <p>The location on the surface of the Earth, described by a latitude and longitude (and optional altitude).</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.core.Geoposition maps to Location:\n  position is 1..1\n  Latitude maps to position.latitude\n  Longitude maps to position.longitude\n  Altitude maps to position.altitude\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR Geoposition Profile</b></p>\n  <p>The location on the surface of the Earth, described by a latitude and longitude (and optional altitude).</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.core.Geoposition maps to Location:\n  constrain position to 1..1\n  Latitude maps to position.latitude\n  Longitude maps to position.longitude\n  Altitude maps to position.altitude\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-Geoposition",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.core.Geoposition"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Geoposition Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.422Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.303Z",
   "description": "The location on the surface of the Earth, described by a latitude and longitude (and optional altitude).",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "rim",
@@ -108,7 +109,7 @@
         "path": "Location.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -147,7 +148,7 @@
         "path": "Location.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -168,7 +169,7 @@
         "path": "Location.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -188,6 +189,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -202,7 +211,7 @@
         "path": "Location.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -236,7 +245,7 @@
         "path": "Location.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -266,7 +275,7 @@
         "path": "Location.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -295,7 +304,7 @@
         "path": "Location.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -349,7 +358,8 @@
         "id": "Location:shr-core-Geoposition.status",
         "path": "Location.status",
         "short": "active | suspended | inactive",
-        "definition": "active | suspended | inactive.",
+        "definition": "The status property covers the general availability of the resource, not the current value which may be covered by the operationStatus, or by a schedule/slots if they are configured for the location.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "min": 0,
         "max": "1",
         "type": [
@@ -360,6 +370,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "LocationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Indicates whether the location is still in use.",
           "valueSetReference": {
@@ -377,12 +393,49 @@
           }
         ]
       },
+      {
+        "id": "Location:shr-core-Geoposition.operationalStatus",
+        "path": "Location.operationalStatus",
+        "short": "The Operational status of the location (typically only for a bed/room)",
+        "definition": "The Operational status covers operation values most relevant to beds (but can also apply to rooms/units/chair/etc such as an isolation unit/dialisys chair). This typically covers concepts such as contamination, housekeeping and other activities like maintenance.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Coding"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "OperationalStatus"
+            }
+          ],
+          "strength": "preferred",
+          "description": "The operational status if the location (where typically a bed/room)",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/v2-0116"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          },
+          {
+            "identity": "w5",
+            "map": "status"
+          }
+        ]
+      },
       {
         "id": "Location:shr-core-Geoposition.name",
         "path": "Location.name",
         "short": "Name of the location as used by humans",
         "definition": "Name of the location as used by humans. Does not need to be unique.",
-        "comments": "If the name of an location changes, consider putting the old name in the alias column so that it can still be located through searches.",
+        "comment": "If the name of an location changes, consider putting the old name in the alias column so that it can still be located through searches.",
         "min": 0,
         "max": "1",
         "type": [
@@ -403,7 +456,7 @@
         "path": "Location.alias",
         "short": "A list of alternate names that the location is known as, or was known as in the past",
         "definition": "A list of alternate names that the location is known as, or was known as in the past.",
-        "comments": "There are no dates associated with the alias/historic names, as this is not intended to track when names were used, but to assist in searching so that older names can still result in identifying the location.",
+        "comment": "There are no dates associated with the alias/historic names, as this is not intended to track when names were used, but to assist in searching so that older names can still result in identifying the location.",
         "requirements": "Over time locations and organizations go through many changes and can be known by different names.\n\nFor searching knowing previous names that the location was known by can be very useful.",
         "min": 0,
         "max": "*",
@@ -445,6 +498,7 @@
         "path": "Location.mode",
         "short": "instance | kind",
         "definition": "Indicates whether a resource instance represents a specific location or a class of locations.",
+        "comment": "This is labeled as a modifer because whether or not the location is a class of locations changes how it can be used and understood.",
         "requirements": "When using a Location resource for scheduling or orders, we need to be able to refer to a class of Locations instead of a specific Location.",
         "min": 0,
         "max": "1",
@@ -456,6 +510,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "LocationMode"
+            }
+          ],
           "strength": "required",
           "description": "Indicates whether a resource instance represents a specific location or a class of locations.",
           "valueSetReference": {
@@ -487,6 +547,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "LocationType"
+            }
+          ],
           "strength": "extensible",
           "description": "Indicates the type of function performed at the location.",
           "valueSetReference": {
@@ -528,7 +594,7 @@
         "path": "Location.address",
         "short": "Physical location",
         "definition": "Physical location.",
-        "comments": "This was kept as 0..1 as there is no use property on the address, so wouldn't be able to identify different address types.",
+        "comment": "This was kept as 0..1 as there is no use property on the address, so wouldn't be able to identify different address types.",
         "requirements": "If locations can be visited, we need to keep track of their address.",
         "min": 0,
         "max": "1",
@@ -559,6 +625,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "PhysicalType"
+            }
+          ],
           "strength": "example",
           "description": "Physical form of the location",
           "valueSetReference": {
@@ -638,7 +710,7 @@
         "path": "Location.position.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -667,7 +739,7 @@
         "path": "Location.position.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -756,7 +828,7 @@
         "path": "Location.managingOrganization",
         "short": "Organization responsible for provisioning and upkeep",
         "definition": "The organization responsible for the provisioning and upkeep of the location.",
-        "comments": "This can also be used as the part of the organization hierarchy where this location provides services. These services can be defined through the HealthcareService resource.",
+        "comment": "This can also be used as the part of the organization hierarchy where this location provides services. These services can be defined through the HealthcareService resource.",
         "requirements": "Need to know who manages the location.",
         "min": 0,
         "max": "1",
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-GestationalAge-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-GestationalAge-extension.json
old mode 100755
new mode 100644
index d54b984..ec72a1c
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-GestationalAge-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-GestationalAge-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.core.GestationalAge"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR GestationalAge Extension",
   "title": "SHR GestationalAge Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.595Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.865Z",
   "description": "The age of the embryo or fetus. This may be assessed by medical history, physical examination, early immunologic pregnancy tests, radiography, ultrasonography, and amniotic fluid analysis.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-GestationalTemporalContext-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-GestationalTemporalContext-extension.json
old mode 100755
new mode 100644
index 4e41c0c..f81eda3
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-GestationalTemporalContext-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-GestationalTemporalContext-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.core.GestationalTemporalContext"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR GestationalTemporalContext Extension",
   "title": "SHR GestationalTemporalContext Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.595Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.865Z",
   "description": "A named gestational time period, or a gestational age.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -111,9 +112,12 @@
         "id": "Extension:gestationaltemporalcontext.extension",
         "path": "Extension.extension",
         "slicing": {
-          "id": "23",
+          "id": "21",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -193,7 +197,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-GestationalTimePeriod-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-GestationalTimePeriod-extension.json
old mode 100755
new mode 100644
index 093ee79..ba811ae
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-GestationalTimePeriod-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-GestationalTimePeriod-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.core.GestationalTimePeriod"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR GestationalTimePeriod Extension",
   "title": "SHR GestationalTimePeriod Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.595Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.865Z",
   "description": "A time relative to a pregnancy or childbirth event.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-HumanName.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-HumanName.json
old mode 100755
new mode 100644
index 8bb67f9..d9c4938
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-HumanName.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-HumanName.json
@@ -12,8 +12,10 @@
       "value": "shr.core.HumanName"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR HumanName Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.430Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,10 +27,9 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.308Z",
   "description": "A name used by a human being, written as it would be typically expressed. May include a breakdown of the various elements of the name (family name, given name, etc.).",
   "purpose": "Need to be able to record names, along with notes about their use.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "v2",
@@ -58,7 +59,7 @@
         "path": "HumanName",
         "short": "SHR HumanName Profile",
         "definition": "A name used by a human being, written as it would be typically expressed. May include a breakdown of the various elements of the name (family name, given name, etc.).",
-        "comments": "Names may be changed, or repudiated, or people may have different names in different contexts. Names may be divided into parts of different type that have variable significance depending on context, though the division into parts does not always matter. With personal names, the different parts may or may not be imbued with some implicit meaning; various cultures associate different importance with the name parts and the degree to which systems must care about name parts around the world varies widely.",
+        "comment": "Names may be changed, or repudiated, or people may have different names in different contexts. Names may be divided into parts of different type that have variable significance depending on context, though the division into parts does not always matter. With personal names, the different parts may or may not be imbued with some implicit meaning; various cultures associate different importance with the name parts and the degree to which systems must care about name parts around the world varies widely.",
         "min": 0,
         "max": "*",
         "condition": [
@@ -123,9 +124,19 @@
       {
         "id": "HumanName:shr-core-HumanName.extension",
         "path": "HumanName.extension",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -154,7 +165,7 @@
         "path": "HumanName.use",
         "short": "usual | official | temp | nickname | anonymous | old | maiden",
         "definition": "Identifies the purpose for this name.",
-        "comments": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary or old name etc.for a current/permanent one. Applications can assume that a name is current unless it explicitly says that it is temporary or old.",
+        "comment": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary or old name etc.for a current/permanent one. Applications can assume that a name is current unless it explicitly says that it is temporary or old.",
         "requirements": "Allows the appropriate name for a particular context of use to be selected from among a set of names.",
         "min": 0,
         "max": "1",
@@ -166,6 +177,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "NameUse"
+            }
+          ],
           "strength": "required",
           "description": "The use of a human name",
           "valueSetReference": {
@@ -192,7 +209,7 @@
         "path": "HumanName.text",
         "short": "Text representation of the full name",
         "definition": "A full text representation of the name.",
-        "comments": "Can provide both a text representation and structured parts.",
+        "comment": "Can provide both a text representation and structured parts.",
         "requirements": "A renderable, unencoded form.",
         "min": 1,
         "max": "1",
@@ -218,7 +235,7 @@
         "path": "HumanName.family",
         "short": "Family name (often called 'Surname')",
         "definition": "The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.",
-        "comments": "Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).",
+        "comment": "Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).",
         "alias": [
           "surname"
         ],
@@ -250,7 +267,7 @@
         "path": "HumanName.given",
         "short": "Given names (not always 'first'). Includes middle names",
         "definition": "Given name.",
-        "comments": "If only initials are recorded, they may be used in place of the full name.  Not called \"first name\" since given names do not always come first.",
+        "comment": "If only initials are recorded, they may be used in place of the full name.  Not called \"first name\" since given names do not always come first.",
         "alias": [
           "first name",
           "middle name"
@@ -262,6 +279,7 @@
             "code": "string"
           }
         ],
+        "orderMeaning": "Given Names appear in the correct order for presenting the name",
         "isSummary": true,
         "mapping": [
           {
@@ -290,6 +308,7 @@
             "code": "string"
           }
         ],
+        "orderMeaning": "Prefixes appear in the correct order for presenting the name",
         "isSummary": true,
         "mapping": [
           {
@@ -318,6 +337,7 @@
             "code": "string"
           }
         ],
+        "orderMeaning": "Suffixes appear in the correct order for presenting the name",
         "isSummary": true,
         "mapping": [
           {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-Identifier.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-Identifier.json
old mode 100755
new mode 100644
index b33a3c0..d85f43d
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-Identifier.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-Identifier.json
@@ -12,8 +12,10 @@
       "value": "shr.core.Identifier"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Identifier Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.443Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,10 +27,9 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.314Z",
   "description": "A numeric or alphanumeric string that is associated with a single object or entity within a given system. Typically, identifiers are used to connect content in resources to external content available in other frameworks or protocols. Identifiers are associated with objects, and may be changed or retired due to human or system process and errors.",
   "purpose": "Need to be able to identify things with confidence and be sure that the identification is not subject to misinterpretation.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "v2",
@@ -122,9 +123,19 @@
       {
         "id": "Identifier:shr-core-Identifier.extension",
         "path": "Identifier.extension",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -153,7 +164,7 @@
         "path": "Identifier.use",
         "short": "usual | official | temp | secondary (If known)",
         "definition": "The purpose of this identifier.",
-        "comments": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.",
+        "comment": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.",
         "requirements": "Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.",
         "min": 0,
         "max": "1",
@@ -165,6 +176,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "IdentifierUse"
+            }
+          ],
           "strength": "required",
           "description": "Identifies the purpose for this identifier, if known .",
           "valueSetReference": {
@@ -187,7 +204,7 @@
         "path": "Identifier.type",
         "short": "Description of identifier",
         "definition": "A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.",
-        "comments": "This element deals only with general categories of identifiers.  It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. \n\nWhere the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.",
+        "comment": "This element deals only with general categories of identifiers.  It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. \n\nWhere the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.",
         "requirements": "Allows users to make use of identifiers when the identifier system is not known.",
         "min": 0,
         "max": "1",
@@ -198,6 +215,16 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "IdentifierType"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
+            }
+          ],
           "strength": "extensible",
           "description": "A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.",
           "valueSetReference": {
@@ -218,9 +245,9 @@
       {
         "id": "Identifier:shr-core-Identifier.system",
         "path": "Identifier.system",
-        "short": "The namespace for the identifier",
-        "definition": "Establishes the namespace in which set of possible id values is unique.",
-        "requirements": "There are many sequences of identifiers.  To perform matching, we need to know what sequence we're dealing with. The system identifies a particular sequence or set of unique identifiers.",
+        "short": "The namespace for the identifier value",
+        "definition": "Establishes the namespace for the value - that is, a URL that describes a set values that are unique.",
+        "requirements": "There are many sets  of identifiers.  To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.",
         "min": 0,
         "max": "1",
         "type": [
@@ -255,7 +282,7 @@
         "path": "Identifier.value",
         "short": "The value that is unique",
         "definition": "The portion of the identifier typically relevant to the user and which is unique within the context of the system.",
-        "comments": "If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986.  The value's primary purpose is computational mapping.  As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.)  A value formatted for human display can be conveyed using the [Rendered Value extension](extension-rendered-value.html).",
+        "comment": "If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986.  The value's primary purpose is computational mapping.  As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.)  A value formatted for human display can be conveyed using the [Rendered Value extension](extension-rendered-value.html).",
         "min": 1,
         "max": "1",
         "type": [
@@ -319,7 +346,7 @@
         "path": "Identifier.assigner",
         "short": "Organization that issued id (may be just text)",
         "definition": "Organization that issued/manages the identifier.",
-        "comments": "The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.",
+        "comment": "The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.",
         "min": 0,
         "max": "1",
         "type": [
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-Length-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-Length-extension.json
old mode 100755
new mode 100644
index ca5e3e4..6b48e08
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-Length-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-Length-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.core.Length"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Length Extension",
   "title": "SHR Length Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.120Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.520Z",
   "description": "The measurement or linear extent of something from end to end; the greater of two or the greatest of three dimensions of a body.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-Likelihood-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-Likelihood-extension.json
old mode 100755
new mode 100644
index 2021d20..fb37b02
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-Likelihood-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-Likelihood-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.core.Likelihood"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Likelihood Extension",
   "title": "SHR Likelihood Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.594Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.864Z",
   "description": "A measure of the expectation of the occurrence of a particular event, as a percentage.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-Location-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-Location-extension.json
old mode 100755
new mode 100644
index fba008e..668a124
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-Location-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-Location-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.core.Location"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Location Extension",
   "title": "SHR Location Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.665Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.896Z",
   "description": "A position, site, or point in space where something can be found.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-LowerBound-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-LowerBound-extension.json
old mode 100755
new mode 100644
index 8ad3c8e..a74e7c0
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-LowerBound-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-LowerBound-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.core.LowerBound"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR LowerBound Extension",
   "title": "SHR LowerBound Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.517Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.832Z",
   "description": "A measured or measurable amount with units that is known to be bounded from below by the quantity represented.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-LowerBound.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-LowerBound.json
old mode 100755
new mode 100644
index bcbb1c0..adb0b67
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-LowerBound.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-LowerBound.json
@@ -12,8 +12,10 @@
       "value": "shr.core.LowerBound"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR LowerBound Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.410Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,10 +27,9 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.295Z",
   "description": "A measured or measurable amount with units that is known to be bounded from below by the quantity represented.",
   "purpose": "Need to able to capture all sorts of measured values, even if the measured value are not precisely quantified. Values include exact measures such as 3.51g, customary units such as 3 tablets, and currencies such as $100.32USD.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "v2",
@@ -53,7 +54,7 @@
         "path": "Quantity",
         "short": "SHR LowerBound Profile",
         "definition": "A measured or measurable amount with units that is known to be bounded from below by the quantity represented.",
-        "comments": "The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.",
+        "comment": "The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.",
         "min": 0,
         "max": "*",
         "condition": [
@@ -121,9 +122,19 @@
       {
         "id": "Quantity:shr-core-LowerBound.extension",
         "path": "Quantity.extension",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -152,7 +163,7 @@
         "path": "Quantity.value",
         "short": "Numerical value (with implicit precision)",
         "definition": "The value of the measured amount. The value includes an implicit precision in the presentation of the value.",
-        "comments": "The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).",
+        "comment": "The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).",
         "requirements": "Precision is handled implicitly in almost all cases of measurement.",
         "min": 1,
         "max": "1",
@@ -178,7 +189,7 @@
         "path": "Quantity.comparator",
         "short": "< | <= | >= | > - how to understand the value",
         "definition": "How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is \"<\" , then the real value is < stated value.",
-        "comments": "This is labeled as \"Is Modifier\" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value.",
+        "comment": "This is labeled as \"Is Modifier\" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value.",
         "requirements": "Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.",
         "min": 1,
         "max": "1",
@@ -192,9 +203,8 @@
         "isSummary": true,
         "binding": {
           "strength": "required",
-          "description": "How the Quantity should be understood and represented.",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/quantity-comparator"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/LowerBoundTypeVS"
           }
         },
         "mapping": [
@@ -210,6 +220,12 @@
       },
       {
         "id": "Quantity:shr-core-LowerBound.unit",
+        "extension": [
+          {
+            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
+            "valueBoolean": true
+          }
+        ],
         "path": "Quantity.unit",
         "short": "Unit representation",
         "definition": "A human-readable form of the unit.",
@@ -266,7 +282,7 @@
         "path": "Quantity.code",
         "short": "Coded form of the unit",
         "definition": "A computer processable form of the unit in some unit representation system.",
-        "comments": "The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency.  The context of use may additionally require a code from a particular system.",
+        "comment": "The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency.  The context of use may additionally require a code from a particular system.",
         "requirements": "Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.",
         "min": 0,
         "max": "1",
@@ -307,7 +323,13 @@
         "id": "Quantity:shr-core-LowerBound.comparator",
         "path": "Quantity.comparator",
         "min": 1,
-        "max": "1"
+        "max": "1",
+        "binding": {
+          "strength": "required",
+          "valueSetReference": {
+            "reference": "http://standardhealthrecord.org/shr/core/vs/LowerBoundTypeVS"
+          }
+        }
       }
     ]
   }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-OccurrenceTime-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-OccurrenceTime-extension.json
old mode 100755
new mode 100644
index 664b143..148b2e4
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-OccurrenceTime-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-OccurrenceTime-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.core.OccurrenceTime"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR OccurrenceTime Extension",
   "title": "SHR OccurrenceTime Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.168Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.257Z",
   "description": "The point in time or span of time in which something happens.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-Percentage-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-Percentage-extension.json
old mode 100755
new mode 100644
index effb5eb..11b1876
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-Percentage-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-Percentage-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.core.Percentage"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Percentage Extension",
   "title": "SHR Percentage Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.871Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.440Z",
   "description": "A percentage value where 100.0 represents 100%.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-PeriodOfUse.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-PeriodOfUse.json
old mode 100755
new mode 100644
index c0b5458..36da318
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-PeriodOfUse.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-PeriodOfUse.json
@@ -12,8 +12,10 @@
       "value": "shr.core.PeriodOfUse"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR PeriodOfUse Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.420Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.301Z",
   "description": "A period of time when a device, medication, or other therapy is used.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "v2",
@@ -52,7 +53,7 @@
         "path": "Period",
         "short": "SHR PeriodOfUse Profile",
         "definition": "A period of time when a device, medication, or other therapy is used.",
-        "comments": "This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. \"the patient was an inpatient of the hospital for this time range\") or one value from the range applies (e.g. \"give to the patient between these two times\"). If duration is required, specify the type as Interval|Duration.",
+        "comment": "This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. \"the patient was an inpatient of the hospital for this time range\") or one value from the range applies (e.g. \"give to the patient between these two times\"). If duration is required, specify the type as Interval|Duration.",
         "min": 0,
         "max": "*",
         "condition": [
@@ -120,9 +121,19 @@
       {
         "id": "Period:shr-core-PeriodOfUse.extension",
         "path": "Period.extension",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -151,7 +162,7 @@
         "path": "Period.start",
         "short": "Starting time with inclusive boundary",
         "definition": "The start of the period. The boundary is inclusive.",
-        "comments": "If the low element is missing, the meaning is that the low boundary is not known.",
+        "comment": "If the low element is missing, the meaning is that the low boundary is not known.",
         "min": 1,
         "max": "1",
         "type": [
@@ -179,7 +190,7 @@
         "path": "Period.end",
         "short": "End time with inclusive boundary, if not ongoing",
         "definition": "The end of the period. If the end of the period is missing, it means that the period is ongoing. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.",
-        "comments": "The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.",
+        "comment": "The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.",
         "min": 0,
         "max": "1",
         "type": [
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-Priority-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-Priority-extension.json
old mode 100755
new mode 100644
index ba192cc..157e0fc
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-Priority-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-Priority-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.core.Priority"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Priority Extension",
   "title": "SHR Priority Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.550Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.845Z",
   "description": "An ordinal numbered priority where 1=highest priority, 2=second highest priority, etc.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-QualitativeDateTime-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-QualitativeDateTime-extension.json
old mode 100755
new mode 100644
index 8e64e4e..5d66a6a
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-QualitativeDateTime-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-QualitativeDateTime-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.core.QualitativeDateTime"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR QualitativeDateTime Extension",
   "title": "SHR QualitativeDateTime Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.517Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.832Z",
   "description": "A point in time, described qualitatively.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -170,7 +170,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeDateTimeVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeDateTimeVS"
           }
         },
         "mapping": [
@@ -221,7 +221,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeDateTimeVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeDateTimeVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-QualitativeLikelihood-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-QualitativeLikelihood-extension.json
old mode 100755
new mode 100644
index b5defca..3ca48e5
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-QualitativeLikelihood-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-QualitativeLikelihood-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.core.QualitativeLikelihood"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR QualitativeLikelihood Extension",
   "title": "SHR QualitativeLikelihood Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.594Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.865Z",
   "description": "A qualitative (subjective) likelihood.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -170,7 +170,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeLikelihoodVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeLikelihoodVS"
           }
         },
         "mapping": [
@@ -221,7 +221,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeLikelihoodVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeLikelihoodVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-Quantity-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-Quantity-extension.json
old mode 100755
new mode 100644
index 742a20b..38c0b6e
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-Quantity-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-Quantity-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.core.Quantity"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Quantity Extension",
   "title": "SHR Quantity Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.679Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.633Z",
   "description": "A quantity with Units.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-Quantity.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-Quantity.json
old mode 100755
new mode 100644
index 5e5825e..9820f01
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-Quantity.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-Quantity.json
@@ -12,8 +12,10 @@
       "value": "shr.core.Quantity"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Quantity Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.406Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,10 +27,9 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.293Z",
   "description": "A quantity with Units.",
   "purpose": "Need to able to capture all sorts of measured values, even if the measured value are not precisely quantified. Values include exact measures such as 3.51g, customary units such as 3 tablets, and currencies such as $100.32USD.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "v2",
@@ -53,7 +54,7 @@
         "path": "Quantity",
         "short": "SHR Quantity Profile",
         "definition": "A quantity with Units.",
-        "comments": "The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.",
+        "comment": "The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.",
         "min": 0,
         "max": "*",
         "condition": [
@@ -121,9 +122,19 @@
       {
         "id": "Quantity:shr-core-Quantity.extension",
         "path": "Quantity.extension",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -152,7 +163,7 @@
         "path": "Quantity.value",
         "short": "Numerical value (with implicit precision)",
         "definition": "The value of the measured amount. The value includes an implicit precision in the presentation of the value.",
-        "comments": "The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).",
+        "comment": "The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).",
         "requirements": "Precision is handled implicitly in almost all cases of measurement.",
         "min": 1,
         "max": "1",
@@ -178,7 +189,7 @@
         "path": "Quantity.comparator",
         "short": "< | <= | >= | > - how to understand the value",
         "definition": "How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is \"<\" , then the real value is < stated value.",
-        "comments": "This is labeled as \"Is Modifier\" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value.",
+        "comment": "This is labeled as \"Is Modifier\" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value.",
         "requirements": "Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.",
         "min": 0,
         "max": "1",
@@ -191,6 +202,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "QuantityComparator"
+            }
+          ],
           "strength": "required",
           "description": "How the Quantity should be understood and represented.",
           "valueSetReference": {
@@ -210,6 +227,12 @@
       },
       {
         "id": "Quantity:shr-core-Quantity.unit",
+        "extension": [
+          {
+            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
+            "valueBoolean": true
+          }
+        ],
         "path": "Quantity.unit",
         "short": "Unit representation",
         "definition": "A human-readable form of the unit.",
@@ -266,7 +289,7 @@
         "path": "Quantity.code",
         "short": "Coded form of the unit",
         "definition": "A computer processable form of the unit in some unit representation system.",
-        "comments": "The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency.  The context of use may additionally require a code from a particular system.",
+        "comment": "The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency.  The context of use may additionally require a code from a particular system.",
         "requirements": "Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.",
         "min": 0,
         "max": "1",
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-Reason-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-Reason-extension.json
old mode 100755
new mode 100644
index 4a1e999..9677be5
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-Reason-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-Reason-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.core.Reason"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Reason Extension",
   "title": "SHR Reason Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.550Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.844Z",
   "description": "The justification for an action or non-action, conclusion, opinion, etc.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-Setting-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-Setting-extension.json
old mode 100755
new mode 100644
index 789f779..a81be31
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-Setting-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-Setting-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.core.Setting"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Setting Extension",
   "title": "SHR Setting Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.665Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.896Z",
   "description": "Description of the place or type of surroundings where something is positioned or where an event takes place.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -170,7 +170,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-SettingVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/SettingVS"
           }
         },
         "mapping": [
@@ -221,7 +221,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-SettingVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/SettingVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-State-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-State-extension.json
old mode 100755
new mode 100644
index 71d3283..6b84ce7
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-State-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-State-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.core.State"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR State Extension",
   "title": "SHR State Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.469Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.328Z",
   "description": "Sub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (i.e. US 2 letter state codes). (Source: HL7 FHIR).",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-Statistic.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-Statistic.json
old mode 100755
new mode 100644
index 2024d14..ad1589a
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-Statistic.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-Statistic.json
@@ -12,8 +12,10 @@
       "value": "shr.core.Statistic"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Statistic Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.412Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,10 +27,9 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.296Z",
   "description": "A quantity that represents a statistic, e.g. maximum, minimum, mean, median, etc.",
   "purpose": "Need to able to capture all sorts of measured values, even if the measured value are not precisely quantified. Values include exact measures such as 3.51g, customary units such as 3 tablets, and currencies such as $100.32USD.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "v2",
@@ -53,7 +54,7 @@
         "path": "Quantity",
         "short": "SHR Statistic Profile",
         "definition": "A quantity that represents a statistic, e.g. maximum, minimum, mean, median, etc.",
-        "comments": "The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.",
+        "comment": "The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.",
         "min": 0,
         "max": "*",
         "condition": [
@@ -122,16 +123,18 @@
         "id": "Quantity:shr-core-Statistic.extension",
         "path": "Quantity.extension",
         "slicing": {
-          "id": "191",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
-          "ordered": false,
+          "description": "Extensions are always sliced by (at least) url",
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -159,7 +162,18 @@
         "id": "Quantity:shr-core-Statistic.extension:statistictype",
         "path": "Quantity.extension",
         "sliceName": "statistictype",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
         "definition": "The type of statistic that is represented by the value.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -192,7 +206,7 @@
         "path": "Quantity.value",
         "short": "Numerical value (with implicit precision)",
         "definition": "The value of the measured amount. The value includes an implicit precision in the presentation of the value.",
-        "comments": "The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).",
+        "comment": "The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).",
         "requirements": "Precision is handled implicitly in almost all cases of measurement.",
         "min": 1,
         "max": "1",
@@ -218,7 +232,7 @@
         "path": "Quantity.comparator",
         "short": "< | <= | >= | > - how to understand the value",
         "definition": "How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is \"<\" , then the real value is < stated value.",
-        "comments": "This is labeled as \"Is Modifier\" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value.",
+        "comment": "This is labeled as \"Is Modifier\" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value.",
         "requirements": "Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.",
         "min": 0,
         "max": "1",
@@ -231,6 +245,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "QuantityComparator"
+            }
+          ],
           "strength": "required",
           "description": "How the Quantity should be understood and represented.",
           "valueSetReference": {
@@ -250,6 +270,12 @@
       },
       {
         "id": "Quantity:shr-core-Statistic.unit",
+        "extension": [
+          {
+            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
+            "valueBoolean": true
+          }
+        ],
         "path": "Quantity.unit",
         "short": "Unit representation",
         "definition": "A human-readable form of the unit.",
@@ -306,7 +332,7 @@
         "path": "Quantity.code",
         "short": "Coded form of the unit",
         "definition": "A computer processable form of the unit in some unit representation system.",
-        "comments": "The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency.  The context of use may additionally require a code from a particular system.",
+        "comment": "The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency.  The context of use may additionally require a code from a particular system.",
         "requirements": "Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.",
         "min": 0,
         "max": "1",
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-StatisticType-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-StatisticType-extension.json
old mode 100755
new mode 100644
index 7cd54c8..ec65ae8
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-StatisticType-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-StatisticType-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.core.StatisticType"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR StatisticType Extension",
   "title": "SHR StatisticType Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.414Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.296Z",
   "description": "The type of statistic that is represented by the value.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -170,7 +170,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-StatisticTypeVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/StatisticTypeVS"
           }
         },
         "mapping": [
@@ -221,7 +221,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-StatisticTypeVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/StatisticTypeVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-Substance-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-Substance-extension.json
old mode 100755
new mode 100644
index bdc7a00..cb6949f
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-Substance-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-Substance-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.core.Substance"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Substance Extension",
   "title": "SHR Substance Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.717Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.913Z",
   "description": "Any matter of defined composition that has discrete existence, whose origin may be biological, mineral or chemical.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-TimePeriod-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-TimePeriod-extension.json
old mode 100755
new mode 100644
index d8c2c1d..6c3f005
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-TimePeriod-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-TimePeriod-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.core.TimePeriod"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR TimePeriod Extension",
   "title": "SHR TimePeriod Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.517Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.832Z",
   "description": "A period of time defined by a start and end time, date, or year.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-TimePeriod.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-TimePeriod.json
old mode 100755
new mode 100644
index 9d360ed..6237efa
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-TimePeriod.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-TimePeriod.json
@@ -12,8 +12,10 @@
       "value": "shr.core.TimePeriod"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR TimePeriod Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.416Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.298Z",
   "description": "A period of time defined by a start and end time, date, or year.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "v2",
@@ -52,7 +53,7 @@
         "path": "Period",
         "short": "SHR TimePeriod Profile",
         "definition": "A period of time defined by a start and end time, date, or year.",
-        "comments": "This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. \"the patient was an inpatient of the hospital for this time range\") or one value from the range applies (e.g. \"give to the patient between these two times\"). If duration is required, specify the type as Interval|Duration.",
+        "comment": "This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. \"the patient was an inpatient of the hospital for this time range\") or one value from the range applies (e.g. \"give to the patient between these two times\"). If duration is required, specify the type as Interval|Duration.",
         "min": 0,
         "max": "*",
         "condition": [
@@ -120,9 +121,19 @@
       {
         "id": "Period:shr-core-TimePeriod.extension",
         "path": "Period.extension",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -151,7 +162,7 @@
         "path": "Period.start",
         "short": "Starting time with inclusive boundary",
         "definition": "The start of the period. The boundary is inclusive.",
-        "comments": "If the low element is missing, the meaning is that the low boundary is not known.",
+        "comment": "If the low element is missing, the meaning is that the low boundary is not known.",
         "min": 1,
         "max": "1",
         "type": [
@@ -179,7 +190,7 @@
         "path": "Period.end",
         "short": "End time with inclusive boundary, if not ongoing",
         "definition": "The end of the period. If the end of the period is missing, it means that the period is ongoing. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.",
-        "comments": "The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.",
+        "comment": "The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.",
         "min": 0,
         "max": "1",
         "type": [
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-UnitedStatesAddress.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-UnitedStatesAddress.json
old mode 100755
new mode 100644
index c0dd794..c46ef80
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-UnitedStatesAddress.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-UnitedStatesAddress.json
@@ -3,7 +3,7 @@
   "id": "shr-core-UnitedStatesAddress",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR UnitedStatesAddress Profile</b></p>\n  <p>An address for a place in the USA, conforming to US mail postal conventions. (Source: HL7 FHIR).</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.core.UnitedStatesAddress maps to Address:\n  AddressLine maps to line\n  City maps to city\n  County maps to district\n  State maps to state\n  PostalCode maps to postalCode\n  Country maps to country\n  use is 0..0\n  type is 0..0\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR UnitedStatesAddress Profile</b></p>\n  <p>An address for a place in the USA, conforming to US mail postal conventions. (Source: HL7 FHIR).</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.core.UnitedStatesAddress maps to Address:\n  AddressLine maps to line\n  City maps to city\n  County maps to district\n  State maps to state\n  PostalCode maps to postalCode\n  Country maps to country\n  constrain use to 0..0\n  constrain type to 0..0\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-UnitedStatesAddress",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.core.UnitedStatesAddress"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR UnitedStatesAddress Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.428Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,10 +27,9 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.307Z",
   "description": "An address for a place in the USA, conforming to US mail postal conventions. (Source: HL7 FHIR).",
   "purpose": "Need to be able to record postal addresses, along with notes about their use.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "v2",
@@ -63,7 +64,7 @@
         "path": "Address",
         "short": "SHR UnitedStatesAddress Profile",
         "definition": "An address for a place in the USA, conforming to US mail postal conventions. (Source: HL7 FHIR).",
-        "comments": "Note: address is for postal addresses, not physical locations.",
+        "comment": "Note: address is for postal addresses, not physical locations.",
         "min": 0,
         "max": "*",
         "condition": [
@@ -128,9 +129,19 @@
       {
         "id": "Address:shr-core-UnitedStatesAddress.extension",
         "path": "Address.extension",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -159,7 +170,7 @@
         "path": "Address.use",
         "short": "home | work | temp | old - purpose of this address",
         "definition": "The purpose of this address.",
-        "comments": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary or old address etc.for a current/permanent one. Applications can assume that an address is current unless it explicitly says that it is temporary or old.",
+        "comment": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary or old address etc.for a current/permanent one. Applications can assume that an address is current unless it explicitly says that it is temporary or old.",
         "requirements": "Allows an appropriate address to be chosen from a list of many.",
         "min": 0,
         "max": "0",
@@ -177,6 +188,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AddressUse"
+            }
+          ],
           "strength": "required",
           "description": "The use of an address",
           "valueSetReference": {
@@ -218,6 +235,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AddressType"
+            }
+          ],
           "strength": "required",
           "description": "The type of an address (physical / postal)",
           "valueSetReference": {
@@ -244,7 +267,7 @@
         "path": "Address.text",
         "short": "Text representation of the address",
         "definition": "A full text representation of the address.",
-        "comments": "Can provide both a text representation and parts.",
+        "comment": "Can provide both a text representation and parts.",
         "requirements": "A renderable, unencoded form.",
         "min": 0,
         "max": "1",
@@ -288,6 +311,7 @@
             "code": "string"
           }
         ],
+        "orderMeaning": "The order in which lines should appear in an address label",
         "example": [
           {
             "label": "General",
@@ -360,7 +384,7 @@
         "path": "Address.district",
         "short": "District name (aka county)",
         "definition": "The name of the administrative area (county).",
-        "comments": "District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead.",
+        "comment": "District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead.",
         "alias": [
           "County"
         ],
@@ -471,7 +495,7 @@
         "path": "Address.country",
         "short": "Country (e.g. can be ISO 3166 2 or 3 letter code)",
         "definition": "Country - a nation as commonly understood or generally accepted.",
-        "comments": "ISO 3166 3 letter codes can be used in place of a full country name.",
+        "comment": "ISO 3166 3 letter codes can be used in place of a full country name.",
         "min": 1,
         "max": "1",
         "type": [
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-UpperBound-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-UpperBound-extension.json
old mode 100755
new mode 100644
index edb0806..0983e84
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-UpperBound-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-UpperBound-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.core.UpperBound"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR UpperBound Extension",
   "title": "SHR UpperBound Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.517Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.832Z",
   "description": "A measured or measurable amount with units that is known to be bounded from above by the quantity represented.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-UpperBound.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-UpperBound.json
old mode 100755
new mode 100644
index d19392a..27dab3b
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-UpperBound.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-UpperBound.json
@@ -12,8 +12,10 @@
       "value": "shr.core.UpperBound"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR UpperBound Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.407Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,10 +27,9 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.294Z",
   "description": "A measured or measurable amount with units that is known to be bounded from above by the quantity represented.",
   "purpose": "Need to able to capture all sorts of measured values, even if the measured value are not precisely quantified. Values include exact measures such as 3.51g, customary units such as 3 tablets, and currencies such as $100.32USD.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "v2",
@@ -53,7 +54,7 @@
         "path": "Quantity",
         "short": "SHR UpperBound Profile",
         "definition": "A measured or measurable amount with units that is known to be bounded from above by the quantity represented.",
-        "comments": "The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.",
+        "comment": "The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.",
         "min": 0,
         "max": "*",
         "condition": [
@@ -121,9 +122,19 @@
       {
         "id": "Quantity:shr-core-UpperBound.extension",
         "path": "Quantity.extension",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -152,7 +163,7 @@
         "path": "Quantity.value",
         "short": "Numerical value (with implicit precision)",
         "definition": "The value of the measured amount. The value includes an implicit precision in the presentation of the value.",
-        "comments": "The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).",
+        "comment": "The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).",
         "requirements": "Precision is handled implicitly in almost all cases of measurement.",
         "min": 1,
         "max": "1",
@@ -178,7 +189,7 @@
         "path": "Quantity.comparator",
         "short": "< | <= | >= | > - how to understand the value",
         "definition": "How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is \"<\" , then the real value is < stated value.",
-        "comments": "This is labeled as \"Is Modifier\" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value.",
+        "comment": "This is labeled as \"Is Modifier\" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value.",
         "requirements": "Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.",
         "min": 1,
         "max": "1",
@@ -192,9 +203,8 @@
         "isSummary": true,
         "binding": {
           "strength": "required",
-          "description": "How the Quantity should be understood and represented.",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/quantity-comparator"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/UpperBoundTypeVS"
           }
         },
         "mapping": [
@@ -210,6 +220,12 @@
       },
       {
         "id": "Quantity:shr-core-UpperBound.unit",
+        "extension": [
+          {
+            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
+            "valueBoolean": true
+          }
+        ],
         "path": "Quantity.unit",
         "short": "Unit representation",
         "definition": "A human-readable form of the unit.",
@@ -266,7 +282,7 @@
         "path": "Quantity.code",
         "short": "Coded form of the unit",
         "definition": "A computer processable form of the unit in some unit representation system.",
-        "comments": "The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency.  The context of use may additionally require a code from a particular system.",
+        "comment": "The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency.  The context of use may additionally require a code from a particular system.",
         "requirements": "Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.",
         "min": 0,
         "max": "1",
@@ -307,7 +323,13 @@
         "id": "Quantity:shr-core-UpperBound.comparator",
         "path": "Quantity.comparator",
         "min": 1,
-        "max": "1"
+        "max": "1",
+        "binding": {
+          "strength": "required",
+          "valueSetReference": {
+            "reference": "http://standardhealthrecord.org/shr/core/vs/UpperBoundTypeVS"
+          }
+        }
       }
     ]
   }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-Volume-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-Volume-extension.json
old mode 100755
new mode 100644
index 721d9fe..f927c76
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-Volume-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-Volume-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.core.Volume"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Volume Extension",
   "title": "SHR Volume Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.120Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.520Z",
   "description": "The amount of three dimensional space occupied by an object or the capacity of a space or container.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-core-Width-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-core-Width-extension.json
old mode 100755
new mode 100644
index 7a77303..2af542e
--- a/lib/resources/standard_health_record/StructureDefinition-shr-core-Width-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-core-Width-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.core.Width"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Width Extension",
   "title": "SHR Width Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.120Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.520Z",
   "description": "The measurement or extent of something from side to side.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-demographics-CountryOfIssue-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-demographics-CountryOfIssue-extension.json
old mode 100755
new mode 100644
index 5b6db48..f5d5ade
--- a/lib/resources/standard_health_record/StructureDefinition-shr-demographics-CountryOfIssue-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-demographics-CountryOfIssue-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.demographics.CountryOfIssue"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR CountryOfIssue Extension",
   "title": "SHR CountryOfIssue Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.469Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.328Z",
   "description": "A country acting as an assuing authority for a document.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -105,9 +106,12 @@
         "id": "Extension:countryofissue.extension",
         "path": "Extension.extension",
         "slicing": {
-          "id": "197",
+          "id": "192",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -161,7 +165,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-demographics-DriversLicenseNumber-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-demographics-DriversLicenseNumber-extension.json
old mode 100755
new mode 100644
index 808cfba..a22fe26
--- a/lib/resources/standard_health_record/StructureDefinition-shr-demographics-DriversLicenseNumber-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-demographics-DriversLicenseNumber-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.demographics.DriversLicenseNumber"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR DriversLicenseNumber Extension",
   "title": "SHR DriversLicenseNumber Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.469Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.328Z",
   "description": "Identifying information from a drivers license.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -105,9 +106,12 @@
         "id": "Extension:driverslicensenumber.extension",
         "path": "Extension.extension",
         "slicing": {
-          "id": "194",
+          "id": "189",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -213,7 +217,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-demographics-FamilialRelationship-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-demographics-FamilialRelationship-extension.json
old mode 100755
new mode 100644
index 6a67655..b7c3172
--- a/lib/resources/standard_health_record/StructureDefinition-shr-demographics-FamilialRelationship-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-demographics-FamilialRelationship-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.demographics.FamilialRelationship"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR FamilialRelationship Extension",
   "title": "SHR FamilialRelationship Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.469Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.328Z",
   "description": "The relationship of the subject to another person in the same (extended) family. May or may not be a blood relative (determined by value). Can be used to indicate there is no relation of the given type (e.g., no siblings), using the NonOccurrenceModifier.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -111,9 +112,12 @@
         "id": "Extension:familialrelationship.extension",
         "path": "Extension.extension",
         "slicing": {
-          "id": "198",
+          "id": "193",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -251,7 +255,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-demographics-FathersName-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-demographics-FathersName-extension.json
old mode 100755
new mode 100644
index 5115e49..bc399f6
--- a/lib/resources/standard_health_record/StructureDefinition-shr-demographics-FathersName-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-demographics-FathersName-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.demographics.FathersName"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR FathersName Extension",
   "title": "SHR FathersName Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.469Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.328Z",
   "description": "The name of the father as it was or likely to have been recorded on the birth certificate of the subject; most likely the name of the father at the time of birth of the subject.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-demographics-HealthInsurance.json b/lib/resources/standard_health_record/StructureDefinition-shr-demographics-HealthInsurance.json
old mode 100755
new mode 100644
index cf37a5b..a876242
--- a/lib/resources/standard_health_record/StructureDefinition-shr-demographics-HealthInsurance.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-demographics-HealthInsurance.json
@@ -12,8 +12,10 @@
       "value": "shr.demographics.HealthInsurance"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR HealthInsurance Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.485Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,15 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.336Z",
   "description": "Health insurance coverage available (even if not used for payment for a given encounter).",
   "purpose": "Health care programs and insurers are significant payors of health service costs.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
     {
       "identity": "rim",
       "uri": "http://hl7.org/v3",
@@ -109,6 +115,10 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
           {
             "identity": "rim",
             "map": "Coverage"
@@ -124,7 +134,7 @@
         "path": "Coverage.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -163,7 +173,7 @@
         "path": "Coverage.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -184,7 +194,7 @@
         "path": "Coverage.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -204,6 +214,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -218,7 +236,7 @@
         "path": "Coverage.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -252,7 +270,7 @@
         "path": "Coverage.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -282,7 +300,7 @@
         "path": "Coverage.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -311,7 +329,7 @@
         "path": "Coverage.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -351,6 +369,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "cdanetv4",
             "map": "C02"
@@ -374,6 +396,7 @@
         "path": "Coverage.status",
         "short": "active | cancelled | draft | entered-in-error",
         "definition": "The status of the resource instance.",
+        "comment": "This element is labeled as a modifier because the status contains the code entered-in-error that marks the coverage as not currently valid.",
         "min": 0,
         "max": "1",
         "type": [
@@ -384,6 +407,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "CoverageStatus"
+            }
+          ],
           "strength": "required",
           "description": "A code specifying the state of the resource instance.",
           "valueSetReference": {
@@ -391,6 +420,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
           {
             "identity": "w5",
             "map": "status"
@@ -400,7 +433,7 @@
       {
         "id": "Coverage:shr-demographics-HealthInsurance.type",
         "path": "Coverage.type",
-        "short": "Type of coverage",
+        "short": "Type of coverage such as medical or accident",
         "definition": "The type of coverage: social program, medical plan, accident coverage (workers compensation, auto), group health or payment by an individual or organization.",
         "requirements": "The order of application of coverages is dependent on the types of coverage.",
         "min": 1,
@@ -415,7 +448,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-demographics-InsuranceProviderTypeVS"
+            "reference": "http://standardhealthrecord.org/shr/demographics/vs/InsuranceProviderTypeVS"
           }
         },
         "mapping": [
@@ -554,6 +587,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "cdanetv4",
             "map": "D01 through D09"
@@ -586,6 +623,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Relationship"
+            }
+          ],
           "strength": "example",
           "description": "The relationship between the Policyholder and the Beneficiary (insured/covered party/patient).",
           "valueSetReference": {
@@ -614,6 +657,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence"
+          },
           {
             "identity": "v2",
             "map": "IN1-12 / IN1-13"
@@ -667,14 +714,14 @@
         ]
       },
       {
-        "id": "Coverage:shr-demographics-HealthInsurance.group",
+        "id": "Coverage:shr-demographics-HealthInsurance.grouping",
         "extension": [
           {
             "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
             "valueString": "Group"
           }
         ],
-        "path": "Coverage.group",
+        "path": "Coverage.grouping",
         "short": "Additional coverage classifications",
         "definition": "A suite of underwrite specific classifiers, for example may be used to identify a class of coverage or employer group, Policy, Plan.",
         "min": 0,
@@ -696,8 +743,8 @@
         ]
       },
       {
-        "id": "Coverage:shr-demographics-HealthInsurance.group.id",
-        "path": "Coverage.group.id",
+        "id": "Coverage:shr-demographics-HealthInsurance.grouping.id",
+        "path": "Coverage.grouping.id",
         "representation": [
           "xmlAttr"
         ],
@@ -723,11 +770,11 @@
         ]
       },
       {
-        "id": "Coverage:shr-demographics-HealthInsurance.group.extension",
-        "path": "Coverage.group.extension",
+        "id": "Coverage:shr-demographics-HealthInsurance.grouping.extension",
+        "path": "Coverage.grouping.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -752,11 +799,11 @@
         ]
       },
       {
-        "id": "Coverage:shr-demographics-HealthInsurance.group.modifierExtension",
-        "path": "Coverage.group.modifierExtension",
+        "id": "Coverage:shr-demographics-HealthInsurance.grouping.modifierExtension",
+        "path": "Coverage.grouping.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -784,8 +831,8 @@
         ]
       },
       {
-        "id": "Coverage:shr-demographics-HealthInsurance.group.group",
-        "path": "Coverage.group.group",
+        "id": "Coverage:shr-demographics-HealthInsurance.grouping.group",
+        "path": "Coverage.grouping.group",
         "short": "An identifier for the group",
         "definition": "Identifies a style or collective of coverage issued by the underwriter, for example may be used to identify an employer group. May also be referred to as a Policy or Group ID.",
         "min": 0,
@@ -812,8 +859,8 @@
         ]
       },
       {
-        "id": "Coverage:shr-demographics-HealthInsurance.group.groupDisplay",
-        "path": "Coverage.group.groupDisplay",
+        "id": "Coverage:shr-demographics-HealthInsurance.grouping.groupDisplay",
+        "path": "Coverage.grouping.groupDisplay",
         "short": "Display text for an identifier for the group",
         "definition": "A short description for the group.",
         "min": 0,
@@ -840,8 +887,8 @@
         ]
       },
       {
-        "id": "Coverage:shr-demographics-HealthInsurance.group.subGroup",
-        "path": "Coverage.group.subGroup",
+        "id": "Coverage:shr-demographics-HealthInsurance.grouping.subGroup",
+        "path": "Coverage.grouping.subGroup",
         "short": "An identifier for the subsection of the group",
         "definition": "Identifies a style or collective of coverage issued by the underwriter, for example may be used to identify a subset of an employer group.",
         "min": 0,
@@ -860,8 +907,8 @@
         ]
       },
       {
-        "id": "Coverage:shr-demographics-HealthInsurance.group.subGroupDisplay",
-        "path": "Coverage.group.subGroupDisplay",
+        "id": "Coverage:shr-demographics-HealthInsurance.grouping.subGroupDisplay",
+        "path": "Coverage.grouping.subGroupDisplay",
         "short": "Display text for the subsection of the group",
         "definition": "A short description for the subgroup.",
         "min": 0,
@@ -880,8 +927,8 @@
         ]
       },
       {
-        "id": "Coverage:shr-demographics-HealthInsurance.group.plan",
-        "path": "Coverage.group.plan",
+        "id": "Coverage:shr-demographics-HealthInsurance.grouping.plan",
+        "path": "Coverage.grouping.plan",
         "short": "An identifier for the plan",
         "definition": "Identifies a style or collective of coverage issued by the underwriter, for example may be used to identify a collection of benefits provided to employees. May be referred to as a Section or Division ID.",
         "min": 0,
@@ -904,8 +951,8 @@
         ]
       },
       {
-        "id": "Coverage:shr-demographics-HealthInsurance.group.planDisplay",
-        "path": "Coverage.group.planDisplay",
+        "id": "Coverage:shr-demographics-HealthInsurance.grouping.planDisplay",
+        "path": "Coverage.grouping.planDisplay",
         "short": "Display text for the plan",
         "definition": "A short description for the plan.",
         "min": 0,
@@ -928,8 +975,8 @@
         ]
       },
       {
-        "id": "Coverage:shr-demographics-HealthInsurance.group.subPlan",
-        "path": "Coverage.group.subPlan",
+        "id": "Coverage:shr-demographics-HealthInsurance.grouping.subPlan",
+        "path": "Coverage.grouping.subPlan",
         "short": "An identifier for the subsection of the plan",
         "definition": "Identifies a sub-style or sub-collective of coverage issued by the underwriter, for example may be used to identify a subset of a collection of benefits provided to employees.",
         "min": 0,
@@ -948,8 +995,8 @@
         ]
       },
       {
-        "id": "Coverage:shr-demographics-HealthInsurance.group.subPlanDisplay",
-        "path": "Coverage.group.subPlanDisplay",
+        "id": "Coverage:shr-demographics-HealthInsurance.grouping.subPlanDisplay",
+        "path": "Coverage.grouping.subPlanDisplay",
         "short": "Display text for the subsection of the plan",
         "definition": "A short description for the subplan.",
         "min": 0,
@@ -968,10 +1015,10 @@
         ]
       },
       {
-        "id": "Coverage:shr-demographics-HealthInsurance.group.class",
-        "path": "Coverage.group.class",
+        "id": "Coverage:shr-demographics-HealthInsurance.grouping.class",
+        "path": "Coverage.grouping.class",
         "short": "An identifier for the class",
-        "definition": "Identifies a style or collective of coverage issues by the underwriter, for example may be used to identify a class of coverage or employer group.",
+        "definition": "Identifies a style or collective of coverage issues by the underwriter, for example may be used to identify a class of coverage such as a level of deductables or co-payment.",
         "min": 0,
         "max": "1",
         "type": [
@@ -992,8 +1039,8 @@
         ]
       },
       {
-        "id": "Coverage:shr-demographics-HealthInsurance.group.classDisplay",
-        "path": "Coverage.group.classDisplay",
+        "id": "Coverage:shr-demographics-HealthInsurance.grouping.classDisplay",
+        "path": "Coverage.grouping.classDisplay",
         "short": "Display text for the class",
         "definition": "A short description for the class.",
         "min": 0,
@@ -1016,10 +1063,10 @@
         ]
       },
       {
-        "id": "Coverage:shr-demographics-HealthInsurance.group.subClass",
-        "path": "Coverage.group.subClass",
+        "id": "Coverage:shr-demographics-HealthInsurance.grouping.subClass",
+        "path": "Coverage.grouping.subClass",
         "short": "An identifier for the subsection of the class",
-        "definition": "Identifies a sub-style or sub-collective of coverage issues by the underwriter, for example may be used to identify a subclass of coverage or employer group.",
+        "definition": "Identifies a sub-style or sub-collective of coverage issues by the underwriter, for example may be used to identify a subclass of coverage such as a sub-level of deductables or co-payment.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1040,8 +1087,8 @@
         ]
       },
       {
-        "id": "Coverage:shr-demographics-HealthInsurance.group.subClassDisplay",
-        "path": "Coverage.group.subClassDisplay",
+        "id": "Coverage:shr-demographics-HealthInsurance.grouping.subClassDisplay",
+        "path": "Coverage.grouping.subClassDisplay",
         "short": "Display text for the subsection of the subclass",
         "definition": "A short description for the subclass.",
         "min": 0,
@@ -1205,7 +1252,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-demographics-InsuranceProviderTypeVS"
+            "reference": "http://standardhealthrecord.org/shr/demographics/vs/InsuranceProviderTypeVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-demographics-HomeTelephoneNumber.json b/lib/resources/standard_health_record/StructureDefinition-shr-demographics-HomeTelephoneNumber.json
old mode 100755
new mode 100644
index f01dabc..6471939
--- a/lib/resources/standard_health_record/StructureDefinition-shr-demographics-HomeTelephoneNumber.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-demographics-HomeTelephoneNumber.json
@@ -3,7 +3,7 @@
   "id": "shr-demographics-HomeTelephoneNumber",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR HomeTelephoneNumber Profile</b></p>\n  <p>A telephone number associated with a person&#039;s residence.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.demographics.HomeTelephoneNumber maps to ContactPoint:\n  TelecomNumberOrAddress maps to value\n  TelecomType maps to system\n  TelecomQualifier maps to use\n  EffectiveTimePeriod maps to period\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR HomeTelephoneNumber Profile</b></p>\n  <p>A telephone number associated with a person's residence.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.demographics.HomeTelephoneNumber maps to ContactPoint:\n  TelecomNumberOrAddress maps to value\n  TelecomType maps to system\n  TelecomQualifier maps to use\n  EffectiveTimePeriod maps to period\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-demographics-HomeTelephoneNumber",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.demographics.HomeTelephoneNumber"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR HomeTelephoneNumber Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.477Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,10 +27,9 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.332Z",
   "description": "A telephone number associated with a person's residence.",
   "purpose": "Need to track phone, fax, mobile, sms numbers, email addresses, twitter tags, etc.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "v2",
@@ -130,16 +131,18 @@
         "id": "ContactPoint:shr-demographics-HomeTelephoneNumber.extension",
         "path": "ContactPoint.extension",
         "slicing": {
-          "id": "203",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
-          "ordered": false,
+          "description": "Extensions are always sliced by (at least) url",
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -167,7 +170,18 @@
         "id": "ContactPoint:shr-demographics-HomeTelephoneNumber.extension:telecomtypeother",
         "path": "ContactPoint.extension",
         "sliceName": "telecomtypeother",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
         "definition": "Specification of the type of telecom channel, if the TelecomType is other.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -198,7 +212,7 @@
       {
         "id": "ContactPoint:shr-demographics-HomeTelephoneNumber.system",
         "path": "ContactPoint.system",
-        "short": "phone | fax | email | pager | url | other",
+        "short": "phone | fax | email | pager | url | sms | other",
         "definition": "Telecommunications form for contact point - what communications system is required to make use of the contact.",
         "min": 1,
         "max": "1",
@@ -212,6 +226,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ContactPointSystem"
+            }
+          ],
           "strength": "required",
           "description": "Telecommunications form for contact point",
           "valueSetReference": {
@@ -238,7 +258,7 @@
         "path": "ContactPoint.value",
         "short": "The actual contact point details",
         "definition": "The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).",
-        "comments": "Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.",
+        "comment": "Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.",
         "requirements": "Need to support legacy numbers that are not in a tightly controlled format.",
         "min": 1,
         "max": "1",
@@ -267,16 +287,19 @@
         "id": "ContactPoint:shr-demographics-HomeTelephoneNumber.use",
         "path": "ContactPoint.use",
         "slicing": {
-          "id": "202",
+          "id": "195",
           "discriminator": [
-            "value"
+            {
+              "type": "value",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "home | work | temp | old | mobile - purpose of this contact point",
         "definition": "Identifies the purpose for the contact point.",
-        "comments": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary or old contact etc.for a current/permanent one. Applications can assume that a contact is current unless it explicitly says that it is temporary or old.",
+        "comment": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary or old contact etc.for a current/permanent one. Applications can assume that a contact is current unless it explicitly says that it is temporary or old.",
         "requirements": "Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.",
         "min": 0,
         "max": "1",
@@ -288,6 +311,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ContactPointUse"
+            }
+          ],
           "strength": "required",
           "description": "Use of contact point",
           "valueSetReference": {
@@ -327,7 +356,7 @@
         "path": "ContactPoint.rank",
         "short": "Specify preferred order of use (1 = highest)",
         "definition": "Specifies a preferred order in which to use a set of contacts. Contacts are ranked with lower values coming before higher values.",
-        "comments": "Note that rank does not necessarily follow the order in which the contacts are represented in the instance.",
+        "comment": "Note that rank does not necessarily follow the order in which the contacts are represented in the instance.",
         "min": 0,
         "max": "1",
         "type": [
@@ -368,7 +397,7 @@
           },
           {
             "identity": "rim",
-            "map": "./useablePeriod[type=\"IVL<TS>\"]"
+            "map": "./usablePeriod[type=\"IVL<TS>\"]"
           },
           {
             "identity": "servd",
@@ -418,9 +447,12 @@
         "id": "ContactPoint:shr-demographics-HomeTelephoneNumber.use",
         "path": "ContactPoint.use",
         "slicing": {
-          "id": "202",
+          "id": "195",
           "discriminator": [
-            "value"
+            {
+              "type": "value",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-demographics-PassportNumber-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-demographics-PassportNumber-extension.json
old mode 100755
new mode 100644
index 15abf81..640df99
--- a/lib/resources/standard_health_record/StructureDefinition-shr-demographics-PassportNumber-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-demographics-PassportNumber-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.demographics.PassportNumber"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR PassportNumber Extension",
   "title": "SHR PassportNumber Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.469Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.328Z",
   "description": "Indicator of citizenship and identity.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -105,9 +106,12 @@
         "id": "Extension:passportnumber.extension",
         "path": "Extension.extension",
         "slicing": {
-          "id": "196",
+          "id": "191",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -213,7 +217,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-demographics-PersonOfRecord-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-demographics-PersonOfRecord-extension.json
old mode 100755
new mode 100644
index b8aff4e..3e83455
--- a/lib/resources/standard_health_record/StructureDefinition-shr-demographics-PersonOfRecord-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-demographics-PersonOfRecord-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.demographics.PersonOfRecord"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR PersonOfRecord Extension",
   "title": "SHR PersonOfRecord Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.350Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.281Z",
   "description": "Extended demographic information about the subject of this SHR.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-demographics-PersonOfRecord.json b/lib/resources/standard_health_record/StructureDefinition-shr-demographics-PersonOfRecord.json
old mode 100755
new mode 100644
index 696a84f..7e3d294
--- a/lib/resources/standard_health_record/StructureDefinition-shr-demographics-PersonOfRecord.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-demographics-PersonOfRecord.json
@@ -12,8 +12,10 @@
       "value": "shr.demographics.PersonOfRecord"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR PersonOfRecord Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.464Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,10 +27,9 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.326Z",
   "description": "Extended demographic information about the subject of this SHR.",
   "purpose": "Tracking patient is the center of the healthcare process.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "rim",
@@ -131,7 +132,7 @@
         "path": "Patient.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -170,7 +171,7 @@
         "path": "Patient.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -191,7 +192,7 @@
         "path": "Patient.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -211,6 +212,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -225,7 +234,7 @@
         "path": "Patient.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -259,7 +268,7 @@
         "path": "Patient.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -288,16 +297,19 @@
         "id": "Patient:shr-demographics-PersonOfRecord.extension",
         "path": "Patient.extension",
         "slicing": {
-          "id": "199",
+          "id": "194",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -326,6 +338,7 @@
         "path": "Patient.extension",
         "sliceName": "placeofbirth",
         "definition": "The location of a birth event. There may be multiple entries, but a person has only one place of birth.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -358,6 +371,7 @@
         "path": "Patient.extension",
         "sliceName": "medicalinterpreterneeded",
         "definition": "Whether the subject requires an interpreter to communicate with an English-speaking provider.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -390,6 +404,7 @@
         "path": "Patient.extension",
         "sliceName": "mothersmaidenname",
         "definition": "The name of the mother as it was or likely to have been recorded on the birth certificate of the subject. This is most likely the name prior to marriage of the mother (aka the maiden name).",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -422,6 +437,7 @@
         "path": "Patient.extension",
         "sliceName": "birthsex",
         "definition": "Administrative sex assigned at birth and recorded on birth certificate.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -454,6 +470,7 @@
         "path": "Patient.extension",
         "sliceName": "ethnicity",
         "definition": "Indicator of Hispanic or Latino origin.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -486,6 +503,7 @@
         "path": "Patient.extension",
         "sliceName": "race",
         "definition": "Subjective association of a person with a named category of humans sharing common history, traits, place of family origin, nationality, tribe, or other inherited background.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -518,6 +536,7 @@
         "path": "Patient.extension",
         "sliceName": "anonymized",
         "definition": "Flag indicating if personally identifiable information has been withheld.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -550,6 +569,7 @@
         "path": "Patient.extension",
         "sliceName": "fictionalperson",
         "definition": "Flag indicating if this record represents a fictional (synthetic, not real) person.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -582,6 +602,7 @@
         "path": "Patient.extension",
         "sliceName": "fathersname",
         "definition": "The name of the father as it was or likely to have been recorded on the birth certificate of the subject; most likely the name of the father at the time of birth of the subject.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -614,6 +635,7 @@
         "path": "Patient.extension",
         "sliceName": "socialsecuritynumber",
         "definition": "A US social security number (SSN).",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -646,6 +668,7 @@
         "path": "Patient.extension",
         "sliceName": "driverslicensenumber",
         "definition": "Identifying information from a drivers license.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -678,6 +701,7 @@
         "path": "Patient.extension",
         "sliceName": "passportnumber",
         "definition": "Indicator of citizenship and identity.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -710,6 +734,7 @@
         "path": "Patient.extension",
         "sliceName": "familialrelationship",
         "definition": "The relationship of the subject to another person in the same (extended) family. May or may not be a blood relative (determined by value). Can be used to indicate there is no relation of the given type (e.g., no siblings), using the NonOccurrenceModifier.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -742,7 +767,7 @@
         "path": "Patient.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -805,7 +830,7 @@
         "path": "Patient.active",
         "short": "Whether this patient's record is in active use",
         "definition": "Whether this patient record is in active use.",
-        "comments": "Default is true. If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient.",
+        "comment": "Default is true. If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient\n\nThis element is labeled as a modifier because when the patient record is marked as not active it is not expected to be used/referenced without being changed back to active.",
         "requirements": "Need to be able to mark a patient record as not to be used because it was created in error.",
         "min": 0,
         "max": "1",
@@ -837,7 +862,7 @@
         "path": "Patient.name",
         "short": "A name associated with the patient",
         "definition": "A name associated with the individual.",
-        "comments": "A patient may have multiple names with different uses or applicable periods. For animals, the name is a \"HumanName\" in the sense that is assigned and used by humans and has the same patterns.",
+        "comment": "A patient may have multiple names with different uses or applicable periods. For animals, the name is a \"HumanName\" in the sense that is assigned and used by humans and has the same patterns.",
         "requirements": "Need to be able to track the patient by multiple names. Examples are your official name and a partner name.",
         "min": 0,
         "max": "*",
@@ -868,7 +893,7 @@
         "path": "Patient.telecom",
         "short": "A contact detail for the individual",
         "definition": "A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted.",
-        "comments": "A Patient may have multiple ways to be contacted with different uses or applicable periods.  May need to have options for contacting the person urgently and also to help with identification. The address may not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).",
+        "comment": "A Patient may have multiple ways to be contacted with different uses or applicable periods.  May need to have options for contacting the person urgently and also to help with identification. The address may not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone).",
         "requirements": "People have (primary) ways to contact them in some way such as phone, email.",
         "min": 1,
         "max": "*",
@@ -899,7 +924,7 @@
         "path": "Patient.gender",
         "short": "male | female | other | unknown",
         "definition": "Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes.",
-        "comments": "The gender may not match the biological sex as determined by genetics, or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than M and F, though the vast majority of systems and contexts only support M and F.  Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific gender aspect of interest (anatomical, chromosonal, social, etc.)  However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice.  Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosonal and other gender aspects.  For example, an alert about a hysterectomy on a male should be handled as a warning or overrideable error, not a \"hard\" error.",
+        "comment": "The gender may not match the biological sex as determined by genetics, or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than M and F, though the vast majority of systems and contexts only support M and F.  Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific gender aspect of interest (anatomical, chromosonal, social, etc.)  However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice.  Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosonal and other gender aspects.  For example, an alert about a hysterectomy on a male should be handled as a warning or overrideable error, not a \"hard\" error.",
         "requirements": "Needed for identification of the individual, in combination with (at least) name and birth date. Gender of individual drives many clinical processes.",
         "min": 1,
         "max": "1",
@@ -910,6 +935,16 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AdministrativeGender"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
+            }
+          ],
           "strength": "required",
           "description": "The gender of a person used for administrative purposes.",
           "valueSetReference": {
@@ -936,7 +971,7 @@
         "path": "Patient.birthDate",
         "short": "The date of birth for the individual",
         "definition": "The date of birth for the individual.",
-        "comments": "At least an estimated year should be provided as a guess if the real DOB is unknown  There is a standard extension \"patient-birthTime\" available that should be used where Time is required (such as in maternaty/infant care systems).",
+        "comment": "At least an estimated year should be provided as a guess if the real DOB is unknown  There is a standard extension \"patient-birthTime\" available that should be used where Time is required (such as in maternaty/infant care systems).",
         "requirements": "Age of the individual drives many clinical processes.",
         "min": 1,
         "max": "1",
@@ -970,7 +1005,7 @@
         "path": "Patient.deceased[x]",
         "short": "Indicates if the individual is deceased or not",
         "definition": "Indicates if the individual is deceased or not.",
-        "comments": "If there's no value in the instance it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.",
+        "comment": "If there's no value in the instance it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.\n\nThis element is labeled as a modifier because once a patient is marked as deceased, the actions that are appropriate to perform on the patient may be significantly different.",
         "requirements": "The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive.",
         "min": 0,
         "max": "1",
@@ -1001,7 +1036,7 @@
         "path": "Patient.address",
         "short": "Addresses for the individual",
         "definition": "Addresses for the individual.",
-        "comments": "Patient may have multiple addresses with different uses or applicable periods.",
+        "comment": "Patient may have multiple addresses with different uses or applicable periods.",
         "requirements": "May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification.",
         "min": 1,
         "max": "*",
@@ -1042,6 +1077,16 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MaritalStatus"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
+            }
+          ],
           "strength": "extensible",
           "description": "The domestic partnership status of a person.",
           "valueSetReference": {
@@ -1068,7 +1113,7 @@
         "path": "Patient.multipleBirth[x]",
         "short": "Whether patient is part of a multiple birth",
         "definition": "Indicates whether the patient is part of a multiple (bool) or indicates the actual birth order (integer).",
-        "comments": "Where the valueInteger is provided, the number is the birth number in the sequence.\nE.g. The middle birth in tripplets would be valueInteger=2 and the third born would have valueInteger=3\nIf a bool value was provided for this tripplets examle, then all 3 patient records would have valueBool=true (the ordering is not indicated).",
+        "comment": "Where the valueInteger is provided, the number is the birth number in the sequence.\nE.g. The middle birth in tripplets would be valueInteger=2 and the third born would have valueInteger=3\nIf a bool value was provided for this tripplets examle, then all 3 patient records would have valueBool=true (the ordering is not indicated).",
         "requirements": "For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs.",
         "min": 1,
         "max": "1",
@@ -1134,7 +1179,7 @@
         "path": "Patient.contact",
         "short": "A contact party (e.g. guardian, partner, friend) for the patient",
         "definition": "A contact party (e.g. guardian, partner, friend) for the patient.",
-        "comments": "Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact.",
+        "comment": "Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact.",
         "requirements": "Need to track people you can contact about the patient.",
         "min": 0,
         "max": "*",
@@ -1203,7 +1248,7 @@
         "path": "Patient.contact.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1232,7 +1277,7 @@
         "path": "Patient.contact.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1273,6 +1318,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ContactRelationship"
+            }
+          ],
           "strength": "extensible",
           "description": "The nature of the relationship between a patient and a contact person for that patient.",
           "valueSetReference": {
@@ -1327,7 +1378,7 @@
         "path": "Patient.contact.telecom",
         "short": "A contact detail for the person",
         "definition": "A contact detail for the person, e.g. a telephone number or an email address.",
-        "comments": "Contact may have multiple ways to be contacted with different uses or applicable periods.  May need to have options for contacting the person urgently, and also to help with identification.",
+        "comment": "Contact may have multiple ways to be contacted with different uses or applicable periods.  May need to have options for contacting the person urgently, and also to help with identification.",
         "requirements": "People have (primary) ways to contact them in some way such as phone, email.",
         "min": 0,
         "max": "*",
@@ -1393,6 +1444,16 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AdministrativeGender"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
+            }
+          ],
           "strength": "required",
           "description": "The gender of a person used for administrative purposes.",
           "valueSetReference": {
@@ -1480,7 +1541,7 @@
         "path": "Patient.animal",
         "short": "This patient is known to be an animal (non-human)",
         "definition": "This patient is known to be an animal.",
-        "comments": "The animal element is labeled \"Is Modifier\" since patients may be non-human. Systems SHALL either handle patient details appropriately (e.g. inform users patient is not human) or reject declared animal records.   The absense of the animal element does not imply that the patient is a human. If a system requires such a positive assertion that the patient is human, an extension will be required.  (Do not use a species of homo-sapiens in animal species, as this would incorrectly infer that the patient is an animal).",
+        "comment": "The animal element is labeled \"Is Modifier\" since patients may be non-human. Systems SHALL either handle patient details appropriately (e.g. inform users patient is not human) or reject declared animal records.   The absense of the animal element does not imply that the patient is a human. If a system requires such a positive assertion that the patient is human, an extension will be required.  (Do not use a species of homo-sapiens in animal species, as this would incorrectly infer that the patient is an animal).",
         "requirements": "Many clinical systems are extended to care for animal patients as well as human.",
         "min": 0,
         "max": "1",
@@ -1544,7 +1605,7 @@
         "path": "Patient.animal.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1573,7 +1634,7 @@
         "path": "Patient.animal.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1605,7 +1666,7 @@
         "path": "Patient.animal.species",
         "short": "E.g. Dog, Cow",
         "definition": "Identifies the high level taxonomic categorization of the kind of animal.",
-        "comments": "If the patient is non-human, at least a species SHALL be specified. Species SHALL be a widely recognised taxonomic classification.  It may or may not be Linnaean taxonomy and may or may not be at the level of species. If the level is finer than species--such as a breed code--the code system used SHALL allow inference of the species.  (The common example is that the word \"Hereford\" does not allow inference of the species Bos taurus, because there is a Hereford pig breed, but the SNOMED CT code for \"Hereford Cattle Breed\" does.).",
+        "comment": "If the patient is non-human, at least a species SHALL be specified. Species SHALL be a widely recognised taxonomic classification.  It may or may not be Linnaean taxonomy and may or may not be at the level of species. If the level is finer than species--such as a breed code--the code system used SHALL allow inference of the species.  (The common example is that the word \"Hereford\" does not allow inference of the species Bos taurus, because there is a Hereford pig breed, but the SNOMED CT code for \"Hereford Cattle Breed\" does.).",
         "requirements": "Need to know what kind of animal.",
         "min": 1,
         "max": "1",
@@ -1616,6 +1677,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AnimalSpecies"
+            }
+          ],
           "strength": "example",
           "description": "The species of an animal.",
           "valueSetReference": {
@@ -1642,7 +1709,7 @@
         "path": "Patient.animal.breed",
         "short": "E.g. Poodle, Angus",
         "definition": "Identifies the detailed categorization of the kind of animal.",
-        "comments": "Breed MAY be used to provide further taxonomic or non-taxonomic classification.  It may involve local or proprietary designation--such as commercial strain--and/or additional information such as production type.",
+        "comment": "Breed MAY be used to provide further taxonomic or non-taxonomic classification.  It may involve local or proprietary designation--such as commercial strain--and/or additional information such as production type.",
         "requirements": "May need to know the specific kind within the species.",
         "min": 0,
         "max": "1",
@@ -1653,6 +1720,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AnimalBreed"
+            }
+          ],
           "strength": "example",
           "description": "The breed of an animal.",
           "valueSetReference": {
@@ -1689,6 +1762,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AnimalGenderStatus"
+            }
+          ],
           "strength": "example",
           "description": "The state of the animal's reproductive organs.",
           "valueSetReference": {
@@ -1715,7 +1794,7 @@
         "path": "Patient.communication",
         "short": "A list of Languages which may be used to communicate with the patient about his or her health",
         "definition": "Languages which may be used to communicate with the patient about his or her health.",
-        "comments": "If no language is specified, this *implies* that the default local language is spoken.  If you need to convey proficiency for multiple modes then you need multiple Patient.Communication associations.   For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required.",
+        "comment": "If no language is specified, this *implies* that the default local language is spoken.  If you need to convey proficiency for multiple modes then you need multiple Patient.Communication associations.   For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required.",
         "requirements": "If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency is an important things to keep track of both for patient and other persons of interest.",
         "min": 1,
         "max": "*",
@@ -1777,7 +1856,7 @@
         "path": "Patient.communication.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1806,7 +1885,7 @@
         "path": "Patient.communication.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1838,7 +1917,7 @@
         "path": "Patient.communication.language",
         "short": "The language which can be used to communicate with the patient about his or her health",
         "definition": "The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. \"en\" for English, or \"en-US\" for American English versus \"en-EN\" for England English.",
-        "comments": "The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.",
+        "comment": "The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.",
         "requirements": "Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect.",
         "min": 1,
         "max": "1",
@@ -1854,6 +1933,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -1882,7 +1969,7 @@
         "path": "Patient.communication.preferred",
         "short": "Language preference indicator",
         "definition": "Indicates whether or not the patient prefers this language (over other languages he masters up a certain level).",
-        "comments": "This language is specifically identified for communicating healthcare information.",
+        "comment": "This language is specifically identified for communicating healthcare information.",
         "requirements": "People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method.",
         "min": 0,
         "max": "1",
@@ -1911,7 +1998,7 @@
         "path": "Patient.generalPractitioner",
         "short": "Patient's nominated primary care provider",
         "definition": "Patient's nominated care provider.",
-        "comments": "This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disablity setting, or even organization that will provide people to perform the care provider roles.\n\nIt is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources.",
+        "comment": "This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disablity setting, or even organization that will provide people to perform the care provider roles.\n\nIt is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources.",
         "alias": [
           "careProvider"
         ],
@@ -1947,7 +2034,7 @@
         "path": "Patient.managingOrganization",
         "short": "Organization that is the custodian of the patient record",
         "definition": "Organization that is the custodian of the patient record.",
-        "comments": "There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association).",
+        "comment": "There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association).",
         "requirements": "Need to know who recognizes this patient record, manages and updates it.",
         "min": 0,
         "max": "1",
@@ -1974,7 +2061,7 @@
         "path": "Patient.link",
         "short": "Link to another patient resource that concerns the same actual person",
         "definition": "Link to another patient resource that concerns the same actual patient.",
-        "comments": "There is no assumption that linked patient records have mutual links.",
+        "comment": "There is no assumption that linked patient records have mutual links. \n\nThis element is labelled as a modifier because it may not be the main Patient resource, and the referenced patient should be used instead of this Patient record. This is when the link.type value is 'replaced-by'.",
         "requirements": "There are multiple usecases: \n\n* Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and * Distribution of patient information across multiple servers.",
         "min": 0,
         "max": "*",
@@ -2038,7 +2125,7 @@
         "path": "Patient.link.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -2067,7 +2154,7 @@
         "path": "Patient.link.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -2099,7 +2186,7 @@
         "path": "Patient.link.other",
         "short": "The other patient or related person resource that the link refers to",
         "definition": "The other patient resource that the link refers to.",
-        "comments": "Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual.",
+        "comment": "Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual.",
         "min": 1,
         "max": "1",
         "type": [
@@ -2112,7 +2199,6 @@
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
           }
         ],
-        "isModifier": true,
         "isSummary": true,
         "mapping": [
           {
@@ -2132,7 +2218,7 @@
       {
         "id": "Patient:shr-demographics-PersonOfRecord.link.type",
         "path": "Patient.link.type",
-        "short": "replace | refer | seealso - type of link",
+        "short": "replaced-by | replaces | refer | seealso - type of link",
         "definition": "The type of link between this patient resource and another patient resource.",
         "min": 1,
         "max": "1",
@@ -2141,9 +2227,14 @@
             "code": "code"
           }
         ],
-        "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "LinkType"
+            }
+          ],
           "strength": "required",
           "description": "The type of link between this patient resource and another patient resource.",
           "valueSetReference": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-demographics-SocialSecurityNumber-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-demographics-SocialSecurityNumber-extension.json
old mode 100755
new mode 100644
index d42bf29..cb5e6d2
--- a/lib/resources/standard_health_record/StructureDefinition-shr-demographics-SocialSecurityNumber-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-demographics-SocialSecurityNumber-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.demographics.SocialSecurityNumber"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR SocialSecurityNumber Extension",
   "title": "SHR SocialSecurityNumber Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.469Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.328Z",
   "description": "A US social security number (SSN).",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-demographics-StateOfIssue-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-demographics-StateOfIssue-extension.json
old mode 100755
new mode 100644
index fb7403d..0e38980
--- a/lib/resources/standard_health_record/StructureDefinition-shr-demographics-StateOfIssue-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-demographics-StateOfIssue-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.demographics.StateOfIssue"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR StateOfIssue Extension",
   "title": "SHR StateOfIssue Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.469Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.328Z",
   "description": "Issuing authority for a drivers license.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -105,9 +106,12 @@
         "id": "Extension:stateofissue.extension",
         "path": "Extension.extension",
         "slicing": {
-          "id": "195",
+          "id": "190",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -161,7 +165,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-demographics-Telecom.json b/lib/resources/standard_health_record/StructureDefinition-shr-demographics-Telecom.json
old mode 100755
new mode 100644
index 3532676..00ee1e9
--- a/lib/resources/standard_health_record/StructureDefinition-shr-demographics-Telecom.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-demographics-Telecom.json
@@ -12,8 +12,10 @@
       "value": "shr.demographics.Telecom"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Telecom Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.471Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,10 +27,9 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.330Z",
   "description": "An electronic means of contacting an organization or individual.",
   "purpose": "Need to track phone, fax, mobile, sms numbers, email addresses, twitter tags, etc.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "v2",
@@ -130,16 +131,18 @@
         "id": "ContactPoint:shr-demographics-Telecom.extension",
         "path": "ContactPoint.extension",
         "slicing": {
-          "id": "200",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
-          "ordered": false,
+          "description": "Extensions are always sliced by (at least) url",
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -167,7 +170,18 @@
         "id": "ContactPoint:shr-demographics-Telecom.extension:telecomtypeother",
         "path": "ContactPoint.extension",
         "sliceName": "telecomtypeother",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
         "definition": "Specification of the type of telecom channel, if the TelecomType is other.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -198,7 +212,7 @@
       {
         "id": "ContactPoint:shr-demographics-Telecom.system",
         "path": "ContactPoint.system",
-        "short": "phone | fax | email | pager | url | other",
+        "short": "phone | fax | email | pager | url | sms | other",
         "definition": "Telecommunications form for contact point - what communications system is required to make use of the contact.",
         "min": 1,
         "max": "1",
@@ -212,6 +226,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ContactPointSystem"
+            }
+          ],
           "strength": "required",
           "description": "Telecommunications form for contact point",
           "valueSetReference": {
@@ -238,7 +258,7 @@
         "path": "ContactPoint.value",
         "short": "The actual contact point details",
         "definition": "The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).",
-        "comments": "Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.",
+        "comment": "Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.",
         "requirements": "Need to support legacy numbers that are not in a tightly controlled format.",
         "min": 1,
         "max": "1",
@@ -268,7 +288,7 @@
         "path": "ContactPoint.use",
         "short": "home | work | temp | old | mobile - purpose of this contact point",
         "definition": "Identifies the purpose for the contact point.",
-        "comments": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary or old contact etc.for a current/permanent one. Applications can assume that a contact is current unless it explicitly says that it is temporary or old.",
+        "comment": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary or old contact etc.for a current/permanent one. Applications can assume that a contact is current unless it explicitly says that it is temporary or old.",
         "requirements": "Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.",
         "min": 0,
         "max": "1",
@@ -280,6 +300,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ContactPointUse"
+            }
+          ],
           "strength": "required",
           "description": "Use of contact point",
           "valueSetReference": {
@@ -306,7 +332,7 @@
         "path": "ContactPoint.rank",
         "short": "Specify preferred order of use (1 = highest)",
         "definition": "Specifies a preferred order in which to use a set of contacts. Contacts are ranked with lower values coming before higher values.",
-        "comments": "Note that rank does not necessarily follow the order in which the contacts are represented in the instance.",
+        "comment": "Note that rank does not necessarily follow the order in which the contacts are represented in the instance.",
         "min": 0,
         "max": "1",
         "type": [
@@ -347,7 +373,7 @@
           },
           {
             "identity": "rim",
-            "map": "./useablePeriod[type=\"IVL<TS>\"]"
+            "map": "./usablePeriod[type=\"IVL<TS>\"]"
           },
           {
             "identity": "servd",
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-demographics-TelecomTypeOther-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-demographics-TelecomTypeOther-extension.json
old mode 100755
new mode 100644
index 2feb860..27414bd
--- a/lib/resources/standard_health_record/StructureDefinition-shr-demographics-TelecomTypeOther-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-demographics-TelecomTypeOther-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.demographics.TelecomTypeOther"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR TelecomTypeOther Extension",
   "title": "SHR TelecomTypeOther Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.472Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.330Z",
   "description": "Specification of the type of telecom channel, if the TelecomType is other.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-demographics-TelephoneNumber.json b/lib/resources/standard_health_record/StructureDefinition-shr-demographics-TelephoneNumber.json
old mode 100755
new mode 100644
index 1ef0999..5eea229
--- a/lib/resources/standard_health_record/StructureDefinition-shr-demographics-TelephoneNumber.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-demographics-TelephoneNumber.json
@@ -12,8 +12,10 @@
       "value": "shr.demographics.TelephoneNumber"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR TelephoneNumber Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.474Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,10 +27,9 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.331Z",
   "description": "A sequence of decimal digits (0-9) that is used for identifying a destination telephone line or other device in a telephone network.",
   "purpose": "Need to track phone, fax, mobile, sms numbers, email addresses, twitter tags, etc.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "v2",
@@ -130,16 +131,18 @@
         "id": "ContactPoint:shr-demographics-TelephoneNumber.extension",
         "path": "ContactPoint.extension",
         "slicing": {
-          "id": "201",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
-          "ordered": false,
+          "description": "Extensions are always sliced by (at least) url",
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -167,7 +170,18 @@
         "id": "ContactPoint:shr-demographics-TelephoneNumber.extension:telecomtypeother",
         "path": "ContactPoint.extension",
         "sliceName": "telecomtypeother",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
         "definition": "Specification of the type of telecom channel, if the TelecomType is other.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -198,7 +212,7 @@
       {
         "id": "ContactPoint:shr-demographics-TelephoneNumber.system",
         "path": "ContactPoint.system",
-        "short": "phone | fax | email | pager | url | other",
+        "short": "phone | fax | email | pager | url | sms | other",
         "definition": "Telecommunications form for contact point - what communications system is required to make use of the contact.",
         "min": 1,
         "max": "1",
@@ -212,6 +226,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ContactPointSystem"
+            }
+          ],
           "strength": "required",
           "description": "Telecommunications form for contact point",
           "valueSetReference": {
@@ -238,7 +258,7 @@
         "path": "ContactPoint.value",
         "short": "The actual contact point details",
         "definition": "The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).",
-        "comments": "Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.",
+        "comment": "Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.",
         "requirements": "Need to support legacy numbers that are not in a tightly controlled format.",
         "min": 1,
         "max": "1",
@@ -268,7 +288,7 @@
         "path": "ContactPoint.use",
         "short": "home | work | temp | old | mobile - purpose of this contact point",
         "definition": "Identifies the purpose for the contact point.",
-        "comments": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary or old contact etc.for a current/permanent one. Applications can assume that a contact is current unless it explicitly says that it is temporary or old.",
+        "comment": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary or old contact etc.for a current/permanent one. Applications can assume that a contact is current unless it explicitly says that it is temporary or old.",
         "requirements": "Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.",
         "min": 0,
         "max": "1",
@@ -280,6 +300,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ContactPointUse"
+            }
+          ],
           "strength": "required",
           "description": "Use of contact point",
           "valueSetReference": {
@@ -306,7 +332,7 @@
         "path": "ContactPoint.rank",
         "short": "Specify preferred order of use (1 = highest)",
         "definition": "Specifies a preferred order in which to use a set of contacts. Contacts are ranked with lower values coming before higher values.",
-        "comments": "Note that rank does not necessarily follow the order in which the contacts are represented in the instance.",
+        "comment": "Note that rank does not necessarily follow the order in which the contacts are represented in the instance.",
         "min": 0,
         "max": "1",
         "type": [
@@ -347,7 +373,7 @@
           },
           {
             "identity": "rim",
-            "map": "./useablePeriod[type=\"IVL<TS>\"]"
+            "map": "./usablePeriod[type=\"IVL<TS>\"]"
           },
           {
             "identity": "servd",
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-demographics-WorkTelephoneNumber.json b/lib/resources/standard_health_record/StructureDefinition-shr-demographics-WorkTelephoneNumber.json
old mode 100755
new mode 100644
index 1d1a5af..7119235
--- a/lib/resources/standard_health_record/StructureDefinition-shr-demographics-WorkTelephoneNumber.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-demographics-WorkTelephoneNumber.json
@@ -3,7 +3,7 @@
   "id": "shr-demographics-WorkTelephoneNumber",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR WorkTelephoneNumber Profile</b></p>\n  <p>A telephone number associated with a person&#039;s residence.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.demographics.WorkTelephoneNumber maps to ContactPoint:\n  TelecomNumberOrAddress maps to value\n  TelecomType maps to system\n  TelecomQualifier maps to use\n  EffectiveTimePeriod maps to period\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR WorkTelephoneNumber Profile</b></p>\n  <p>A telephone number associated with a person's residence.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.demographics.WorkTelephoneNumber maps to ContactPoint:\n  TelecomNumberOrAddress maps to value\n  TelecomType maps to system\n  TelecomQualifier maps to use\n  EffectiveTimePeriod maps to period\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-demographics-WorkTelephoneNumber",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.demographics.WorkTelephoneNumber"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR WorkTelephoneNumber Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.479Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,10 +27,9 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.333Z",
   "description": "A telephone number associated with a person's residence.",
   "purpose": "Need to track phone, fax, mobile, sms numbers, email addresses, twitter tags, etc.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "v2",
@@ -130,16 +131,18 @@
         "id": "ContactPoint:shr-demographics-WorkTelephoneNumber.extension",
         "path": "ContactPoint.extension",
         "slicing": {
-          "id": "205",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
-          "ordered": false,
+          "description": "Extensions are always sliced by (at least) url",
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -167,7 +170,18 @@
         "id": "ContactPoint:shr-demographics-WorkTelephoneNumber.extension:telecomtypeother",
         "path": "ContactPoint.extension",
         "sliceName": "telecomtypeother",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
         "definition": "Specification of the type of telecom channel, if the TelecomType is other.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -198,7 +212,7 @@
       {
         "id": "ContactPoint:shr-demographics-WorkTelephoneNumber.system",
         "path": "ContactPoint.system",
-        "short": "phone | fax | email | pager | url | other",
+        "short": "phone | fax | email | pager | url | sms | other",
         "definition": "Telecommunications form for contact point - what communications system is required to make use of the contact.",
         "min": 1,
         "max": "1",
@@ -212,6 +226,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ContactPointSystem"
+            }
+          ],
           "strength": "required",
           "description": "Telecommunications form for contact point",
           "valueSetReference": {
@@ -238,7 +258,7 @@
         "path": "ContactPoint.value",
         "short": "The actual contact point details",
         "definition": "The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).",
-        "comments": "Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.",
+        "comment": "Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.",
         "requirements": "Need to support legacy numbers that are not in a tightly controlled format.",
         "min": 1,
         "max": "1",
@@ -267,16 +287,19 @@
         "id": "ContactPoint:shr-demographics-WorkTelephoneNumber.use",
         "path": "ContactPoint.use",
         "slicing": {
-          "id": "204",
+          "id": "196",
           "discriminator": [
-            "value"
+            {
+              "type": "value",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "home | work | temp | old | mobile - purpose of this contact point",
         "definition": "Identifies the purpose for the contact point.",
-        "comments": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary or old contact etc.for a current/permanent one. Applications can assume that a contact is current unless it explicitly says that it is temporary or old.",
+        "comment": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary or old contact etc.for a current/permanent one. Applications can assume that a contact is current unless it explicitly says that it is temporary or old.",
         "requirements": "Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.",
         "min": 0,
         "max": "1",
@@ -288,6 +311,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ContactPointUse"
+            }
+          ],
           "strength": "required",
           "description": "Use of contact point",
           "valueSetReference": {
@@ -327,7 +356,7 @@
         "path": "ContactPoint.rank",
         "short": "Specify preferred order of use (1 = highest)",
         "definition": "Specifies a preferred order in which to use a set of contacts. Contacts are ranked with lower values coming before higher values.",
-        "comments": "Note that rank does not necessarily follow the order in which the contacts are represented in the instance.",
+        "comment": "Note that rank does not necessarily follow the order in which the contacts are represented in the instance.",
         "min": 0,
         "max": "1",
         "type": [
@@ -368,7 +397,7 @@
           },
           {
             "identity": "rim",
-            "map": "./useablePeriod[type=\"IVL<TS>\"]"
+            "map": "./usablePeriod[type=\"IVL<TS>\"]"
           },
           {
             "identity": "servd",
@@ -418,9 +447,12 @@
         "id": "ContactPoint:shr-demographics-WorkTelephoneNumber.use",
         "path": "ContactPoint.use",
         "slicing": {
-          "id": "204",
+          "id": "196",
           "discriminator": [
-            "value"
+            {
+              "type": "value",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-device-Device.json b/lib/resources/standard_health_record/StructureDefinition-shr-device-Device.json
old mode 100755
new mode 100644
index b89b7eb..8079c37
--- a/lib/resources/standard_health_record/StructureDefinition-shr-device-Device.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-device-Device.json
@@ -3,7 +3,7 @@
   "id": "shr-device-Device",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR Device Profile</b></p>\n  <p>A specific durable physical device used in diagnosis or treatment. The value is the coding for a type of device, for example, a CPAP machine. The same device might be used on multiple patients.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.device.Device maps to Device:\n  CodeableConcept maps to type\n  DeviceUdi maps to udiCarrier.value\n  VendorModelNumber maps to model\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR Device Profile</b></p>\n  <p>A specific durable physical device used in diagnosis or treatment. The value is the coding for a type of device, for example, a CPAP machine. The same device might be used on multiple patients.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.device.Device maps to Device:\n  CodeableConcept maps to type\n  DeviceUdi maps to udi.carrierHRF\n  VendorModelNumber maps to model\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-device-Device",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.device.Device"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Device Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.489Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,16 +27,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.338Z",
   "description": "A specific durable physical device used in diagnosis or treatment. The value is the coding for a type of device, for example, a CPAP machine. The same device might be used on multiple patients.",
   "purpose": "Allows institutions to track their devices.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
-    {
-      "identity": "udi",
-      "uri": "http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/UniqueDeviceIdentification/default.htm",
-      "name": "UDI Mapping"
-    },
     {
       "identity": "rim",
       "uri": "http://hl7.org/v3",
@@ -44,6 +40,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "udi",
+      "uri": "http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/UniqueDeviceIdentification/default.htm",
+      "name": "UDI Mapping"
     }
   ],
   "kind": "resource",
@@ -99,10 +100,6 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
-          {
-            "identity": "udi",
-            "map": "N/A"
-          },
           {
             "identity": "rim",
             "map": "Device"
@@ -118,7 +115,7 @@
         "path": "Device.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -157,7 +154,7 @@
         "path": "Device.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +175,7 @@
         "path": "Device.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -198,6 +195,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -212,7 +217,7 @@
         "path": "Device.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -246,7 +251,7 @@
         "path": "Device.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -276,7 +281,7 @@
         "path": "Device.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -305,7 +310,7 @@
         "path": "Device.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -335,7 +340,7 @@
         "path": "Device.identifier",
         "short": "Instance identifier",
         "definition": "Unique instance identifiers assigned to a device by manufacturers other organizations or owners.",
-        "comments": "The barcode string from a barcode present on a device label or package may identify the instance, include names given to the device in local usage, or may identify the type of device. If the identifier identifies the type of device, Device.type element should be used.  For [UDI](device.html#5.11.3.2.2),  this element corresponds to the variable portion of the UDI that identifies the serial number of a specific device. See [UDI mappings](device-mappings.html#udi) for a complete mapping of UDI parts to Device.",
+        "comment": "The barcode string from a barcode present on a device label or package may identify the instance, include names given to the device in local usage, or may identify the type of device. If the identifier identifies the type of device, Device.type element should be used.  For [UDI](device.html#5.11.3.2.2),  this element corresponds to the variable portion of the UDI that identifies the serial number of a specific device. See [UDI mappings](device-mappings.html#udi) for a complete mapping of UDI parts to Device.",
         "alias": [
           "Serial Number"
         ],
@@ -349,7 +354,7 @@
         "mapping": [
           {
             "identity": "udi",
-            "map": "The serial number which is a component of the the production identifier (PI), a conditional, variable portion of a UDI.   The identifier.type code should be set to “SNO”(Serial Number) and the system left empty."
+            "map": "The serial number which is a component of the production identifier (PI), a conditional, variable portion of a UDI.   The identifier.type code should be set to “SNO”(Serial Number) and the system left empty."
           },
           {
             "identity": "rim",
@@ -362,42 +367,332 @@
         ]
       },
       {
-        "id": "Device:shr-device-Device.udiCarrier",
-        "path": "Device.udiCarrier",
+        "id": "Device:shr-device-Device.udi",
+        "path": "Device.udi",
         "short": "Unique Device Identifier (UDI) Barcode string",
-        "definition": "[Unique device identifier (UDI)](device.html#5.11.3.2.2) barcode or rfid string assigned to device label or package.",
-        "comments": "The udiCarrier string may identify an unique instance of a device, or it may only identify the type of the device. The Human Readable format (HRF) is required in FHIR. AIDC identifiers cannot be conveyed in FHIR, Because of limitations on character sets in XML and the need to round-trip JSON data through XML.  See [UDI mappings](device-mappings.html#udi) for a complete mapping of UDI parts to Device.",
+        "definition": "[Unique device identifier (UDI)](device.html#5.11.3.2.2) assigned to device label or package.",
+        "comment": "UDI may identify an unique instance of a device, or it may only identify the type of the device.  See [UDI mappings](device-mappings.html#udi) for a complete mapping of UDI parts to Device.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "BackboneElement"
+          }
+        ],
+        "constraint": [
+          {
+            "key": "ele-1",
+            "severity": "error",
+            "human": "All FHIR elements must have a @value or children",
+            "expression": "children().count() > id.count()",
+            "xpath": "@value|f:*|h:div",
+            "source": "Element"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".id and .code"
+          },
+          {
+            "identity": "w5",
+            "map": "id"
+          }
+        ]
+      },
+      {
+        "id": "Device:shr-device-Device.udi.id",
+        "path": "Device.udi.id",
+        "representation": [
+          "xmlAttr"
+        ],
+        "short": "xml:id (or equivalent in JSON)",
+        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Element.id",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "Device:shr-device-Device.udi.extension",
+        "path": "Device.udi.extension",
+        "short": "Additional Content defined by implementations",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
-          "UDI",
-          "Barcode String"
+          "extensions",
+          "user content"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "Element.extension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "Device:shr-device-Device.udi.modifierExtension",
+        "path": "Device.udi.modifierExtension",
+        "short": "Extensions that cannot be ignored",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content",
+          "modifiers"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "BackboneElement.modifierExtension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "isModifier": true,
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "N/A"
+          }
+        ]
+      },
+      {
+        "id": "Device:shr-device-Device.udi.deviceIdentifier",
+        "path": "Device.udi.deviceIdentifier",
+        "short": "Mandatory fixed portion of UDI",
+        "definition": "The device identifier (DI) is a mandatory, fixed portion of a UDI that identifies the labeler and the specific version or model of a device.",
+        "alias": [
+          "DI"
         ],
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "Identifier"
+            "code": "string"
           }
         ],
+        "isSummary": true,
         "mapping": [
           {
             "identity": "udi",
-            "map": "The full UDI carrier - The Human Readable Form (HRF) representation of the barcode string as printed on the packaging of the device.  The  'type' component should be set to “UDI” and the 'system' component to the the appropriate repository url.  the additional URL is needed to identify the authoritative source for UDI generation within the jurisdiction.  All UDIs are globally unique within a single namespace. with the appropriate repository uri as the system.  This allows a recipient of a UDI to know which database will contain the UDI-associated metadata.  For example,  UDIs of devices managed in the U.S. by the FDA, the value is  http://hl7.org/fhir/NamingSystem/fda-udi.  Because of limitations on character sets in XML and the need to round-trip JSON data through XML, AIDC identifiers cannot be conveyed in FHIR."
+            "map": "The device identifier (DI), a mandatory, fixed portion of a UDI that identifies the labeler and the specific version or model of a device."
           },
           {
             "identity": "rim",
-            "map": ".id[where root is root for UDI]"
+            "map": "Role.id.extension"
           },
           {
             "identity": "w5",
-            "map": "id"
+            "map": "what"
+          }
+        ]
+      },
+      {
+        "id": "Device:shr-device-Device.udi.name",
+        "path": "Device.udi.name",
+        "short": "Device Name as appears on UDI label",
+        "definition": "Name of device as used in labeling or catalog.",
+        "comment": "Use the `Device.type`  for a generic type or kind of device name.  Note the [GUDID](http://www.fda.gov/medicaldevices/deviceregulationandguidance/uniquedeviceidentification/globaludidatabasegudid/default.htm) lists the name as the 'Brand Name'.",
+        "alias": [
+          "Brand Name"
+        ],
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "udi",
+            "map": "Propietary/Trade Name of the medical Device as used in the labeling or catalog"
+          },
+          {
+            "identity": "rim",
+            "map": ".displayName"
+          },
+          {
+            "identity": "w5",
+            "map": "what"
+          }
+        ]
+      },
+      {
+        "id": "Device:shr-device-Device.udi.jurisdiction",
+        "path": "Device.udi.jurisdiction",
+        "short": "Regional UDI authority",
+        "definition": "The identity of the authoritative source for UDI generation within a  jurisdiction.  All UDIs are globally unique within a single namespace. with the appropriate repository uri as the system.  For example,  UDIs of devices managed in the U.S. by the FDA, the value is  http://hl7.org/fhir/NamingSystem/fda-udi.",
+        "requirements": "Allows a recipient of a UDI to know which database will contain the UDI-associated metadata.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "uri"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "Role.scoper"
+          }
+        ]
+      },
+      {
+        "id": "Device:shr-device-Device.udi.carrierHRF",
+        "path": "Device.udi.carrierHRF",
+        "short": "UDI Human Readable Barcode String",
+        "definition": "The full UDI carrier as the human readable form (HRF) representation of the barcode string as printed on the packaging of the device.",
+        "comment": "If separate barcodes for DI and PI are present, concatenate the string with DI first and in order of human readable expression on label.",
+        "alias": [
+          "Human Readable Form"
+        ],
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "udi",
+            "map": "A unique device identifier (UDI) on a device label in plain text"
+          },
+          {
+            "identity": "rim",
+            "map": "Role.id.extension"
+          }
+        ]
+      },
+      {
+        "id": "Device:shr-device-Device.udi.carrierAIDC",
+        "path": "Device.udi.carrierAIDC",
+        "short": "UDI Machine Readable Barcode String",
+        "definition": "The full UDI carrier of the Automatic Identification and Data Capture (AIDC) technology representation of the barcode string as printed on the packaging of the device - E.g a barcode or RFID.   Because of limitations on character sets in XML and the need to round-trip JSON data through XML, AIDC Formats *SHALL* be base64 encoded.",
+        "comment": "The AIDC form of UDIs should be scanned or otherwise used for the identification of the device whenever possible to minimize errors in records resulting from manual transcriptions. If separate barcodes for DI and PI are present, concatenate the string with DI first and in order of human readable expression on label.",
+        "alias": [
+          "Automatic Identification and Data Capture"
+        ],
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "base64Binary"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "udi",
+            "map": "A unique device identifier (UDI) on a device label a form that uses automatic identification and data capture (AIDC) technology."
+          },
+          {
+            "identity": "rim",
+            "map": "Role.id.extension"
+          }
+        ]
+      },
+      {
+        "id": "Device:shr-device-Device.udi.issuer",
+        "path": "Device.udi.issuer",
+        "short": "UDI Issuing Organization",
+        "definition": "Organization that is charged with issuing UDIs for devices.  For example, the US FDA issuers include :\n1) GS1: \nhttp://hl7.org/fhir/NamingSystem/gs1-di, \n2) HIBCC:\nhttp://hl7.org/fhir/NamingSystem/hibcc-dI, \n3) ICCBBA for blood containers:\nhttp://hl7.org/fhir/NamingSystem/iccbba-blood-di, \n4) ICCBA for other devices:\nhttp://hl7.org/fhir/NamingSystem/iccbba-other-di.",
+        "alias": [
+          "Barcode System"
+        ],
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "uri"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "udi",
+            "map": "All UDIs are to be issued under a system operated by an Jurisdiction-accredited issuing agency.\nGS1 DIs: \n http://hl7.org/fhir/NamingSystem/gs1\nHIBCC DIs:\n http://hl7.org/fhir/NamingSystem/hibcc\nICCBBA DIs for blood containers:\n http://hl7.org/fhir/NamingSystem/iccbba-blood\nICCBA DIs for other devices:\n http://hl7.org/fhir/NamingSystem/iccbba-other"
+          },
+          {
+            "identity": "rim",
+            "map": "Role.id.root"
+          }
+        ]
+      },
+      {
+        "id": "Device:shr-device-Device.udi.entryType",
+        "path": "Device.udi.entryType",
+        "short": "barcode | rfid | manual +",
+        "definition": "A coded entry to indicate how the data was entered.",
+        "requirements": "Supports a way to distinguish hand entered from machine read data.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "code"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "UDIEntryType"
+            }
+          ],
+          "strength": "required",
+          "description": "Codes to identify how UDI data was entered",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/udi-entry-type"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "NA"
           }
         ]
       },
       {
         "id": "Device:shr-device-Device.status",
         "path": "Device.status",
-        "short": "available | not-available | entered-in-error",
+        "short": "active | inactive | entered-in-error | unknown",
         "definition": "Status of the Device availability.",
+        "comment": "This element is labeled as a modifier because the status contains the codes inactive and entered-in-error that mark the device (record)as not currently valid.",
         "min": 0,
         "max": "1",
         "type": [
@@ -408,17 +703,19 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "FHIRDeviceStatus"
+            }
+          ],
           "strength": "required",
           "description": "The availability status of the device.",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/devicestatus"
+            "reference": "http://hl7.org/fhir/ValueSet/device-status"
           }
         },
         "mapping": [
-          {
-            "identity": "udi",
-            "map": "N/A"
-          },
           {
             "identity": "rim",
             "map": ".statusCode"
@@ -434,7 +731,6 @@
         "path": "Device.type",
         "short": "What kind of device this is",
         "definition": "Code or identifier to identify a kind of device.",
-        "comments": "There can be different code values thath may correspond to different granularities of the same concept.  These can be represented as translations using  the [codeableConcept](datatypes.html#codeableconcept) datatype.  For [UDI](device.html#5.11.3.2.2), this element corresponds to the UDI device identifier (DI) part. See [UDI mappings](device-mappings.html#udi) for a complete mapping of UDI parts to Device.",
         "min": 1,
         "max": "1",
         "type": [
@@ -444,6 +740,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "DeviceKind"
+            }
+          ],
           "strength": "example",
           "description": "Codes to identify medical devices",
           "valueSetReference": {
@@ -453,7 +755,7 @@
         "mapping": [
           {
             "identity": "udi",
-            "map": "The device identifier (DI), a mandatory, fixed portion of a UDI that identifies the labeler and the specific version or model of a devicet.  The system uri should be included. Possible URIs include\nGS1 DIs: \n http://hl7.org/fhir/NamingSystem/gs1-di\nHIBCC DIs:\n http://hl7.org/fhir/NamingSystem/hibcc-di\nICCBBA DIs for blood containers:\n http://hl7.org/fhir/NamingSystem/iccbba-blood-di\nICCBA DIs for other devices:\n http://hl7.org/fhir/NamingSystem/iccbba-other-di"
+            "map": "Type description using GMDN or other code system"
           },
           {
             "identity": "rim",
@@ -470,7 +772,6 @@
         "path": "Device.lotNumber",
         "short": "Lot number of manufacture",
         "definition": "Lot number assigned by the manufacturer.",
-        "comments": "Alphanumeric. For [UDI](device.html#5.11.3.2.2), this element corresponds to the variable portion of a UDI that identifies the lot or batch number within which a physical instance of a device was manufactured. See [UDI mappings](device-mappings.html#udi) for a complete mapping of UDI parts to Device.",
         "min": 0,
         "max": "1",
         "type": [
@@ -481,7 +782,7 @@
         "mapping": [
           {
             "identity": "udi",
-            "map": "The lot or batch number within which a device was manufactured - which is a component of the the production identifier (PI), a conditional, variable portion of a UDI."
+            "map": "The lot or batch number within which a device was manufactured - which is a component of the production identifier (PI), a conditional, variable portion of a UDI."
           },
           {
             "identity": "rim",
@@ -525,7 +826,6 @@
         "path": "Device.manufactureDate",
         "short": "Date when the device was made",
         "definition": "The date and time when the device was manufactured.",
-        "comments": "For [UDI](device.html#5.11.3.2.2), this element corresponds to the variable portion of a UDI that identifies the date a physical instance of a device was manufactured. See [UDI mappings](device-mappings.html#udi) for a complete mapping of UDI parts to Device.",
         "min": 0,
         "max": "1",
         "type": [
@@ -536,7 +836,7 @@
         "mapping": [
           {
             "identity": "udi",
-            "map": "The date a specific device was manufactured - which is a component of the the production identifier (PI), a conditional, variable portion of a UDI.  For FHIR, The datetime syntax must converted to YYYY-MM-DD[THH:MM:SS].  If hour is present, the minutes and seconds should both be set to “00”."
+            "map": "The date a specific device was manufactured - which is a component of the production identifier (PI), a conditional, variable portion of a UDI.  For FHIR, The datetime syntax must converted to YYYY-MM-DD[THH:MM:SS].  If hour is present, the minutes and seconds should both be set to “00”."
           },
           {
             "identity": "rim",
@@ -553,7 +853,6 @@
         "path": "Device.expirationDate",
         "short": "Date and time of expiry of this device (if applicable)",
         "definition": "The date and time beyond which this device is no longer valid or should not be used (if applicable).",
-        "comments": "For [UDI](device.html#5.11.3.2.2), this element corresponds to the variable portion of a UDI that identifies the expiration date of a physical instance of a device. See [UDI mappings](device-mappings.html#udi) for a complete mapping of UDI parts to Device.",
         "min": 0,
         "max": "1",
         "type": [
@@ -564,7 +863,7 @@
         "mapping": [
           {
             "identity": "udi",
-            "map": "the expiration date of a specific device -  which is a component of the the production identifier (PI), a conditional, variable portion of a UDI.  For FHIR, The datetime syntax must converted to YYYY-MM-DD[THH:MM:SS].  If hour is present, the minutes and seconds should both be set to “00”."
+            "map": "the expiration date of a specific device -  which is a component of the production identifier (PI), a conditional, variable portion of a UDI.  For FHIR, The datetime syntax must converted to YYYY-MM-DD[THH:MM:SS].  If hour is present, the minutes and seconds should both be set to “00”."
           },
           {
             "identity": "rim",
@@ -589,10 +888,6 @@
           }
         ],
         "mapping": [
-          {
-            "identity": "udi",
-            "map": "N/A"
-          },
           {
             "identity": "rim",
             "map": ".playedRole[typeCode=MANU].code"
@@ -616,10 +911,6 @@
           }
         ],
         "mapping": [
-          {
-            "identity": "udi",
-            "map": "N/A"
-          },
           {
             "identity": "rim",
             "map": ".softwareName (included as part)"
@@ -645,10 +936,6 @@
           }
         ],
         "mapping": [
-          {
-            "identity": "udi",
-            "map": "N/A"
-          },
           {
             "identity": "rim",
             "map": ".playedRole[typeCode=USED].scoper.playedRole[typeCode=PAT]"
@@ -673,10 +960,6 @@
           }
         ],
         "mapping": [
-          {
-            "identity": "udi",
-            "map": "N/A"
-          },
           {
             "identity": "rim",
             "map": ".playedRole[typeCode=OWN].scoper"
@@ -692,7 +975,7 @@
         "path": "Device.contact",
         "short": "Details for human/organization for support",
         "definition": "Contact details for an organization or a particular human that is responsible for the device.",
-        "comments": "used for troubleshooting etc.",
+        "comment": "used for troubleshooting etc.",
         "min": 0,
         "max": "*",
         "type": [
@@ -701,10 +984,6 @@
           }
         ],
         "mapping": [
-          {
-            "identity": "udi",
-            "map": "N/A"
-          },
           {
             "identity": "rim",
             "map": ".scopedRole[typeCode=CON].player"
@@ -730,10 +1009,6 @@
           }
         ],
         "mapping": [
-          {
-            "identity": "udi",
-            "map": "N/A"
-          },
           {
             "identity": "rim",
             "map": ".playedRole[typeCode=LOCE].scoper"
@@ -749,7 +1024,7 @@
         "path": "Device.url",
         "short": "Network address to contact device",
         "definition": "A network address on which the device may be contacted directly.",
-        "comments": "If the device is running a FHIR server, the network address should  be the Base URL from which a conformance statement may be retrieved.",
+        "comment": "If the device is running a FHIR server, the network address should  be the Base URL from which a conformance statement may be retrieved.",
         "min": 0,
         "max": "1",
         "type": [
@@ -758,10 +1033,6 @@
           }
         ],
         "mapping": [
-          {
-            "identity": "udi",
-            "map": "N/A"
-          },
           {
             "identity": "rim",
             "map": ".telecom"
@@ -785,15 +1056,44 @@
           }
         ],
         "mapping": [
-          {
-            "identity": "udi",
-            "map": "N/A"
-          },
           {
             "identity": "rim",
             "map": ".text"
           }
         ]
+      },
+      {
+        "id": "Device:shr-device-Device.safety",
+        "path": "Device.safety",
+        "short": "Safety Characteristics of Device",
+        "definition": "Provides additional safety characteristics about a medical device.  For example devices containing latex.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "DeviceSafety"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes used to identify medical devices safety characterics. These codes are derived in part from the [United States Food and Drug Administration recommendations](http://www.fda.gov/downloads/medicaldevices/deviceregulationandguidance/guidancedocuments/ucm107708.pdf) and are provided here as a suggestive example.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/device-safety"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "NA"
+          }
+        ]
       }
     ]
   },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-device-DeviceUse.json b/lib/resources/standard_health_record/StructureDefinition-shr-device-DeviceUse.json
old mode 100755
new mode 100644
index edab987..66e5d86
--- a/lib/resources/standard_health_record/StructureDefinition-shr-device-DeviceUse.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-device-DeviceUse.json
@@ -12,8 +12,10 @@
       "value": "shr.device.DeviceUse"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR DeviceUse Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.491Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.339Z",
   "description": "A statement pertaining to the use of a device by a subject. May document the use of a device, or that the subject does not use a particular type of device.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "quick",
@@ -113,7 +114,7 @@
         "path": "DeviceUseStatement.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -152,7 +153,7 @@
         "path": "DeviceUseStatement.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -173,7 +174,7 @@
         "path": "DeviceUseStatement.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -193,6 +194,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -207,7 +216,7 @@
         "path": "DeviceUseStatement.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -241,7 +250,7 @@
         "path": "DeviceUseStatement.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -270,16 +279,19 @@
         "id": "DeviceUseStatement:shr-device-DeviceUse.extension",
         "path": "DeviceUseStatement.extension",
         "slicing": {
-          "id": "206",
+          "id": "197",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -308,6 +320,7 @@
         "path": "DeviceUseStatement.extension",
         "sliceName": "deviceusestatus",
         "definition": "A code representing the patient or other source's judgment about the state of the device used that this statement is about. Generally this will be active or completed.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -340,6 +353,7 @@
         "path": "DeviceUseStatement.extension",
         "sliceName": "implanted",
         "definition": "Whether this device is implanted in the body.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -371,16 +385,19 @@
         "id": "DeviceUseStatement:shr-device-DeviceUse.modifierExtension",
         "path": "DeviceUseStatement.modifierExtension",
         "slicing": {
-          "id": "207",
+          "id": "198",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -410,6 +427,7 @@
         "path": "DeviceUseStatement.modifierExtension",
         "sliceName": "nonoccurrencemodifier",
         "definition": "When true, indicates either that the event or action documented in the entry did not occur, or the the thing documented is absent or does not exist.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -438,228 +456,300 @@
         ]
       },
       {
-        "id": "DeviceUseStatement:shr-device-DeviceUse.bodySite",
-        "path": "DeviceUseStatement.bodySite",
-        "short": "Target body site",
-        "definition": "Indicates the site on the subject's body where the device was used ( i.e. the target site).",
-        "requirements": "Knowing where the device is targeted is important for tracking if multiple sites are possible. If more information than just a code is required, use the extension [http://hl7.org/fhir/StructureDefinition/body-site-instance](null.html).",
+        "id": "DeviceUseStatement:shr-device-DeviceUse.identifier",
+        "path": "DeviceUseStatement.identifier",
+        "short": "External identifier for this record",
+        "definition": "An external identifier for this statement such as an IRI.",
         "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Identifier"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "quick",
+            "map": "ClinicalStatement.identifier"
+          },
+          {
+            "identity": "w5",
+            "map": "id"
+          }
+        ]
+      },
+      {
+        "id": "DeviceUseStatement:shr-device-DeviceUse.status",
+        "path": "DeviceUseStatement.status",
+        "short": "active | completed | entered-in-error +",
+        "definition": "A code representing the patient or other source's judgment about the state of the device used that this statement is about.  Generally this will be active or completed.",
+        "comment": "DeviceUseStatment is a statement at a point in time.  The status is only representative at the point when it was asserted.  The value set for contains codes that assert the status of the use  by the patient (for example, stopped or on hold) as well as codes that assert the status of the resource itself (for example, entered in error).\n\nThis element is labeled as a modifier because the status contains the codes that mark the statement as not currently valid.",
+        "min": 1,
         "max": "1",
         "type": [
           {
-            "code": "CodeableConcept"
+            "code": "code"
           }
         ],
+        "isModifier": true,
         "isSummary": true,
         "binding": {
-          "strength": "example",
-          "description": "Codes describing anatomical locations. May include laterality.",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "DeviceUseStatementStatus"
+            }
+          ],
+          "strength": "required",
+          "description": "A coded concept indicating the current status of a the Device Usage",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/body-site"
+            "reference": "http://hl7.org/fhir/ValueSet/device-statement-status"
           }
         },
         "mapping": [
           {
             "identity": "rim",
-            "map": "targetSiteCode"
+            "map": ".statusCode"
+          },
+          {
+            "identity": "quick",
+            "map": "…status"
+          },
+          {
+            "identity": "w5",
+            "map": "status"
           }
         ]
       },
       {
-        "id": "DeviceUseStatement:shr-device-DeviceUse.whenUsed",
-        "path": "DeviceUseStatement.whenUsed",
-        "short": "Period device was used",
-        "definition": "The time period over which the device was used.",
-        "min": 0,
+        "id": "DeviceUseStatement:shr-device-DeviceUse.subject",
+        "path": "DeviceUseStatement.subject",
+        "short": "Patient using device",
+        "definition": "The patient who used the device.",
+        "min": 1,
         "max": "1",
         "type": [
           {
-            "code": "Period",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-PeriodOfUse"
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-demographics-PersonOfRecord"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Group"
           }
         ],
-        "isSummary": true,
         "mapping": [
           {
             "identity": "quick",
-            "map": "Performance.performanceTime"
+            "map": "ClinicalStatement.subject"
           },
           {
             "identity": "w5",
-            "map": "when.done"
+            "map": "who.focus"
           }
         ]
       },
       {
-        "id": "DeviceUseStatement:shr-device-DeviceUse.device",
-        "path": "DeviceUseStatement.device",
-        "short": "Reference to device used",
-        "definition": "The details of the device used.",
-        "min": 1,
+        "id": "DeviceUseStatement:shr-device-DeviceUse.whenUsed",
+        "path": "DeviceUseStatement.whenUsed",
+        "short": "Period device was used",
+        "definition": "The time period over which the device was used.",
+        "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-device-Device"
+            "code": "Period",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-PeriodOfUse"
           }
         ],
-        "isSummary": true,
         "mapping": [
           {
             "identity": "quick",
-            "map": "DeviceUse.device"
+            "map": "Performance.performanceTime"
           },
           {
             "identity": "w5",
-            "map": "who.actor"
+            "map": "when.done"
           }
         ]
       },
       {
-        "id": "DeviceUseStatement:shr-device-DeviceUse.identifier",
-        "path": "DeviceUseStatement.identifier",
-        "short": "External identifier for this record",
-        "definition": "An external identifier for this statement such as an IRI.",
+        "id": "DeviceUseStatement:shr-device-DeviceUse.timing[x]",
+        "path": "DeviceUseStatement.timing[x]",
+        "short": "How often  the device was used",
+        "definition": "How often the device was used.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
-            "code": "Identifier"
+            "code": "Timing"
+          },
+          {
+            "code": "Period"
+          },
+          {
+            "code": "dateTime"
           }
         ],
-        "isSummary": true,
         "mapping": [
           {
             "identity": "quick",
-            "map": "ClinicalStatement.identifier"
+            "map": "DeviceUse.applicationSchedule"
           },
           {
             "identity": "w5",
-            "map": "id"
+            "map": "when.done"
           }
         ]
       },
       {
-        "id": "DeviceUseStatement:shr-device-DeviceUse.indication",
-        "path": "DeviceUseStatement.indication",
-        "short": "Why device was used",
-        "definition": "Reason or justification for the use of the device.",
+        "id": "DeviceUseStatement:shr-device-DeviceUse.recordedOn",
+        "path": "DeviceUseStatement.recordedOn",
+        "short": "When statement was recorded",
+        "definition": "The time at which the statement was made/recorded.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
-            "code": "CodeableConcept",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+            "code": "dateTime"
           }
         ],
-        "isSummary": true,
         "mapping": [
           {
             "identity": "quick",
-            "map": "Action.indication.reason"
+            "map": "ClinicalStatement.statementDateTime"
           },
           {
             "identity": "w5",
-            "map": "why"
+            "map": "when.recorded"
           }
         ]
       },
       {
-        "id": "DeviceUseStatement:shr-device-DeviceUse.notes",
-        "path": "DeviceUseStatement.notes",
-        "short": "Addition details (comments, instructions)",
-        "definition": "Details about the device statement that were not represented at all or sufficiently in one of the attributes provided in a class. These may include for example a comment, an instruction, or a note associated with the statement.",
+        "id": "DeviceUseStatement:shr-device-DeviceUse.source",
+        "path": "DeviceUseStatement.source",
+        "short": "Who made the statement",
+        "definition": "Who reported the device was being used by the patient.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
-            "code": "string"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
           }
         ],
-        "isSummary": true,
         "mapping": [
           {
-            "identity": "quick",
-            "map": "ClinicalStatement.additionalText"
+            "identity": "w5",
+            "map": "who.actor"
           }
         ]
       },
       {
-        "id": "DeviceUseStatement:shr-device-DeviceUse.recordedOn",
-        "path": "DeviceUseStatement.recordedOn",
-        "short": "When statement was recorded",
-        "definition": "The time at which the statement was made/recorded.",
-        "min": 0,
+        "id": "DeviceUseStatement:shr-device-DeviceUse.device",
+        "path": "DeviceUseStatement.device",
+        "short": "Reference to device used",
+        "definition": "The details of the device used.",
+        "min": 1,
         "max": "1",
         "type": [
           {
-            "code": "dateTime"
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-device-Device"
           }
         ],
-        "isSummary": true,
         "mapping": [
           {
             "identity": "quick",
-            "map": "ClinicalStatement.statementDateTime"
+            "map": "DeviceUse.device"
           },
           {
             "identity": "w5",
-            "map": "when.recorded"
+            "map": "who.actor"
           }
         ]
       },
       {
-        "id": "DeviceUseStatement:shr-device-DeviceUse.subject",
-        "path": "DeviceUseStatement.subject",
-        "short": "Patient using device",
-        "definition": "The patient who used the device.",
-        "min": 1,
-        "max": "1",
+        "id": "DeviceUseStatement:shr-device-DeviceUse.indication",
+        "path": "DeviceUseStatement.indication",
+        "short": "Why device was used",
+        "definition": "Reason or justification for the use of the device.",
+        "min": 0,
+        "max": "*",
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-demographics-PersonOfRecord"
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
           }
         ],
-        "isSummary": true,
         "mapping": [
           {
             "identity": "quick",
-            "map": "ClinicalStatement.subject"
+            "map": "Action.indication.reason"
           },
           {
             "identity": "w5",
-            "map": "who.focus"
+            "map": "why"
           }
         ]
       },
       {
-        "id": "DeviceUseStatement:shr-device-DeviceUse.timing[x]",
-        "path": "DeviceUseStatement.timing[x]",
-        "short": "How often  the device was used",
-        "definition": "How often the device was used.",
+        "id": "DeviceUseStatement:shr-device-DeviceUse.bodySite",
+        "path": "DeviceUseStatement.bodySite",
+        "short": "Target body site",
+        "definition": "Indicates the site on the subject's body where the device was used ( i.e. the target site).",
+        "requirements": "Knowing where the device is targeted is important for tracking if multiple sites are possible. If more information than just a code is required, use the extension [http://hl7.org/fhir/StructureDefinition/body-site-instance](null.html).",
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "Timing"
-          },
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes describing anatomical locations. May include laterality.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/body-site"
+          }
+        },
+        "mapping": [
           {
-            "code": "Period"
-          },
+            "identity": "rim",
+            "map": "targetSiteCode"
+          }
+        ]
+      },
+      {
+        "id": "DeviceUseStatement:shr-device-DeviceUse.note",
+        "path": "DeviceUseStatement.note",
+        "short": "Addition details (comments, instructions)",
+        "definition": "Details about the device statement that were not represented at all or sufficiently in one of the attributes provided in a class. These may include for example a comment, an instruction, or a note associated with the statement.",
+        "min": 0,
+        "max": "*",
+        "type": [
           {
-            "code": "dateTime"
+            "code": "Annotation"
           }
         ],
-        "isSummary": true,
         "mapping": [
           {
             "identity": "quick",
-            "map": "DeviceUse.applicationSchedule"
-          },
-          {
-            "identity": "w5",
-            "map": "when.done"
+            "map": "ClinicalStatement.additionalText"
           }
         ]
       }
@@ -721,6 +811,20 @@
         "isModifier": true,
         "isSummary": false
       },
+      {
+        "id": "DeviceUseStatement:shr-device-DeviceUse.subject",
+        "path": "DeviceUseStatement.subject",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-demographics-PersonOfRecord"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Group"
+          }
+        ]
+      },
       {
         "id": "DeviceUseStatement:shr-device-DeviceUse.whenUsed",
         "path": "DeviceUseStatement.whenUsed",
@@ -750,16 +854,6 @@
             "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
           }
         ]
-      },
-      {
-        "id": "DeviceUseStatement:shr-device-DeviceUse.subject",
-        "path": "DeviceUseStatement.subject",
-        "type": [
-          {
-            "code": "Reference",
-            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-demographics-PersonOfRecord"
-          }
-        ]
       }
     ]
   }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-device-DeviceUseStatus-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-device-DeviceUseStatus-extension.json
old mode 100755
new mode 100644
index ed67cb3..4a883c1
--- a/lib/resources/standard_health_record/StructureDefinition-shr-device-DeviceUseStatus-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-device-DeviceUseStatus-extension.json
@@ -3,7 +3,7 @@
   "id": "shr-device-DeviceUseStatus-extension",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR DeviceUseStatus Extension</b></p>\n  <p>A code representing the patient or other source&#039;s judgment about the state of the device used that this statement is about. Generally this will be active or completed.</p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR DeviceUseStatus Extension</b></p>\n  <p>A code representing the patient or other source's judgment about the state of the device used that this statement is about. Generally this will be active or completed.</p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-device-DeviceUseStatus-extension",
   "identifier": [
@@ -12,9 +12,11 @@
       "value": "shr.device.DeviceUseStatus"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR DeviceUseStatus Extension",
   "title": "SHR DeviceUseStatus Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.497Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.340Z",
   "description": "A code representing the patient or other source's judgment about the state of the device used that this statement is about. Generally this will be active or completed.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-device-Implanted-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-device-Implanted-extension.json
old mode 100755
new mode 100644
index 6dfdc4a..0e0dd9a
--- a/lib/resources/standard_health_record/StructureDefinition-shr-device-Implanted-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-device-Implanted-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.device.Implanted"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Implanted Extension",
   "title": "SHR Implanted Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.497Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.340Z",
   "description": "Whether this device is implanted in the body.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-encounter-Encounter.json b/lib/resources/standard_health_record/StructureDefinition-shr-encounter-Encounter.json
old mode 100755
new mode 100644
index cbfb597..f91d24a
--- a/lib/resources/standard_health_record/StructureDefinition-shr-encounter-Encounter.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-encounter-Encounter.json
@@ -3,7 +3,7 @@
   "id": "shr-encounter-Encounter",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR Encounter Profile</b></p>\n  <p>A statement about a planned or actual interaction between a patient and healthcare provider(s) for the purpose of providing healthcare service(s) or assessing the health status of a patient.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.encounter.Encounter maps to Encounter:\n  Entry.FocalSubject maps to patient\n  OccurrenceTime maps to period\n  EncounterType maps to class\n  Participant maps to participant\n  Participant.Practitioner maps to participant.individual\n  Participant.RelatedPerson maps to participant.individual\n  Participant.OccurrenceTime maps to participant.period\n  Participant.ParticipationType maps to participant.type\n  ProviderOrganization maps to serviceProvider\n  TBD &quot;HealthConcern&quot; maps to indication\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR Encounter Profile</b></p>\n  <p>A statement about a planned or actual interaction between a patient and healthcare provider(s) for the purpose of providing healthcare service(s) or assessing the health status of a patient.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.encounter.Encounter maps to Encounter:\n  Entry.FocalSubject maps to subject\n  OccurrenceTime maps to period\n  EncounterType maps to class\n  Participant maps to participant\n  Participant.Practitioner maps to participant.individual\n  Participant.RelatedPerson maps to participant.individual\n  Participant.OccurrenceTime maps to participant.period\n  Participant.ParticipationType maps to participant.type\n  ProviderOrganization maps to serviceProvider\n  &lt;TBD &quot;HealthConcern&quot;&gt; maps to indication\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.encounter.Encounter"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Encounter Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.509Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.348Z",
   "description": "A statement about a planned or actual interaction between a patient and healthcare provider(s) for the purpose of providing healthcare service(s) or assessing the health status of a patient.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "rim",
@@ -116,7 +117,7 @@
         "path": "Encounter.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -155,7 +156,7 @@
         "path": "Encounter.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -176,7 +177,7 @@
         "path": "Encounter.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -196,6 +197,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -210,7 +219,7 @@
         "path": "Encounter.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -244,7 +253,7 @@
         "path": "Encounter.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -273,16 +282,19 @@
         "id": "Encounter:shr-encounter-Encounter.extension",
         "path": "Encounter.extension",
         "slicing": {
-          "id": "211",
+          "id": "202",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -311,6 +323,7 @@
         "path": "Encounter.extension",
         "sliceName": "referraldate",
         "definition": "The date when the provider received a referral for service. A referral includes an oral, written, faxed or electronic request for services made by the client or on the client�s behalf.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -343,6 +356,7 @@
         "path": "Encounter.extension",
         "sliceName": "referralsourcetype",
         "definition": "The type of person or entity that instigated the encounter.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -375,6 +389,7 @@
         "path": "Encounter.extension",
         "sliceName": "facility",
         "definition": "Services and space and equipment provided for a particular purpose; a building or place that provides a particular service or is used for a particular industry. Could be a clinical site, community site, or a mobile facility.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -407,6 +422,7 @@
         "path": "Encounter.extension",
         "sliceName": "treatmentcooperation",
         "definition": "Whether the patient is undergoing treatment voluntarily, or under a legal order.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -439,6 +455,7 @@
         "path": "Encounter.extension",
         "sliceName": "paymentsource",
         "definition": "The source of payment for the current encounter.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -470,16 +487,19 @@
         "id": "Encounter:shr-encounter-Encounter.modifierExtension",
         "path": "Encounter.modifierExtension",
         "slicing": {
-          "id": "212",
+          "id": "203",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -509,6 +529,7 @@
         "path": "Encounter.modifierExtension",
         "sliceName": "encounternonoccurrencemodifier",
         "definition": "True if the encounter did not occur.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -567,8 +588,9 @@
       {
         "id": "Encounter:shr-encounter-Encounter.status",
         "path": "Encounter.status",
-        "short": "planned | arrived | in-progress | onleave | finished | cancelled | entered-in-error",
-        "definition": "planned | arrived | in-progress | onleave | finished | cancelled | entered-in-error.",
+        "short": "planned | arrived | triaged | in-progress | onleave | finished | cancelled +",
+        "definition": "planned | arrived | triaged | in-progress | onleave | finished | cancelled +.",
+        "comment": "Note that internal business rules will detemine the appropraite transitions that may occur between statuses (and also classes).\n\nThis element is labeled as a modifier because the status contains codes that mark the encounter as not currently valid.",
         "min": 1,
         "max": "1",
         "type": [
@@ -579,6 +601,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "EncounterStatus"
+            }
+          ],
           "strength": "required",
           "description": "Current state of the encounter",
           "valueSetReference": {
@@ -602,10 +630,16 @@
       },
       {
         "id": "Encounter:shr-encounter-Encounter.statusHistory",
+        "extension": [
+          {
+            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+            "valueString": "StatusHistory"
+          }
+        ],
         "path": "Encounter.statusHistory",
         "short": "List of past encounter statuses",
         "definition": "The status history permits the encounter resource to contain the status history without needing to read through the historical versions of the resource, or even have the server store them.",
-        "comments": "The current status is always found in the current version of the resource, not the status history.",
+        "comment": "The current status is always found in the current version of the resource, not the status history.",
         "min": 0,
         "max": "*",
         "type": [
@@ -662,7 +696,7 @@
         "path": "Encounter.statusHistory.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -691,7 +725,7 @@
         "path": "Encounter.statusHistory.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -721,8 +755,8 @@
       {
         "id": "Encounter:shr-encounter-Encounter.statusHistory.status",
         "path": "Encounter.statusHistory.status",
-        "short": "planned | arrived | in-progress | onleave | finished | cancelled | entered-in-error",
-        "definition": "planned | arrived | in-progress | onleave | finished | cancelled | entered-in-error.",
+        "short": "planned | arrived | triaged | in-progress | onleave | finished | cancelled +",
+        "definition": "planned | arrived | triaged | in-progress | onleave | finished | cancelled +.",
         "min": 1,
         "max": "1",
         "type": [
@@ -731,6 +765,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "EncounterStatus"
+            }
+          ],
           "strength": "required",
           "description": "Current state of the encounter",
           "valueSetReference": {
@@ -780,7 +820,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-encounter-EncounterTypeVS"
+            "reference": "http://standardhealthrecord.org/shr/encounter/vs/EncounterTypeVS"
           }
         },
         "mapping": [
@@ -798,12 +838,186 @@
           }
         ]
       },
+      {
+        "id": "Encounter:shr-encounter-Encounter.classHistory",
+        "extension": [
+          {
+            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+            "valueString": "ClassHistory"
+          }
+        ],
+        "path": "Encounter.classHistory",
+        "short": "List of past encounter classes",
+        "definition": "The class history permits the tracking of the encounters transitions without needing to go  through the resource history.\n\nThis would be used for a case where an admission starts of as an emergency encounter, then transisions into an inpatient scenario. Doing this and not restarting a new encounter ensures that any lab/diagnostic results can more easily follow the patient and not require re-processing and not get lost or cancelled during a kindof discharge from emergency to inpatient.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "BackboneElement"
+          }
+        ],
+        "constraint": [
+          {
+            "key": "ele-1",
+            "severity": "error",
+            "human": "All FHIR elements must have a @value or children",
+            "expression": "children().count() > id.count()",
+            "xpath": "@value|f:*|h:div",
+            "source": "Element"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "Encounter:shr-encounter-Encounter.classHistory.id",
+        "path": "Encounter.classHistory.id",
+        "representation": [
+          "xmlAttr"
+        ],
+        "short": "xml:id (or equivalent in JSON)",
+        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Element.id",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "Encounter:shr-encounter-Encounter.classHistory.extension",
+        "path": "Encounter.classHistory.extension",
+        "short": "Additional Content defined by implementations",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "Element.extension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "Encounter:shr-encounter-Encounter.classHistory.modifierExtension",
+        "path": "Encounter.classHistory.modifierExtension",
+        "short": "Extensions that cannot be ignored",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content",
+          "modifiers"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "BackboneElement.modifierExtension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "isModifier": true,
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "N/A"
+          }
+        ]
+      },
+      {
+        "id": "Encounter:shr-encounter-Encounter.classHistory.class",
+        "path": "Encounter.classHistory.class",
+        "short": "inpatient | outpatient | ambulatory | emergency +",
+        "definition": "inpatient | outpatient | ambulatory | emergency +.",
+        "min": 1,
+        "max": "1",
+        "type": [
+          {
+            "code": "Coding"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "EncounterClass"
+            }
+          ],
+          "strength": "extensible",
+          "description": "Classification of the encounter",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/v3-ActEncounterCode"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "Encounter:shr-encounter-Encounter.classHistory.period",
+        "path": "Encounter.classHistory.period",
+        "short": "The time that the episode was in the specified class",
+        "definition": "The time that the episode was in the specified class.",
+        "min": 1,
+        "max": "1",
+        "type": [
+          {
+            "code": "Period"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
       {
         "id": "Encounter:shr-encounter-Encounter.type",
         "path": "Encounter.type",
         "short": "Specific type of encounter",
         "definition": "Specific type of encounter (e.g. e-mail consultation, surgical day-care, skilled nursing, rehabilitation).",
-        "comments": "Since there are many ways to further classify encounters, this element is 0..*.",
+        "comment": "Since there are many ways to further classify encounters, this element is 0..*.",
         "min": 0,
         "max": "*",
         "type": [
@@ -813,6 +1027,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "EncounterType"
+            }
+          ],
           "strength": "example",
           "description": "The type of encounter",
           "valueSetReference": {
@@ -847,6 +1067,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Priority"
+            }
+          ],
           "strength": "example",
           "description": "Indicates the urgency of the encounter.",
           "valueSetReference": {
@@ -869,11 +1095,11 @@
         ]
       },
       {
-        "id": "Encounter:shr-encounter-Encounter.patient",
-        "path": "Encounter.patient",
-        "short": "The patient present at the encounter",
-        "definition": "The patient present at the encounter.",
-        "comments": "While the encounter is always about the patient, the patient may not actually be known in all contexts of use.",
+        "id": "Encounter:shr-encounter-Encounter.subject",
+        "path": "Encounter.subject",
+        "short": "The patient ro group present at the encounter",
+        "definition": "The patient ro group present at the encounter.",
+        "comment": "While the encounter is always about the patient, the patient may not actually be known in all contexts of use, and there may be a group of patients that could be anonymous (such as in a group therapy for Alcoholics Anonymous - where the recording of the encounter could be used for billing on the number of people/staff and not important to the context of the specific patients) or alternately in veterinary care a herd of sheep receiving treatment (where the animals are not individually tracked).",
         "alias": [
           "patient"
         ],
@@ -883,6 +1109,10 @@
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-demographics-PersonOfRecord"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Group"
           }
         ],
         "isSummary": true,
@@ -1016,7 +1246,7 @@
         "path": "Encounter.participant.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1045,7 +1275,7 @@
         "path": "Encounter.participant.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1077,7 +1307,7 @@
         "path": "Encounter.participant.type",
         "short": "Role of participant in encounter",
         "definition": "Role of participant in encounter.",
-        "comments": "The participant type indicates how an individual partitipates in an encounter. It includes non-practitioner participants, and for practitioners this is to describe the action type in the context of this encounter (e.g. Admitting Dr, Attending Dr, Translator, Consulting Dr). This is different to the practitioner roles which are functional roles, derived from terms of employment, education, licensing, etc.",
+        "comment": "The participant type indicates how an individual partitipates in an encounter. It includes non-practitioner participants, and for practitioners this is to describe the action type in the context of this encounter (e.g. Admitting Dr, Attending Dr, Translator, Consulting Dr). This is different to the practitioner roles which are functional roles, derived from terms of employment, education, licensing, etc.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1088,6 +1318,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ParticipantType"
+            }
+          ],
           "strength": "extensible",
           "description": "Role of participant in encounter",
           "valueSetReference": {
@@ -1192,7 +1428,7 @@
         "path": "Encounter.period",
         "short": "The start and end time of the encounter",
         "definition": "The start and end time of the encounter.",
-        "comments": "If not (yet) known, the end of the Period may be omitted.",
+        "comment": "If not (yet) known, the end of the Period may be omitted.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1221,7 +1457,7 @@
         "path": "Encounter.length",
         "short": "Quantity of time the encounter lasted (less time absent)",
         "definition": "Quantity of time the encounter lasted. This excludes the time during leaves of absence.",
-        "comments": "May differ from the time the Encounter.period lasted because of leave of absence.",
+        "comment": "May differ from the time the Encounter.period lasted because of leave of absence.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1245,7 +1481,7 @@
         "path": "Encounter.reason",
         "short": "Reason the encounter takes place (code)",
         "definition": "Reason the encounter takes place, expressed as a code. For admissions, this can be used for a coded admission diagnosis.",
-        "comments": "For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis).",
+        "comment": "For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis).",
         "alias": [
           "Indication",
           "Admission diagnosis"
@@ -1259,7 +1495,13 @@
         ],
         "isSummary": true,
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "EncounterReason"
+            }
+          ],
+          "strength": "preferred",
           "description": "Reason why the encounter takes place.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/encounter-reason"
@@ -1281,16 +1523,142 @@
         ]
       },
       {
-        "id": "Encounter:shr-encounter-Encounter.indication",
-        "path": "Encounter.indication",
-        "short": "Reason the encounter takes place (resource)",
-        "definition": "Reason the encounter takes place, as specified using information from another resource. For admissions, this is the admission diagnosis. The indication will typically be a Condition (with other resources referenced in the evidence.detail), or a Procedure.",
-        "comments": "For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis).",
+        "id": "Encounter:shr-encounter-Encounter.diagnosis",
+        "extension": [
+          {
+            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
+            "valueString": "Diagnosis"
+          }
+        ],
+        "path": "Encounter.diagnosis",
+        "short": "The list of diagnosis relevant to this encounter",
+        "definition": "The list of diagnosis relevant to this encounter.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "BackboneElement"
+          }
+        ],
+        "constraint": [
+          {
+            "key": "ele-1",
+            "severity": "error",
+            "human": "All FHIR elements must have a @value or children",
+            "expression": "children().count() > id.count()",
+            "xpath": "@value|f:*|h:div",
+            "source": "Element"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=RSON]"
+          }
+        ]
+      },
+      {
+        "id": "Encounter:shr-encounter-Encounter.diagnosis.id",
+        "path": "Encounter.diagnosis.id",
+        "representation": [
+          "xmlAttr"
+        ],
+        "short": "xml:id (or equivalent in JSON)",
+        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Element.id",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "Encounter:shr-encounter-Encounter.diagnosis.extension",
+        "path": "Encounter.diagnosis.extension",
+        "short": "Additional Content defined by implementations",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
-          "Admission diagnosis"
+          "extensions",
+          "user content"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "Element.extension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "Encounter:shr-encounter-Encounter.diagnosis.modifierExtension",
+        "path": "Encounter.diagnosis.modifierExtension",
+        "short": "Extensions that cannot be ignored",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content",
+          "modifiers"
         ],
         "min": 0,
         "max": "*",
+        "base": {
+          "path": "BackboneElement.modifierExtension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "isModifier": true,
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "N/A"
+          }
+        ]
+      },
+      {
+        "id": "Encounter:shr-encounter-Encounter.diagnosis.condition",
+        "path": "Encounter.diagnosis.condition",
+        "short": "Reason the encounter takes place (resource)",
+        "definition": "Reason the encounter takes place, as specified using information from another resource. For admissions, this is the admission diagnosis. The indication will typically be a Condition (with other resources referenced in the evidence.detail), or a Procedure.",
+        "comment": "For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis).",
+        "alias": [
+          "Admission diagnosis",
+          "discharge diagnosis",
+          "indication"
+        ],
+        "min": 1,
+        "max": "1",
         "type": [
           {
             "code": "Reference",
@@ -1316,12 +1684,67 @@
           }
         ]
       },
+      {
+        "id": "Encounter:shr-encounter-Encounter.diagnosis.role",
+        "path": "Encounter.diagnosis.role",
+        "short": "Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …)",
+        "definition": "Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …).",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "DiagnosisRole"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
+            }
+          ],
+          "strength": "preferred",
+          "description": "The type of diagnosis this condition represents",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/diagnosis-role"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "Encounter:shr-encounter-Encounter.diagnosis.rank",
+        "path": "Encounter.diagnosis.rank",
+        "short": "Ranking of the diagnosis (for each role type)",
+        "definition": "Ranking of the diagnosis (for each role type).",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "positiveInt"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=RSON].priority"
+          }
+        ]
+      },
       {
         "id": "Encounter:shr-encounter-Encounter.account",
         "path": "Encounter.account",
         "short": "The set of accounts that may be used for billing for this Encounter",
         "definition": "The set of accounts that may be used for billing for this Encounter.",
-        "comments": "The billing system may choose to allocate billable items associated with the Encounter to different referenced Accounts based on internal business rules.",
+        "comment": "The billing system may choose to allocate billable items associated with the Encounter to different referenced Accounts based on internal business rules.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1342,7 +1765,7 @@
         "path": "Encounter.hospitalization",
         "short": "Details about the admission to a healthcare service",
         "definition": "Details about the admission to a healthcare service.",
-        "comments": "An Encounter may cover more than just the inpatient stay. Contexts such as outpatients, community clinics, and aged care facilities are also included.\r\rThe duration recorded in the period of this encounter covers the entire scope of this hospitalization record.",
+        "comment": "An Encounter may cover more than just the inpatient stay. Contexts such as outpatients, community clinics, and aged care facilities are also included.\r\rThe duration recorded in the period of this encounter covers the entire scope of this hospitalization record.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1399,7 +1822,7 @@
         "path": "Encounter.hospitalization.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1428,7 +1851,7 @@
         "path": "Encounter.hospitalization.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1511,6 +1934,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AdmitSource"
+            }
+          ],
           "strength": "preferred",
           "description": "From where the patient was admitted.",
           "valueSetReference": {
@@ -1528,26 +1957,6 @@
           }
         ]
       },
-      {
-        "id": "Encounter:shr-encounter-Encounter.hospitalization.admittingDiagnosis",
-        "path": "Encounter.hospitalization.admittingDiagnosis",
-        "short": "The admitting diagnosis as reported by admitting practitioner",
-        "definition": "The admitting diagnosis field is used to record the diagnosis codes as reported by admitting practitioner. This could be different or in addition to the conditions reported as reason-condition(s) for the encounter.",
-        "min": 0,
-        "max": "*",
-        "type": [
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Condition"
-          }
-        ],
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": ".reason.A_ObservationDx"
-          }
-        ]
-      },
       {
         "id": "Encounter:shr-encounter-Encounter.hospitalization.reAdmission",
         "path": "Encounter.hospitalization.reAdmission",
@@ -1561,6 +1970,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ReAdmissionType"
+            }
+          ],
           "strength": "example",
           "description": "The reason for re-admission of this hospitalization encounter.",
           "valueSetReference": {
@@ -1574,7 +1989,7 @@
           },
           {
             "identity": "rim",
-            "map": "Propose at harmonization"
+            "map": "n/a"
           }
         ]
       },
@@ -1583,7 +1998,7 @@
         "path": "Encounter.hospitalization.dietPreference",
         "short": "Diet preferences reported by the patient",
         "definition": "Diet preferences reported by the patient.",
-        "comments": "For example a patient may request both a dairy-free and nut-free diet preference (not mutually exclusive).",
+        "comment": "For example a patient may request both a dairy-free and nut-free diet preference (not mutually exclusive).",
         "requirements": "Used to track patient's diet restrictions and/or preference. For a complete description of the nutrition needs of a patient during their stay, one should use the nutritionOrder resource which links to Encounter.",
         "min": 0,
         "max": "*",
@@ -1593,6 +2008,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "PatientDiet"
+            }
+          ],
           "strength": "example",
           "description": "Medical, cultural or ethical food preferences to help with catering requirements.",
           "valueSetReference": {
@@ -1623,6 +2044,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Courtesies"
+            }
+          ],
           "strength": "preferred",
           "description": "Special courtesies",
           "valueSetReference": {
@@ -1644,7 +2071,7 @@
         "id": "Encounter:shr-encounter-Encounter.hospitalization.specialArrangement",
         "path": "Encounter.hospitalization.specialArrangement",
         "short": "Wheelchair, translator, stretcher, etc.",
-        "definition": "Wheelchair, translator, stretcher, etc.",
+        "definition": "Any special requests that have been made for this hospitalization encounter, such as the provision of specific equipment or other things.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1653,6 +2080,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Arrangements"
+            }
+          ],
           "strength": "preferred",
           "description": "Special arrangements",
           "valueSetReference": {
@@ -1707,6 +2140,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "DischargeDisp"
+            }
+          ],
           "strength": "example",
           "description": "Discharge Disposition",
           "valueSetReference": {
@@ -1724,32 +2163,12 @@
           }
         ]
       },
-      {
-        "id": "Encounter:shr-encounter-Encounter.hospitalization.dischargeDiagnosis",
-        "path": "Encounter.hospitalization.dischargeDiagnosis",
-        "short": "The final diagnosis given a patient before release from the hospital after all testing, surgery, and workup are complete",
-        "definition": "The final diagnosis given a patient before release from the hospital after all testing, surgery, and workup are complete.",
-        "min": 0,
-        "max": "*",
-        "type": [
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Condition"
-          }
-        ],
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": ".outboundRelationship[typeCode=OUT].target[classCode=OBS, moodCode=EVN, code=ASSERTION].value"
-          }
-        ]
-      },
       {
         "id": "Encounter:shr-encounter-Encounter.location",
         "path": "Encounter.location",
         "short": "List of locations where the patient has been",
         "definition": "List of locations where  the patient has been during this encounter.",
-        "comments": "Virtual encounters can be recorded in the Encounter by specifying a location reference to a location of type \"kind\" such as \"client's home\" and an encounter.class = \"virtual\".",
+        "comment": "Virtual encounters can be recorded in the Encounter by specifying a location reference to a location of type \"kind\" such as \"client's home\" and an encounter.class = \"virtual\".",
         "min": 0,
         "max": "*",
         "type": [
@@ -1806,7 +2225,7 @@
         "path": "Encounter.location.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1835,7 +2254,7 @@
         "path": "Encounter.location.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1895,7 +2314,7 @@
         "path": "Encounter.location.status",
         "short": "planned | active | reserved | completed",
         "definition": "The status of the participants' presence at the specified location during the period specified. If the participant is is no longer at the location, then the period will have an end date/time.",
-        "comments": "When the patient is no longer active at a location, then the period end date is entered, and the status may be changed to completed.",
+        "comment": "When the patient is no longer active at a location, then the period end date is entered, and the status may be changed to completed.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1904,6 +2323,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "EncounterLocationStatus"
+            }
+          ],
           "strength": "required",
           "description": "The status of the location.",
           "valueSetReference": {
@@ -1965,7 +2390,7 @@
         "path": "Encounter.partOf",
         "short": "Another Encounter this encounter is part of",
         "definition": "Another Encounter of which this encounter is a part of (administratively or in time).",
-        "comments": "This is also used for associating a child's encounter back to the mother's encounter.\r\rRefer to the Notes section in the Patient resource for further details.",
+        "comment": "This is also used for associating a child's encounter back to the mother's encounter.\r\rRefer to the Notes section in the Patient resource for further details.",
         "min": 0,
         "max": "1",
         "type": [
@@ -2099,19 +2524,23 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-encounter-EncounterTypeVS"
+            "reference": "http://standardhealthrecord.org/shr/encounter/vs/EncounterTypeVS"
           }
         }
       },
       {
-        "id": "Encounter:shr-encounter-Encounter.patient",
-        "path": "Encounter.patient",
+        "id": "Encounter:shr-encounter-Encounter.subject",
+        "path": "Encounter.subject",
         "min": 1,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-demographics-PersonOfRecord"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Group"
           }
         ]
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-encounter-EncounterNonOccurrenceModifier-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-encounter-EncounterNonOccurrenceModifier-extension.json
old mode 100755
new mode 100644
index 1f298f9..db77294
--- a/lib/resources/standard_health_record/StructureDefinition-shr-encounter-EncounterNonOccurrenceModifier-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-encounter-EncounterNonOccurrenceModifier-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.encounter.EncounterNonOccurrenceModifier"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR EncounterNonOccurrenceModifier Extension",
   "title": "SHR EncounterNonOccurrenceModifier Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.521Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.349Z",
   "description": "True if the encounter did not occur.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -105,9 +106,12 @@
         "id": "Extension:encounternonoccurrencemodifier.extension",
         "path": "Extension.extension",
         "slicing": {
-          "id": "209",
+          "id": "200",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -233,7 +237,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -290,7 +293,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-encounter-Facility-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-encounter-Facility-extension.json
old mode 100755
new mode 100644
index e9d0379..1f3ae29
--- a/lib/resources/standard_health_record/StructureDefinition-shr-encounter-Facility-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-encounter-Facility-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.encounter.Facility"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Facility Extension",
   "title": "SHR Facility Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.522Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.350Z",
   "description": "Services and space and equipment provided for a particular purpose; a building or place that provides a particular service or is used for a particular industry. Could be a clinical site, community site, or a mobile facility.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-encounter-Facility.json b/lib/resources/standard_health_record/StructureDefinition-shr-encounter-Facility.json
old mode 100755
new mode 100644
index c16af5b..32d13bb
--- a/lib/resources/standard_health_record/StructureDefinition-shr-encounter-Facility.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-encounter-Facility.json
@@ -12,8 +12,10 @@
       "value": "shr.encounter.Facility"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Facility Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.499Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.342Z",
   "description": "Services and space and equipment provided for a particular purpose; a building or place that provides a particular service or is used for a particular industry. Could be a clinical site, community site, or a mobile facility.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "rim",
@@ -108,7 +109,7 @@
         "path": "Location.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -147,7 +148,7 @@
         "path": "Location.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -168,7 +169,7 @@
         "path": "Location.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -188,6 +189,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -202,7 +211,7 @@
         "path": "Location.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -236,7 +245,7 @@
         "path": "Location.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -265,16 +274,19 @@
         "id": "Location:shr-encounter-Facility.extension",
         "path": "Location.extension",
         "slicing": {
-          "id": "208",
+          "id": "199",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -303,6 +315,7 @@
         "path": "Location.extension",
         "sliceName": "mobilefacility",
         "definition": "A facility that moves from place to place, such as Meals-On-Wheels.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -335,7 +348,7 @@
         "path": "Location.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -389,7 +402,8 @@
         "id": "Location:shr-encounter-Facility.status",
         "path": "Location.status",
         "short": "active | suspended | inactive",
-        "definition": "active | suspended | inactive.",
+        "definition": "The status property covers the general availability of the resource, not the current value which may be covered by the operationStatus, or by a schedule/slots if they are configured for the location.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "min": 0,
         "max": "1",
         "type": [
@@ -400,6 +414,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "LocationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Indicates whether the location is still in use.",
           "valueSetReference": {
@@ -417,12 +437,49 @@
           }
         ]
       },
+      {
+        "id": "Location:shr-encounter-Facility.operationalStatus",
+        "path": "Location.operationalStatus",
+        "short": "The Operational status of the location (typically only for a bed/room)",
+        "definition": "The Operational status covers operation values most relevant to beds (but can also apply to rooms/units/chair/etc such as an isolation unit/dialisys chair). This typically covers concepts such as contamination, housekeeping and other activities like maintenance.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Coding"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "OperationalStatus"
+            }
+          ],
+          "strength": "preferred",
+          "description": "The operational status if the location (where typically a bed/room)",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/v2-0116"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          },
+          {
+            "identity": "w5",
+            "map": "status"
+          }
+        ]
+      },
       {
         "id": "Location:shr-encounter-Facility.name",
         "path": "Location.name",
         "short": "Name of the location as used by humans",
         "definition": "Name of the location as used by humans. Does not need to be unique.",
-        "comments": "If the name of an location changes, consider putting the old name in the alias column so that it can still be located through searches.",
+        "comment": "If the name of an location changes, consider putting the old name in the alias column so that it can still be located through searches.",
         "min": 1,
         "max": "1",
         "type": [
@@ -443,7 +500,7 @@
         "path": "Location.alias",
         "short": "A list of alternate names that the location is known as, or was known as in the past",
         "definition": "A list of alternate names that the location is known as, or was known as in the past.",
-        "comments": "There are no dates associated with the alias/historic names, as this is not intended to track when names were used, but to assist in searching so that older names can still result in identifying the location.",
+        "comment": "There are no dates associated with the alias/historic names, as this is not intended to track when names were used, but to assist in searching so that older names can still result in identifying the location.",
         "requirements": "Over time locations and organizations go through many changes and can be known by different names.\n\nFor searching knowing previous names that the location was known by can be very useful.",
         "min": 0,
         "max": "*",
@@ -485,6 +542,7 @@
         "path": "Location.mode",
         "short": "instance | kind",
         "definition": "Indicates whether a resource instance represents a specific location or a class of locations.",
+        "comment": "This is labeled as a modifer because whether or not the location is a class of locations changes how it can be used and understood.",
         "requirements": "When using a Location resource for scheduling or orders, we need to be able to refer to a class of Locations instead of a specific Location.",
         "min": 0,
         "max": "1",
@@ -496,6 +554,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "LocationMode"
+            }
+          ],
           "strength": "required",
           "description": "Indicates whether a resource instance represents a specific location or a class of locations.",
           "valueSetReference": {
@@ -528,6 +592,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "LocationType"
+            }
+          ],
           "strength": "extensible",
           "description": "Indicates the type of function performed at the location.",
           "valueSetReference": {
@@ -570,7 +640,7 @@
         "path": "Location.address",
         "short": "Physical location",
         "definition": "Physical location.",
-        "comments": "This was kept as 0..1 as there is no use property on the address, so wouldn't be able to identify different address types.",
+        "comment": "This was kept as 0..1 as there is no use property on the address, so wouldn't be able to identify different address types.",
         "requirements": "If locations can be visited, we need to keep track of their address.",
         "min": 0,
         "max": "1",
@@ -602,6 +672,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "PhysicalType"
+            }
+          ],
           "strength": "example",
           "description": "Physical form of the location",
           "valueSetReference": {
@@ -681,7 +757,7 @@
         "path": "Location.position.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -710,7 +786,7 @@
         "path": "Location.position.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -799,7 +875,7 @@
         "path": "Location.managingOrganization",
         "short": "Organization responsible for provisioning and upkeep",
         "definition": "The organization responsible for the provisioning and upkeep of the location.",
-        "comments": "This can also be used as the part of the organization hierarchy where this location provides services. These services can be defined through the HealthcareService resource.",
+        "comment": "This can also be used as the part of the organization hierarchy where this location provides services. These services can be defined through the HealthcareService resource.",
         "requirements": "Need to know who manages the location.",
         "min": 1,
         "max": "1",
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-encounter-MobileFacility-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-encounter-MobileFacility-extension.json
old mode 100755
new mode 100644
index a4cbc94..7bd8741
--- a/lib/resources/standard_health_record/StructureDefinition-shr-encounter-MobileFacility-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-encounter-MobileFacility-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.encounter.MobileFacility"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR MobileFacility Extension",
   "title": "SHR MobileFacility Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.504Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.343Z",
   "description": "A facility that moves from place to place, such as Meals-On-Wheels.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-encounter-PaymentSource-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-encounter-PaymentSource-extension.json
old mode 100755
new mode 100644
index fc328b1..c327360
--- a/lib/resources/standard_health_record/StructureDefinition-shr-encounter-PaymentSource-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-encounter-PaymentSource-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.encounter.PaymentSource"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR PaymentSource Extension",
   "title": "SHR PaymentSource Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.522Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.350Z",
   "description": "The source of payment for the current encounter.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -105,9 +106,12 @@
         "id": "Extension:paymentsource.extension",
         "path": "Extension.extension",
         "slicing": {
-          "id": "210",
+          "id": "201",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -135,7 +139,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-encounter-ReferralDate-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-encounter-ReferralDate-extension.json
old mode 100755
new mode 100644
index 66d1e81..599bea4
--- a/lib/resources/standard_health_record/StructureDefinition-shr-encounter-ReferralDate-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-encounter-ReferralDate-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.encounter.ReferralDate"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ReferralDate Extension",
   "title": "SHR ReferralDate Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.521Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.349Z",
   "description": "The date when the provider received a referral for service. A referral includes an oral, written, faxed or electronic request for services made by the client or on the client�s behalf.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-encounter-ReferralSourceType-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-encounter-ReferralSourceType-extension.json
old mode 100755
new mode 100644
index 21b6e2b..b58c633
--- a/lib/resources/standard_health_record/StructureDefinition-shr-encounter-ReferralSourceType-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-encounter-ReferralSourceType-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.encounter.ReferralSourceType"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ReferralSourceType Extension",
   "title": "SHR ReferralSourceType Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.521Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.349Z",
   "description": "The type of person or entity that instigated the encounter.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -170,7 +170,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-encounter-ReferralSourceTypeVS"
+            "reference": "http://standardhealthrecord.org/shr/encounter/vs/ReferralSourceTypeVS"
           }
         },
         "mapping": [
@@ -221,7 +221,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-encounter-ReferralSourceTypeVS"
+            "reference": "http://standardhealthrecord.org/shr/encounter/vs/ReferralSourceTypeVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-encounter-TreatmentCooperation-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-encounter-TreatmentCooperation-extension.json
old mode 100755
new mode 100644
index 2d484ab..f784f18
--- a/lib/resources/standard_health_record/StructureDefinition-shr-encounter-TreatmentCooperation-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-encounter-TreatmentCooperation-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.encounter.TreatmentCooperation"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR TreatmentCooperation Extension",
   "title": "SHR TreatmentCooperation Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.522Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.350Z",
   "description": "Whether the patient is undergoing treatment voluntarily, or under a legal order.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -170,7 +170,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-encounter-TreatmentCooperationVS"
+            "reference": "http://standardhealthrecord.org/shr/encounter/vs/TreatmentCooperationVS"
           }
         },
         "mapping": [
@@ -221,7 +221,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-encounter-TreatmentCooperationVS"
+            "reference": "http://standardhealthrecord.org/shr/encounter/vs/TreatmentCooperationVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-AnimalExposure-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-AnimalExposure-extension.json
old mode 100755
new mode 100644
index e9136ad..c4ca560
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-AnimalExposure-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-AnimalExposure-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.environment.AnimalExposure"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR AnimalExposure Extension",
   "title": "SHR AnimalExposure Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.963Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.210Z",
   "description": "The type of animals or pets the subject is exposed to.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-AnimalExposure.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-AnimalExposure.json
old mode 100755
new mode 100644
index 9c50f89..7faab0e
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-AnimalExposure.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-AnimalExposure.json
@@ -3,7 +3,7 @@
   "id": "shr-environment-AnimalExposure",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR AnimalExposure Profile</b></p>\n  <p>The type of animals or pets the subject is exposed to.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.AnimalExposure maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR AnimalExposure Profile</b></p>\n  <p>The type of animals or pets the subject is exposed to.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.AnimalExposure maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-environment-AnimalExposure",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.environment.AnimalExposure"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR AnimalExposure Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.970Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.216Z",
   "description": "The type of animals or pets the subject is exposed to.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR AnimalExposure Profile",
         "definition": "The type of animals or pets the subject is exposed to.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-environment-AnimalExposure.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "158",
+          "id": "156",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -398,6 +435,7 @@
         "path": "Observation.extension",
         "sliceName": "setting",
         "definition": "Description of the place or type of surroundings where something is positioned or where an event takes place.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -430,6 +468,7 @@
         "path": "Observation.extension",
         "sliceName": "location",
         "definition": "A position, site, or point in space where something can be found.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -462,6 +501,7 @@
         "path": "Observation.extension",
         "sliceName": "frequency",
         "definition": "How many occurrences of an event per unit of time.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -494,6 +534,7 @@
         "path": "Observation.extension",
         "sliceName": "substance",
         "definition": "Any matter of defined composition that has discrete existence, whose origin may be biological, mineral or chemical.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -526,6 +567,7 @@
         "path": "Observation.extension",
         "sliceName": "generalizedlikelihood",
         "definition": "Quantitative or qualitative measure of likelihood.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -558,6 +600,7 @@
         "path": "Observation.extension",
         "sliceName": "exposuresourceorvector",
         "definition": "Where the substance originated. Vectors include animals (e.g., tick, mosquito, cats, livestock) capable of transmitting an infectious agent among vertebrates. Sources could include food, contaminated drinking water, air, radon gas in the home, etc.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -639,7 +682,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -681,7 +723,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-environment-AnimalExposureVS"
+            "reference": "http://standardhealthrecord.org/shr/environment/vs/AnimalExposureVS"
           }
         },
         "mapping": [
@@ -696,6 +738,7 @@
         "path": "Observation.extension",
         "sliceName": "exposurereason",
         "definition": "Why the exposure occurred.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -728,6 +771,7 @@
         "path": "Observation.extension",
         "sliceName": "exposuremethod",
         "definition": "How the exposure occurred, e.g. cutaneous contact, injection, ingestion, sexual contact, inhalation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -760,6 +804,7 @@
         "path": "Observation.extension",
         "sliceName": "routeintobody",
         "definition": "The way a substance enters an organism after contact, particularly, the route of drug administration.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -792,6 +837,7 @@
         "path": "Observation.extension",
         "sliceName": "test",
         "definition": "A laboratory, radiologic, or other clinical test or measurement used to determine the presence, absence, or degree of a condition, or assess the function or health of an individual. This includes patient-generated data, such as pedometer readings.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -823,16 +869,19 @@
         "id": "Observation:shr-environment-AnimalExposure.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "159",
+          "id": "157",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -862,6 +911,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -892,8 +942,8 @@
       {
         "id": "Observation:shr-environment-AnimalExposure.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -902,7 +952,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -917,6 +972,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-environment-AnimalExposure.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-environment-AnimalExposure.status",
         "extension": [
@@ -928,6 +1040,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -939,6 +1052,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -946,6 +1065,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -964,17 +1091,20 @@
         "id": "Observation:shr-environment-AnimalExposure.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "157",
+          "id": "155",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 1,
         "max": "*",
         "type": [
@@ -984,8 +1114,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -1049,6 +1185,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -1067,6 +1206,12 @@
         },
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1074,6 +1219,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1082,6 +1235,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -1093,7 +1250,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -1117,6 +1274,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -1132,20 +1293,32 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-AnimalExposure.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-environment-AnimalExposure.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -1165,8 +1338,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -1180,6 +1356,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -1199,7 +1379,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -1251,6 +1431,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -1270,8 +1454,8 @@
         "path": "Observation.value[x]",
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1284,6 +1468,9 @@
           {
             "code": "string"
           },
+          {
+            "code": "boolean"
+          },
           {
             "code": "Range"
           },
@@ -1311,6 +1498,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1318,6 +1513,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1326,7 +1525,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1339,6 +1538,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1346,6 +1551,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -1373,6 +1582,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1380,6 +1595,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1387,6 +1606,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1404,6 +1627,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -1419,8 +1646,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1429,6 +1655,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -1436,6 +1668,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -1443,6 +1679,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1451,7 +1691,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1462,6 +1702,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1484,7 +1730,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1494,6 +1740,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1501,6 +1751,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1509,7 +1763,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1523,6 +1777,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1530,6 +1788,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1538,7 +1800,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1607,7 +1869,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1636,7 +1898,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1718,30 +1980,82 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-AnimalExposure.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-environment-AnimalExposure.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-environment-AnimalExposure.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1797,8 +2111,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1860,7 +2174,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1889,7 +2203,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1921,7 +2235,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1931,6 +2245,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1981,7 +2301,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -2044,7 +2364,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -2073,7 +2393,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -2115,6 +2435,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -2122,6 +2448,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -2141,8 +2471,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -2179,6 +2509,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -2186,6 +2520,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -2194,7 +2532,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -2207,6 +2545,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -2229,7 +2573,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -2242,6 +2586,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -2249,6 +2599,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -2256,6 +2610,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -2264,7 +2622,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -2420,7 +2778,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-environment-AnimalExposureVS"
+            "reference": "http://standardhealthrecord.org/shr/environment/vs/AnimalExposureVS"
           }
         }
       },
@@ -2508,9 +2866,12 @@
         "id": "Observation:shr-environment-AnimalExposure.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "157",
+          "id": "155",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -2609,12 +2970,16 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-AnimalExposure.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-environment-AnimalExposure.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-AnnualIncome-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-AnnualIncome-extension.json
old mode 100755
new mode 100644
index bb96c84..2f0489e
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-AnnualIncome-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-AnnualIncome-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.environment.AnnualIncome"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR AnnualIncome Extension",
   "title": "SHR AnnualIncome Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.471Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.091Z",
   "description": "The amount of earnings made by a family unit in one year, estimated or self-reported.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-AnnualIncome.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-AnnualIncome.json
old mode 100755
new mode 100644
index 2e05bc2..44f13f4
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-AnnualIncome.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-AnnualIncome.json
@@ -3,7 +3,7 @@
   "id": "shr-environment-AnnualIncome",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR AnnualIncome Profile</b></p>\n  <p>The amount of earnings made by a family unit in one year, estimated or self-reported.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.AnnualIncome maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  DollarAmount maps to value[x].quantity\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR AnnualIncome Profile</b></p>\n  <p>The amount of earnings made by a family unit in one year, estimated or self-reported.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.AnnualIncome maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  DollarAmount maps to value[x].Quantity\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-environment-AnnualIncome",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.environment.AnnualIncome"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR AnnualIncome Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.479Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.098Z",
   "description": "The amount of earnings made by a family unit in one year, estimated or self-reported.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR AnnualIncome Profile",
         "definition": "The amount of earnings made by a family unit in one year, estimated or self-reported.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-environment-AnnualIncome.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "114",
+          "id": "112",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -397,16 +434,19 @@
         "id": "Observation:shr-environment-AnnualIncome.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "115",
+          "id": "113",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -436,6 +476,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -466,8 +507,8 @@
       {
         "id": "Observation:shr-environment-AnnualIncome.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -476,7 +517,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -491,6 +537,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-environment-AnnualIncome.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-environment-AnnualIncome.status",
         "extension": [
@@ -502,6 +605,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -513,6 +617,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -520,6 +630,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -539,8 +657,8 @@
         "path": "Observation.category",
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 0,
         "max": "*",
         "type": [
@@ -550,8 +668,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -573,6 +697,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -591,6 +718,12 @@
         },
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -598,6 +731,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -606,6 +747,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -617,7 +762,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -641,6 +786,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -656,20 +805,32 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-AnnualIncome.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-environment-AnnualIncome.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -689,8 +850,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -704,6 +868,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -723,7 +891,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -775,6 +943,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -794,40 +966,14 @@
         "path": "Observation.value[x]",
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
-        "min": 0,
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
+        "min": 1,
         "max": "1",
         "type": [
           {
-            "code": "Quantity"
-          },
-          {
-            "code": "CodeableConcept"
-          },
-          {
-            "code": "string"
-          },
-          {
-            "code": "Range"
-          },
-          {
-            "code": "Ratio"
-          },
-          {
-            "code": "SampledData"
-          },
-          {
-            "code": "Attachment"
-          },
-          {
-            "code": "time"
-          },
-          {
-            "code": "dateTime"
-          },
-          {
-            "code": "Period"
+            "code": "Quantity",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-DollarAmount"
           }
         ],
         "condition": [
@@ -835,6 +981,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -842,6 +996,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -850,7 +1008,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -863,6 +1021,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -870,6 +1034,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -897,6 +1065,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -904,6 +1078,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -911,6 +1089,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -928,6 +1110,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -943,8 +1129,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -953,6 +1138,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -960,6 +1151,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -967,6 +1162,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -975,7 +1174,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -986,6 +1185,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1008,7 +1213,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1018,6 +1223,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1025,6 +1234,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1033,7 +1246,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1047,6 +1260,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1054,6 +1271,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1062,7 +1283,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1131,7 +1352,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1160,7 +1381,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1242,30 +1463,82 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-AnnualIncome.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-environment-AnnualIncome.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-environment-AnnualIncome.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1321,8 +1594,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1384,7 +1657,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1413,7 +1686,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1445,7 +1718,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1455,6 +1728,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1505,7 +1784,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1568,7 +1847,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1597,7 +1876,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1639,6 +1918,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1646,6 +1931,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1665,8 +1954,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1703,6 +1992,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1710,6 +2003,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1718,7 +2015,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1731,6 +2028,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1753,7 +2056,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1766,6 +2069,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1773,6 +2082,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1780,6 +2093,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1788,7 +2105,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1915,12 +2232,16 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-AnnualIncome.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-environment-AnnualIncome.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
@@ -1965,6 +2286,18 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-environment-AnnualIncome.value[x]",
+        "path": "Observation.value[x]",
+        "min": 1,
+        "max": "1",
+        "type": [
+          {
+            "code": "Quantity",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-DollarAmount"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-environment-AnnualIncome.method",
         "path": "Observation.method",
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordChildCare-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordChildCare-extension.json
old mode 100755
new mode 100644
index e73b63f..9b30446
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordChildCare-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordChildCare-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.environment.CanAffordChildCare"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR CanAffordChildCare Extension",
   "title": "SHR CanAffordChildCare Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.473Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.092Z",
   "description": "How often can the subject afford child care?",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordChildCare.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordChildCare.json
old mode 100755
new mode 100644
index 7197067..20d6251
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordChildCare.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordChildCare.json
@@ -3,7 +3,7 @@
   "id": "shr-environment-CanAffordChildCare",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR CanAffordChildCare Profile</b></p>\n  <p>How often can the subject afford child care?</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.CanAffordChildCare maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR CanAffordChildCare Profile</b></p>\n  <p>How often can the subject afford child care?</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.CanAffordChildCare maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-environment-CanAffordChildCare",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.environment.CanAffordChildCare"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR CanAffordChildCare Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.787Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.173Z",
   "description": "How often can the subject afford child care?",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR CanAffordChildCare Profile",
         "definition": "How often can the subject afford child care?",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-environment-CanAffordChildCare.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "144",
+          "id": "142",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -397,16 +434,19 @@
         "id": "Observation:shr-environment-CanAffordChildCare.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "145",
+          "id": "143",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -436,6 +476,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -466,8 +507,8 @@
       {
         "id": "Observation:shr-environment-CanAffordChildCare.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -476,7 +517,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -491,6 +537,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-environment-CanAffordChildCare.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-environment-CanAffordChildCare.status",
         "extension": [
@@ -502,6 +605,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -513,6 +617,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -520,6 +630,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -539,8 +657,8 @@
         "path": "Observation.category",
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 0,
         "max": "*",
         "type": [
@@ -550,8 +668,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -573,6 +697,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -583,6 +710,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -590,6 +723,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -598,6 +739,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -609,7 +754,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -633,6 +778,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -648,20 +797,32 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-CanAffordChildCare.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-environment-CanAffordChildCare.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -681,8 +842,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -696,6 +860,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -715,7 +883,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -767,6 +935,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -785,17 +957,20 @@
         "id": "Observation:shr-environment-CanAffordChildCare.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "143",
+          "id": "141",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 1,
         "max": "1",
         "type": [
@@ -809,6 +984,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -816,6 +999,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -837,7 +1024,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeFrequencyVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeFrequencyVS"
           }
         }
       },
@@ -846,7 +1033,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -859,6 +1046,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -866,6 +1059,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -893,6 +1090,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -900,6 +1103,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -907,6 +1114,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -924,6 +1135,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -939,8 +1154,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -949,6 +1163,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -956,6 +1176,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -963,6 +1187,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -971,7 +1199,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -982,6 +1210,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1004,7 +1238,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1014,6 +1248,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1021,6 +1259,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1029,7 +1271,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1043,6 +1285,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1050,6 +1296,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1058,7 +1308,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1127,7 +1377,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1156,7 +1406,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1238,30 +1488,82 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-CanAffordChildCare.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-environment-CanAffordChildCare.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-environment-CanAffordChildCare.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1317,8 +1619,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1380,7 +1682,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1409,7 +1711,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1441,7 +1743,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1451,6 +1753,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1501,7 +1809,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1564,7 +1872,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1593,7 +1901,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1635,6 +1943,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1642,6 +1956,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1661,8 +1979,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1699,6 +2017,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1706,6 +2028,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1714,7 +2040,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1727,6 +2053,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1749,7 +2081,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1762,6 +2094,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1769,6 +2107,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1776,6 +2118,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1784,7 +2130,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1903,12 +2249,16 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-CanAffordChildCare.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-environment-CanAffordChildCare.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
@@ -1957,9 +2307,12 @@
         "id": "Observation:shr-environment-CanAffordChildCare.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "143",
+          "id": "141",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -1985,7 +2338,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeFrequencyVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeFrequencyVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordClothing-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordClothing-extension.json
old mode 100755
new mode 100644
index de62288..e7cca5a
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordClothing-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordClothing-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.environment.CanAffordClothing"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR CanAffordClothing Extension",
   "title": "SHR CanAffordClothing Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.472Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.092Z",
   "description": "How often can the subject afford clothing?",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordClothing.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordClothing.json
old mode 100755
new mode 100644
index babfc9e..bfc0501
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordClothing.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordClothing.json
@@ -3,7 +3,7 @@
   "id": "shr-environment-CanAffordClothing",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR CanAffordClothing Profile</b></p>\n  <p>How often can the subject afford clothing?</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.CanAffordClothing maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR CanAffordClothing Profile</b></p>\n  <p>How often can the subject afford clothing?</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.CanAffordClothing maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-environment-CanAffordClothing",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.environment.CanAffordClothing"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR CanAffordClothing Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.632Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.137Z",
   "description": "How often can the subject afford clothing?",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR CanAffordClothing Profile",
         "definition": "How often can the subject afford clothing?",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-environment-CanAffordClothing.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "129",
+          "id": "127",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -397,16 +434,19 @@
         "id": "Observation:shr-environment-CanAffordClothing.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "130",
+          "id": "128",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -436,6 +476,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -466,8 +507,8 @@
       {
         "id": "Observation:shr-environment-CanAffordClothing.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -476,7 +517,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -491,6 +537,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-environment-CanAffordClothing.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-environment-CanAffordClothing.status",
         "extension": [
@@ -502,6 +605,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -513,6 +617,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -520,6 +630,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -539,8 +657,8 @@
         "path": "Observation.category",
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 0,
         "max": "*",
         "type": [
@@ -550,8 +668,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -573,6 +697,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -583,6 +710,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -590,6 +723,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -598,6 +739,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -609,7 +754,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -633,6 +778,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -648,20 +797,32 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-CanAffordClothing.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-environment-CanAffordClothing.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -681,8 +842,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -696,6 +860,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -715,7 +883,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -767,6 +935,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -785,17 +957,20 @@
         "id": "Observation:shr-environment-CanAffordClothing.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "128",
+          "id": "126",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 1,
         "max": "1",
         "type": [
@@ -809,6 +984,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -816,6 +999,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -837,7 +1024,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeFrequencyVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeFrequencyVS"
           }
         }
       },
@@ -846,7 +1033,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -859,6 +1046,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -866,6 +1059,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -893,6 +1090,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -900,6 +1103,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -907,6 +1114,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -924,6 +1135,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -939,8 +1154,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -949,6 +1163,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -956,6 +1176,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -963,6 +1187,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -971,7 +1199,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -982,6 +1210,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1004,7 +1238,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1014,6 +1248,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1021,6 +1259,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1029,7 +1271,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1043,6 +1285,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1050,6 +1296,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1058,7 +1308,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1127,7 +1377,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1156,7 +1406,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1238,30 +1488,82 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-CanAffordClothing.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-environment-CanAffordClothing.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-environment-CanAffordClothing.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1317,8 +1619,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1380,7 +1682,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1409,7 +1711,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1441,7 +1743,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1451,6 +1753,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1501,7 +1809,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1564,7 +1872,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1593,7 +1901,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1635,6 +1943,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1642,6 +1956,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1661,8 +1979,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1699,6 +2017,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1706,6 +2028,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1714,7 +2040,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1727,6 +2053,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1749,7 +2081,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1762,6 +2094,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1769,6 +2107,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1776,6 +2118,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1784,7 +2130,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1903,12 +2249,16 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-CanAffordClothing.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-environment-CanAffordClothing.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
@@ -1957,9 +2307,12 @@
         "id": "Observation:shr-environment-CanAffordClothing.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "128",
+          "id": "126",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -1985,7 +2338,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeFrequencyVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeFrequencyVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordDentalCare-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordDentalCare-extension.json
old mode 100755
new mode 100644
index ddf842d..54f91f7
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordDentalCare-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordDentalCare-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.environment.CanAffordDentalCare"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR CanAffordDentalCare Extension",
   "title": "SHR CanAffordDentalCare Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.472Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.092Z",
   "description": "How often can the subject afford dental care?",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordDentalCare.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordDentalCare.json
old mode 100755
new mode 100644
index 8b23cf5..f285c4e
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordDentalCare.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordDentalCare.json
@@ -3,7 +3,7 @@
   "id": "shr-environment-CanAffordDentalCare",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR CanAffordDentalCare Profile</b></p>\n  <p>How often can the subject afford dental care?</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.CanAffordDentalCare maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR CanAffordDentalCare Profile</b></p>\n  <p>How often can the subject afford dental care?</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.CanAffordDentalCare maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-environment-CanAffordDentalCare",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.environment.CanAffordDentalCare"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR CanAffordDentalCare Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.757Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.166Z",
   "description": "How often can the subject afford dental care?",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR CanAffordDentalCare Profile",
         "definition": "How often can the subject afford dental care?",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-environment-CanAffordDentalCare.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "141",
+          "id": "139",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -397,16 +434,19 @@
         "id": "Observation:shr-environment-CanAffordDentalCare.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "142",
+          "id": "140",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -436,6 +476,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -466,8 +507,8 @@
       {
         "id": "Observation:shr-environment-CanAffordDentalCare.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -476,7 +517,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -491,6 +537,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-environment-CanAffordDentalCare.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-environment-CanAffordDentalCare.status",
         "extension": [
@@ -502,6 +605,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -513,6 +617,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -520,6 +630,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -539,8 +657,8 @@
         "path": "Observation.category",
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 0,
         "max": "*",
         "type": [
@@ -550,8 +668,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -573,6 +697,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -583,6 +710,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -590,6 +723,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -598,6 +739,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -609,7 +754,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -633,6 +778,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -648,20 +797,32 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-CanAffordDentalCare.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-environment-CanAffordDentalCare.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -681,8 +842,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -696,6 +860,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -715,7 +883,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -767,6 +935,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -785,17 +957,20 @@
         "id": "Observation:shr-environment-CanAffordDentalCare.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "140",
+          "id": "138",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 1,
         "max": "1",
         "type": [
@@ -809,6 +984,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -816,6 +999,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -837,7 +1024,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeFrequencyVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeFrequencyVS"
           }
         }
       },
@@ -846,7 +1033,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -859,6 +1046,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -866,6 +1059,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -893,6 +1090,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -900,6 +1103,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -907,6 +1114,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -924,6 +1135,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -939,8 +1154,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -949,6 +1163,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -956,6 +1176,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -963,6 +1187,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -971,7 +1199,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -982,6 +1210,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1004,7 +1238,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1014,6 +1248,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1021,6 +1259,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1029,7 +1271,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1043,6 +1285,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1050,6 +1296,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1058,7 +1308,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1127,7 +1377,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1156,7 +1406,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1238,30 +1488,82 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-CanAffordDentalCare.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-environment-CanAffordDentalCare.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-environment-CanAffordDentalCare.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1317,8 +1619,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1380,7 +1682,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1409,7 +1711,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1441,7 +1743,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1451,6 +1753,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1501,7 +1809,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1564,7 +1872,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1593,7 +1901,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1635,6 +1943,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1642,6 +1956,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1661,8 +1979,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1699,6 +2017,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1706,6 +2028,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1714,7 +2040,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1727,6 +2053,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1749,7 +2081,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1762,6 +2094,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1769,6 +2107,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1776,6 +2118,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1784,7 +2130,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1903,12 +2249,16 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-CanAffordDentalCare.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-environment-CanAffordDentalCare.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
@@ -1957,9 +2307,12 @@
         "id": "Observation:shr-environment-CanAffordDentalCare.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "140",
+          "id": "138",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -1985,7 +2338,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeFrequencyVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeFrequencyVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordFood-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordFood-extension.json
old mode 100755
new mode 100644
index a23ca27..4d2121d
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordFood-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordFood-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.environment.CanAffordFood"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR CanAffordFood Extension",
   "title": "SHR CanAffordFood Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.472Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.091Z",
   "description": "How often can the subject afford food?",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordFood.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordFood.json
old mode 100755
new mode 100644
index 18e117f..e125719
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordFood.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordFood.json
@@ -3,7 +3,7 @@
   "id": "shr-environment-CanAffordFood",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR CanAffordFood Profile</b></p>\n  <p>How often can the subject afford food?</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.CanAffordFood maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR CanAffordFood Profile</b></p>\n  <p>How often can the subject afford food?</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.CanAffordFood maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-environment-CanAffordFood",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.environment.CanAffordFood"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR CanAffordFood Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.573Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.122Z",
   "description": "How often can the subject afford food?",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR CanAffordFood Profile",
         "definition": "How often can the subject afford food?",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-environment-CanAffordFood.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "123",
+          "id": "121",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -397,16 +434,19 @@
         "id": "Observation:shr-environment-CanAffordFood.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "124",
+          "id": "122",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -436,6 +476,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -466,8 +507,8 @@
       {
         "id": "Observation:shr-environment-CanAffordFood.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -476,7 +517,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -491,6 +537,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-environment-CanAffordFood.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-environment-CanAffordFood.status",
         "extension": [
@@ -502,6 +605,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -513,6 +617,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -520,6 +630,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -539,8 +657,8 @@
         "path": "Observation.category",
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 0,
         "max": "*",
         "type": [
@@ -550,8 +668,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -573,6 +697,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -583,6 +710,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -590,6 +723,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -598,6 +739,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -609,7 +754,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -633,6 +778,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -648,20 +797,32 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-CanAffordFood.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-environment-CanAffordFood.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -681,8 +842,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -696,6 +860,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -715,7 +883,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -767,6 +935,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -785,17 +957,20 @@
         "id": "Observation:shr-environment-CanAffordFood.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "122",
+          "id": "120",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 1,
         "max": "1",
         "type": [
@@ -809,6 +984,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -816,6 +999,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -837,7 +1024,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeFrequencyVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeFrequencyVS"
           }
         }
       },
@@ -846,7 +1033,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -859,6 +1046,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -866,6 +1059,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -893,6 +1090,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -900,6 +1103,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -907,6 +1114,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -924,6 +1135,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -939,8 +1154,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -949,6 +1163,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -956,6 +1176,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -963,6 +1187,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -971,7 +1199,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -982,6 +1210,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1004,7 +1238,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1014,6 +1248,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1021,6 +1259,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1029,7 +1271,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1043,6 +1285,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1050,6 +1296,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1058,7 +1308,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1127,7 +1377,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1156,7 +1406,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1238,30 +1488,82 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-CanAffordFood.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-environment-CanAffordFood.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-environment-CanAffordFood.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1317,8 +1619,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1380,7 +1682,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1409,7 +1711,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1441,7 +1743,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1451,6 +1753,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1501,7 +1809,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1564,7 +1872,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1593,7 +1901,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1635,6 +1943,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1642,6 +1956,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1661,8 +1979,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1699,6 +2017,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1706,6 +2028,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1714,7 +2040,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1727,6 +2053,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1749,7 +2081,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1762,6 +2094,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1769,6 +2107,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1776,6 +2118,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1784,7 +2130,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1903,12 +2249,16 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-CanAffordFood.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-environment-CanAffordFood.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
@@ -1957,9 +2307,12 @@
         "id": "Observation:shr-environment-CanAffordFood.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "122",
+          "id": "120",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -1985,7 +2338,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeFrequencyVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeFrequencyVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordHousing-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordHousing-extension.json
old mode 100755
new mode 100644
index a23a22d..b1e0e86
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordHousing-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordHousing-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.environment.CanAffordHousing"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR CanAffordHousing Extension",
   "title": "SHR CanAffordHousing Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.472Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.091Z",
   "description": "How often can the subject afford housing?",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordHousing.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordHousing.json
old mode 100755
new mode 100644
index f95a0ba..b667b78
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordHousing.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordHousing.json
@@ -3,7 +3,7 @@
   "id": "shr-environment-CanAffordHousing",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR CanAffordHousing Profile</b></p>\n  <p>How often can the subject afford housing?</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.CanAffordHousing maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR CanAffordHousing Profile</b></p>\n  <p>How often can the subject afford housing?</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.CanAffordHousing maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-environment-CanAffordHousing",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.environment.CanAffordHousing"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR CanAffordHousing Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.602Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.129Z",
   "description": "How often can the subject afford housing?",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR CanAffordHousing Profile",
         "definition": "How often can the subject afford housing?",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-environment-CanAffordHousing.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "126",
+          "id": "124",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -397,16 +434,19 @@
         "id": "Observation:shr-environment-CanAffordHousing.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "127",
+          "id": "125",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -436,6 +476,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -466,8 +507,8 @@
       {
         "id": "Observation:shr-environment-CanAffordHousing.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -476,7 +517,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -491,6 +537,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-environment-CanAffordHousing.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-environment-CanAffordHousing.status",
         "extension": [
@@ -502,6 +605,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -513,6 +617,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -520,6 +630,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -539,8 +657,8 @@
         "path": "Observation.category",
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 0,
         "max": "*",
         "type": [
@@ -550,8 +668,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -573,6 +697,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -583,6 +710,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -590,6 +723,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -598,6 +739,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -609,7 +754,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -633,6 +778,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -648,20 +797,32 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-CanAffordHousing.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-environment-CanAffordHousing.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -681,8 +842,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -696,6 +860,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -715,7 +883,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -767,6 +935,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -785,17 +957,20 @@
         "id": "Observation:shr-environment-CanAffordHousing.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "125",
+          "id": "123",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 1,
         "max": "1",
         "type": [
@@ -809,6 +984,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -816,6 +999,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -837,7 +1024,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeFrequencyVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeFrequencyVS"
           }
         }
       },
@@ -846,7 +1033,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -859,6 +1046,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -866,6 +1059,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -893,6 +1090,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -900,6 +1103,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -907,6 +1114,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -924,6 +1135,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -939,8 +1154,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -949,6 +1163,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -956,6 +1176,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -963,6 +1187,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -971,7 +1199,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -982,6 +1210,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1004,7 +1238,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1014,6 +1248,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1021,6 +1259,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1029,7 +1271,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1043,6 +1285,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1050,6 +1296,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1058,7 +1308,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1127,7 +1377,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1156,7 +1406,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1238,30 +1488,82 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-CanAffordHousing.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-environment-CanAffordHousing.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-environment-CanAffordHousing.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1317,8 +1619,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1380,7 +1682,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1409,7 +1711,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1441,7 +1743,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1451,6 +1753,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1501,7 +1809,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1564,7 +1872,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1593,7 +1901,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1635,6 +1943,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1642,6 +1956,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1661,8 +1979,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1699,6 +2017,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1706,6 +2028,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1714,7 +2040,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1727,6 +2053,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1749,7 +2081,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1762,6 +2094,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1769,6 +2107,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1776,6 +2118,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1784,7 +2130,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1903,12 +2249,16 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-CanAffordHousing.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-environment-CanAffordHousing.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
@@ -1957,9 +2307,12 @@
         "id": "Observation:shr-environment-CanAffordHousing.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "125",
+          "id": "123",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -1985,7 +2338,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeFrequencyVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeFrequencyVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordMedication-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordMedication-extension.json
old mode 100755
new mode 100644
index b05ea5b..453784f
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordMedication-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordMedication-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.environment.CanAffordMedication"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR CanAffordMedication Extension",
   "title": "SHR CanAffordMedication Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.472Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.092Z",
   "description": "How often can the subject afford medications?",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordMedication.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordMedication.json
old mode 100755
new mode 100644
index f03a514..49e03d9
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordMedication.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordMedication.json
@@ -3,7 +3,7 @@
   "id": "shr-environment-CanAffordMedication",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR CanAffordMedication Profile</b></p>\n  <p>How often can the subject afford medications?</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.CanAffordMedication maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR CanAffordMedication Profile</b></p>\n  <p>How often can the subject afford medications?</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.CanAffordMedication maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-environment-CanAffordMedication",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.environment.CanAffordMedication"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR CanAffordMedication Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.727Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.157Z",
   "description": "How often can the subject afford medications?",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR CanAffordMedication Profile",
         "definition": "How often can the subject afford medications?",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-environment-CanAffordMedication.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "138",
+          "id": "136",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -397,16 +434,19 @@
         "id": "Observation:shr-environment-CanAffordMedication.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "139",
+          "id": "137",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -436,6 +476,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -466,8 +507,8 @@
       {
         "id": "Observation:shr-environment-CanAffordMedication.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -476,7 +517,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -491,6 +537,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-environment-CanAffordMedication.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-environment-CanAffordMedication.status",
         "extension": [
@@ -502,6 +605,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -513,6 +617,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -520,6 +630,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -539,8 +657,8 @@
         "path": "Observation.category",
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 0,
         "max": "*",
         "type": [
@@ -550,8 +668,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -573,6 +697,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -583,6 +710,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -590,6 +723,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -598,6 +739,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -609,7 +754,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -633,6 +778,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -648,20 +797,32 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-CanAffordMedication.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-environment-CanAffordMedication.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -681,8 +842,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -696,6 +860,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -715,7 +883,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -767,6 +935,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -785,17 +957,20 @@
         "id": "Observation:shr-environment-CanAffordMedication.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "137",
+          "id": "135",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 1,
         "max": "1",
         "type": [
@@ -809,6 +984,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -816,6 +999,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -837,7 +1024,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeFrequencyVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeFrequencyVS"
           }
         }
       },
@@ -846,7 +1033,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -859,6 +1046,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -866,6 +1059,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -893,6 +1090,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -900,6 +1103,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -907,6 +1114,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -924,6 +1135,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -939,8 +1154,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -949,6 +1163,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -956,6 +1176,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -963,6 +1187,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -971,7 +1199,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -982,6 +1210,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1004,7 +1238,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1014,6 +1248,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1021,6 +1259,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1029,7 +1271,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1043,6 +1285,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1050,6 +1296,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1058,7 +1308,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1127,7 +1377,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1156,7 +1406,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1238,30 +1488,82 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-CanAffordMedication.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-environment-CanAffordMedication.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-environment-CanAffordMedication.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1317,8 +1619,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1380,7 +1682,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1409,7 +1711,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1441,7 +1743,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1451,6 +1753,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1501,7 +1809,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1564,7 +1872,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1593,7 +1901,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1635,6 +1943,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1642,6 +1956,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1661,8 +1979,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1699,6 +2017,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1706,6 +2028,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1714,7 +2040,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1727,6 +2053,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1749,7 +2081,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1762,6 +2094,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1769,6 +2107,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1776,6 +2118,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1784,7 +2130,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1903,12 +2249,16 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-CanAffordMedication.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-environment-CanAffordMedication.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
@@ -1957,9 +2307,12 @@
         "id": "Observation:shr-environment-CanAffordMedication.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "137",
+          "id": "135",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -1985,7 +2338,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeFrequencyVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeFrequencyVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordTransportation-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordTransportation-extension.json
old mode 100755
new mode 100644
index 7f6e7ef..ef38ea0
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordTransportation-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordTransportation-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.environment.CanAffordTransportation"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR CanAffordTransportation Extension",
   "title": "SHR CanAffordTransportation Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.472Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.092Z",
   "description": "How often can the subject afford transportation?",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordTransportation.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordTransportation.json
old mode 100755
new mode 100644
index ff98b5f..44c74ba
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordTransportation.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordTransportation.json
@@ -3,7 +3,7 @@
   "id": "shr-environment-CanAffordTransportation",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR CanAffordTransportation Profile</b></p>\n  <p>How often can the subject afford transportation?</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.CanAffordTransportation maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR CanAffordTransportation Profile</b></p>\n  <p>How often can the subject afford transportation?</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.CanAffordTransportation maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-environment-CanAffordTransportation",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.environment.CanAffordTransportation"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR CanAffordTransportation Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.696Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.151Z",
   "description": "How often can the subject afford transportation?",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR CanAffordTransportation Profile",
         "definition": "How often can the subject afford transportation?",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-environment-CanAffordTransportation.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "135",
+          "id": "133",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -397,16 +434,19 @@
         "id": "Observation:shr-environment-CanAffordTransportation.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "136",
+          "id": "134",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -436,6 +476,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -466,8 +507,8 @@
       {
         "id": "Observation:shr-environment-CanAffordTransportation.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -476,7 +517,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -491,6 +537,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-environment-CanAffordTransportation.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-environment-CanAffordTransportation.status",
         "extension": [
@@ -502,6 +605,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -513,6 +617,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -520,6 +630,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -539,8 +657,8 @@
         "path": "Observation.category",
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 0,
         "max": "*",
         "type": [
@@ -550,8 +668,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -573,6 +697,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -583,6 +710,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -590,6 +723,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -598,6 +739,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -609,7 +754,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -633,6 +778,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -648,20 +797,32 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-CanAffordTransportation.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-environment-CanAffordTransportation.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -681,8 +842,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -696,6 +860,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -715,7 +883,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -767,6 +935,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -785,17 +957,20 @@
         "id": "Observation:shr-environment-CanAffordTransportation.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "134",
+          "id": "132",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 1,
         "max": "1",
         "type": [
@@ -809,6 +984,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -816,6 +999,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -837,7 +1024,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeFrequencyVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeFrequencyVS"
           }
         }
       },
@@ -846,7 +1033,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -859,6 +1046,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -866,6 +1059,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -893,6 +1090,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -900,6 +1103,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -907,6 +1114,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -924,6 +1135,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -939,8 +1154,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -949,6 +1163,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -956,6 +1176,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -963,6 +1187,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -971,7 +1199,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -982,6 +1210,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1004,7 +1238,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1014,6 +1248,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1021,6 +1259,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1029,7 +1271,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1043,6 +1285,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1050,6 +1296,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1058,7 +1308,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1127,7 +1377,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1156,7 +1406,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1238,30 +1488,82 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-CanAffordTransportation.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-environment-CanAffordTransportation.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-environment-CanAffordTransportation.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1317,8 +1619,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1380,7 +1682,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1409,7 +1711,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1441,7 +1743,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1451,6 +1753,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1501,7 +1809,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1564,7 +1872,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1593,7 +1901,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1635,6 +1943,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1642,6 +1956,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1661,8 +1979,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1699,6 +2017,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1706,6 +2028,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1714,7 +2040,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1727,6 +2053,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1749,7 +2081,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1762,6 +2094,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1769,6 +2107,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1776,6 +2118,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1784,7 +2130,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1903,12 +2249,16 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-CanAffordTransportation.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-environment-CanAffordTransportation.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
@@ -1957,9 +2307,12 @@
         "id": "Observation:shr-environment-CanAffordTransportation.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "134",
+          "id": "132",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -1985,7 +2338,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeFrequencyVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeFrequencyVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordUtilities-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordUtilities-extension.json
old mode 100755
new mode 100644
index c561726..e4d099e
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordUtilities-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordUtilities-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.environment.CanAffordUtilities"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR CanAffordUtilities Extension",
   "title": "SHR CanAffordUtilities Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.472Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.092Z",
   "description": "How often can the subject afford utilities?",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordUtilities.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordUtilities.json
old mode 100755
new mode 100644
index 7ca2380..c5273d9
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordUtilities.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-CanAffordUtilities.json
@@ -3,7 +3,7 @@
   "id": "shr-environment-CanAffordUtilities",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR CanAffordUtilities Profile</b></p>\n  <p>How often can the subject afford utilities?</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.CanAffordUtilities maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR CanAffordUtilities Profile</b></p>\n  <p>How often can the subject afford utilities?</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.CanAffordUtilities maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-environment-CanAffordUtilities",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.environment.CanAffordUtilities"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR CanAffordUtilities Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.666Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.144Z",
   "description": "How often can the subject afford utilities?",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR CanAffordUtilities Profile",
         "definition": "How often can the subject afford utilities?",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-environment-CanAffordUtilities.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "132",
+          "id": "130",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -397,16 +434,19 @@
         "id": "Observation:shr-environment-CanAffordUtilities.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "133",
+          "id": "131",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -436,6 +476,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -466,8 +507,8 @@
       {
         "id": "Observation:shr-environment-CanAffordUtilities.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -476,7 +517,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -491,6 +537,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-environment-CanAffordUtilities.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-environment-CanAffordUtilities.status",
         "extension": [
@@ -502,6 +605,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -513,6 +617,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -520,6 +630,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -539,8 +657,8 @@
         "path": "Observation.category",
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 0,
         "max": "*",
         "type": [
@@ -550,8 +668,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -573,6 +697,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -583,6 +710,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -590,6 +723,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -598,6 +739,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -609,7 +754,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -633,6 +778,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -648,20 +797,32 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-CanAffordUtilities.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-environment-CanAffordUtilities.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -681,8 +842,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -696,6 +860,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -715,7 +883,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -767,6 +935,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -785,17 +957,20 @@
         "id": "Observation:shr-environment-CanAffordUtilities.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "131",
+          "id": "129",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 1,
         "max": "1",
         "type": [
@@ -809,6 +984,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -816,6 +999,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -837,7 +1024,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeFrequencyVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeFrequencyVS"
           }
         }
       },
@@ -846,7 +1033,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -859,6 +1046,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -866,6 +1059,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -893,6 +1090,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -900,6 +1103,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -907,6 +1114,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -924,6 +1135,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -939,8 +1154,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -949,6 +1163,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -956,6 +1176,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -963,6 +1187,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -971,7 +1199,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -982,6 +1210,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1004,7 +1238,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1014,6 +1248,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1021,6 +1259,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1029,7 +1271,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1043,6 +1285,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1050,6 +1296,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1058,7 +1308,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1127,7 +1377,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1156,7 +1406,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1238,30 +1488,82 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-CanAffordUtilities.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-environment-CanAffordUtilities.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-environment-CanAffordUtilities.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1317,8 +1619,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1380,7 +1682,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1409,7 +1711,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1441,7 +1743,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1451,6 +1753,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1501,7 +1809,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1564,7 +1872,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1593,7 +1901,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1635,6 +1943,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1642,6 +1956,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1661,8 +1979,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1699,6 +2017,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1706,6 +2028,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1714,7 +2040,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1727,6 +2053,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1749,7 +2081,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1762,6 +2094,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1769,6 +2107,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1776,6 +2118,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1784,7 +2130,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1903,12 +2249,16 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-CanAffordUtilities.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-environment-CanAffordUtilities.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
@@ -1957,9 +2307,12 @@
         "id": "Observation:shr-environment-CanAffordUtilities.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "131",
+          "id": "129",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -1985,7 +2338,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeFrequencyVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeFrequencyVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-Coinhabitant-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-Coinhabitant-extension.json
old mode 100755
new mode 100644
index 84a45af..401dba0
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-Coinhabitant-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-Coinhabitant-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.environment.Coinhabitant"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Coinhabitant Extension",
   "title": "SHR Coinhabitant Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.861Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.184Z",
   "description": "A person living with the subject.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-Coinhabitant.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-Coinhabitant.json
old mode 100755
new mode 100644
index b549fbb..1640823
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-Coinhabitant.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-Coinhabitant.json
@@ -3,7 +3,7 @@
   "id": "shr-environment-Coinhabitant",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR Coinhabitant Profile</b></p>\n  <p>A person living with the subject.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.Coinhabitant maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR Coinhabitant Profile</b></p>\n  <p>A person living with the subject.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.Coinhabitant maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-environment-Coinhabitant",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.environment.Coinhabitant"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Coinhabitant Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.897Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.197Z",
   "description": "A person living with the subject.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR Coinhabitant Profile",
         "definition": "A person living with the subject.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-environment-Coinhabitant.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "152",
+          "id": "150",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "codeableconcept",
         "definition": "A set of codes drawn from different coding systems, representing the same concept.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -357,7 +393,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-environment-CoinhabitantVS"
+            "reference": "http://standardhealthrecord.org/shr/environment/vs/CoinhabitantVS"
           }
         },
         "mapping": [
@@ -372,6 +408,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -404,6 +441,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -435,16 +473,19 @@
         "id": "Observation:shr-environment-Coinhabitant.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "153",
+          "id": "151",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -474,6 +515,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -504,8 +546,8 @@
       {
         "id": "Observation:shr-environment-Coinhabitant.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -514,7 +556,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -529,6 +576,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-environment-Coinhabitant.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-environment-Coinhabitant.status",
         "extension": [
@@ -540,6 +644,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -551,6 +656,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -558,6 +669,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -577,8 +696,8 @@
         "path": "Observation.category",
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 0,
         "max": "*",
         "type": [
@@ -588,8 +707,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -611,6 +736,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -621,6 +749,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -628,6 +762,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -636,6 +778,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -647,7 +793,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -671,6 +817,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -686,20 +836,32 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-Coinhabitant.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-environment-Coinhabitant.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -719,8 +881,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -734,6 +899,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -753,7 +922,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -805,6 +974,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -824,8 +997,8 @@
         "path": "Observation.value[x]",
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -838,6 +1011,9 @@
           {
             "code": "string"
           },
+          {
+            "code": "boolean"
+          },
           {
             "code": "Range"
           },
@@ -865,6 +1041,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -872,6 +1056,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -880,7 +1068,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -893,6 +1081,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -900,6 +1094,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -927,6 +1125,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -934,6 +1138,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -941,6 +1149,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -958,6 +1170,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -973,8 +1189,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -983,6 +1198,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -990,6 +1211,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -997,6 +1222,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1005,7 +1234,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1016,6 +1245,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1038,7 +1273,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1048,6 +1283,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1055,6 +1294,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1063,7 +1306,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1077,6 +1320,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1084,6 +1331,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1092,7 +1343,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1161,7 +1412,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1190,7 +1441,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1272,30 +1523,82 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-Coinhabitant.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-environment-Coinhabitant.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-environment-Coinhabitant.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1351,8 +1654,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1414,7 +1717,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1443,7 +1746,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1475,7 +1778,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1485,6 +1788,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1535,7 +1844,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1598,7 +1907,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1627,7 +1936,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1669,6 +1978,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1676,6 +1991,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1695,8 +2014,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1733,6 +2052,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1740,6 +2063,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1748,7 +2075,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1761,6 +2088,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1783,7 +2116,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1796,6 +2129,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1803,6 +2142,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1810,6 +2153,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1818,7 +2165,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1862,7 +2209,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-environment-CoinhabitantVS"
+            "reference": "http://standardhealthrecord.org/shr/environment/vs/CoinhabitantVS"
           }
         }
       },
@@ -1959,12 +2306,16 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-Coinhabitant.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-environment-Coinhabitant.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-DomesticViolence-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-DomesticViolence-extension.json
old mode 100755
new mode 100644
index e3c09e7..2adbce1
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-DomesticViolence-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-DomesticViolence-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.environment.DomesticViolence"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR DomesticViolence Extension",
   "title": "SHR DomesticViolence Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.010Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.222Z",
   "description": "Whether the subject experiences domestic violence.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-DomesticViolence.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-DomesticViolence.json
old mode 100755
new mode 100644
index 23b328d..9e681fc
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-DomesticViolence.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-DomesticViolence.json
@@ -3,7 +3,7 @@
   "id": "shr-environment-DomesticViolence",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR DomesticViolence Profile</b></p>\n  <p>Whether the subject experiences domestic violence.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.DomesticViolence maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR DomesticViolence Profile</b></p>\n  <p>Whether the subject experiences domestic violence.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.DomesticViolence maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-environment-DomesticViolence",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.environment.DomesticViolence"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR DomesticViolence Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.153Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.257Z",
   "description": "Whether the subject experiences domestic violence.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR DomesticViolence Profile",
         "definition": "Whether the subject experiences domestic violence.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-environment-DomesticViolence.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "174",
+          "id": "172",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -398,6 +435,7 @@
         "path": "Observation.extension",
         "sliceName": "occurrencetime",
         "definition": "The point in time or span of time in which something happens.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -430,6 +468,7 @@
         "path": "Observation.extension",
         "sliceName": "details",
         "definition": "Particulars considered individually and in relation to a whole.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -461,16 +500,19 @@
         "id": "Observation:shr-environment-DomesticViolence.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "175",
+          "id": "173",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -500,6 +542,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -530,8 +573,8 @@
       {
         "id": "Observation:shr-environment-DomesticViolence.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -540,7 +583,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -555,6 +603,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-environment-DomesticViolence.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-environment-DomesticViolence.status",
         "extension": [
@@ -566,6 +671,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -577,6 +683,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -584,6 +696,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -603,8 +723,8 @@
         "path": "Observation.category",
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 0,
         "max": "*",
         "type": [
@@ -614,8 +734,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -637,6 +763,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -655,6 +784,12 @@
         },
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -662,6 +797,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -670,6 +813,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -681,7 +828,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -705,6 +852,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -720,20 +871,32 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-DomesticViolence.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-environment-DomesticViolence.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -753,8 +916,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -768,6 +934,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -787,7 +957,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -839,6 +1009,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -857,17 +1031,20 @@
         "id": "Observation:shr-environment-DomesticViolence.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "173",
+          "id": "171",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 1,
         "max": "1",
         "type": [
@@ -881,6 +1058,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -888,6 +1073,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -909,7 +1098,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeFrequencyVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeFrequencyVS"
           }
         }
       },
@@ -918,7 +1107,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -931,6 +1120,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -938,6 +1133,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -965,6 +1164,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -972,6 +1177,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -979,6 +1188,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -996,6 +1209,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -1011,8 +1228,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1021,6 +1237,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -1028,6 +1250,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -1035,6 +1261,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1043,7 +1273,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1054,6 +1284,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1076,7 +1312,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1086,6 +1322,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1093,6 +1333,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1101,7 +1345,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1115,6 +1359,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1122,6 +1370,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1130,7 +1382,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1199,7 +1451,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1228,7 +1480,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1310,30 +1562,82 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-DomesticViolence.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-environment-DomesticViolence.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-environment-DomesticViolence.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1389,8 +1693,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1452,7 +1756,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1481,7 +1785,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1513,7 +1817,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1523,6 +1827,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1573,7 +1883,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1636,7 +1946,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1665,7 +1975,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1707,6 +2017,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1714,6 +2030,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1733,8 +2053,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1771,6 +2091,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1778,6 +2102,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1786,7 +2114,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1799,6 +2127,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1821,7 +2155,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1834,6 +2168,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1841,6 +2181,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1848,6 +2192,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1856,7 +2204,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -2015,12 +2363,16 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-DomesticViolence.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-environment-DomesticViolence.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
@@ -2069,9 +2421,12 @@
         "id": "Observation:shr-environment-DomesticViolence.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "173",
+          "id": "171",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -2097,7 +2452,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeFrequencyVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeFrequencyVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-EmotionalSafety-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-EmotionalSafety-extension.json
old mode 100755
new mode 100644
index 22c61e5..d925c4a
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-EmotionalSafety-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-EmotionalSafety-extension.json
@@ -3,7 +3,7 @@
   "id": "shr-environment-EmotionalSafety-extension",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR EmotionalSafety Extension</b></p>\n  <p>Whether the subject feels physically safe in the subject&#039;s home environment.</p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR EmotionalSafety Extension</b></p>\n  <p>Whether the subject feels physically safe in the subject's home environment.</p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-environment-EmotionalSafety-extension",
   "identifier": [
@@ -12,9 +12,11 @@
       "value": "shr.environment.EmotionalSafety"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR EmotionalSafety Extension",
   "title": "SHR EmotionalSafety Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.010Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.222Z",
   "description": "Whether the subject feels physically safe in the subject's home environment.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-EmotionalSafety.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-EmotionalSafety.json
old mode 100755
new mode 100644
index fb311a8..9f01f30
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-EmotionalSafety.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-EmotionalSafety.json
@@ -3,7 +3,7 @@
   "id": "shr-environment-EmotionalSafety",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR EmotionalSafety Profile</b></p>\n  <p>Whether the subject feels physically safe in the subject&#039;s home environment.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.EmotionalSafety maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR EmotionalSafety Profile</b></p>\n  <p>Whether the subject feels physically safe in the subject's home environment.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.EmotionalSafety maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-environment-EmotionalSafety",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.environment.EmotionalSafety"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR EmotionalSafety Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.119Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.250Z",
   "description": "Whether the subject feels physically safe in the subject's home environment.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR EmotionalSafety Profile",
         "definition": "Whether the subject feels physically safe in the subject's home environment.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-environment-EmotionalSafety.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "171",
+          "id": "169",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -398,6 +435,7 @@
         "path": "Observation.extension",
         "sliceName": "details",
         "definition": "Particulars considered individually and in relation to a whole.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -429,16 +467,19 @@
         "id": "Observation:shr-environment-EmotionalSafety.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "172",
+          "id": "170",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -468,6 +509,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -498,8 +540,8 @@
       {
         "id": "Observation:shr-environment-EmotionalSafety.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -508,7 +550,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -523,6 +570,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-environment-EmotionalSafety.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-environment-EmotionalSafety.status",
         "extension": [
@@ -534,6 +638,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -545,6 +650,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -552,6 +663,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -571,8 +690,8 @@
         "path": "Observation.category",
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 0,
         "max": "*",
         "type": [
@@ -582,8 +701,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -605,6 +730,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -615,6 +743,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -622,6 +756,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -630,6 +772,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -641,7 +787,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -665,6 +811,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -680,20 +830,32 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-EmotionalSafety.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-environment-EmotionalSafety.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -713,8 +875,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -728,6 +893,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -747,7 +916,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -799,6 +968,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -817,17 +990,20 @@
         "id": "Observation:shr-environment-EmotionalSafety.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "170",
+          "id": "168",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 1,
         "max": "1",
         "type": [
@@ -841,6 +1017,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -848,6 +1032,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -869,7 +1057,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeFrequencyVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeFrequencyVS"
           }
         }
       },
@@ -878,7 +1066,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -891,6 +1079,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -898,6 +1092,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -925,6 +1123,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -932,6 +1136,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -939,6 +1147,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -956,6 +1168,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -971,8 +1187,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -981,6 +1196,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -988,6 +1209,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -995,6 +1220,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1003,7 +1232,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1014,6 +1243,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1036,7 +1271,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1046,6 +1281,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1053,6 +1292,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1061,7 +1304,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1075,6 +1318,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1082,6 +1329,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1090,7 +1341,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1159,7 +1410,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1188,7 +1439,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1270,30 +1521,82 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-EmotionalSafety.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-environment-EmotionalSafety.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-environment-EmotionalSafety.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1349,8 +1652,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1412,7 +1715,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1441,7 +1744,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1473,7 +1776,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1483,6 +1786,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1533,7 +1842,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1596,7 +1905,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1625,7 +1934,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1667,6 +1976,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1674,6 +1989,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1693,8 +2012,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1731,6 +2050,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1738,6 +2061,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1746,7 +2073,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1759,6 +2086,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1781,7 +2114,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1794,6 +2127,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1801,6 +2140,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1808,6 +2151,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1816,7 +2163,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1951,12 +2298,16 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-EmotionalSafety.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-environment-EmotionalSafety.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
@@ -2005,9 +2356,12 @@
         "id": "Observation:shr-environment-EmotionalSafety.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "170",
+          "id": "168",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -2033,7 +2387,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeFrequencyVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeFrequencyVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-EnvironmentalExposuresPanel.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-EnvironmentalExposuresPanel.json
old mode 100755
new mode 100644
index 5280628..8ec89b6
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-EnvironmentalExposuresPanel.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-EnvironmentalExposuresPanel.json
@@ -3,7 +3,7 @@
   "id": "shr-environment-EnvironmentalExposuresPanel",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR EnvironmentalExposuresPanel Profile</b></p>\n  <p></p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.EnvironmentalExposuresPanel maps to DiagnosticReport:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  CodeableConcept maps to codedDiagnosis\n  Observation maps to result\n  TBD &quot;Specimen&quot; maps to specimen\n  Interpretation maps to conclusion\n  ObservationCategory maps to category\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR EnvironmentalExposuresPanel Profile</b></p>\n  <p/>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.EnvironmentalExposuresPanel maps to DiagnosticReport:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  CodeableConcept maps to codedDiagnosis\n  Observation maps to result\n  &lt;TBD &quot;Specimen&quot;&gt; maps to specimen\n  Interpretation maps to conclusion\n  ObservationCategory maps to category\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-environment-EnvironmentalExposuresPanel",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.environment.EnvironmentalExposuresPanel"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR EnvironmentalExposuresPanel Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.950Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,10 +27,14 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.209Z",
   "purpose": "To support reporting for any diagnostic report into a clinical data repository.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -57,7 +63,7 @@
         "path": "DiagnosticReport",
         "short": "SHR EnvironmentalExposuresPanel Profile",
         "definition": "The findings and interpretation of diagnostic  tests performed on patients, groups of patients, devices, and locations, and/or specimens derived from these. The report includes clinical context such as requesting and provider information, and some mix of atomic results, images, textual and coded interpretations, and formatted representation of diagnostic reports.",
-        "comments": "This is intended to capture a single report, and is not suitable for use in displaying summary information that covers multiple reports.  For example, this resource has not been designed for laboratory cumulative reporting formats nor detailed structured reports for sequencing.",
+        "comment": "This is intended to capture a single report, and is not suitable for use in displaying summary information that covers multiple reports.  For example, this resource has not been designed for laboratory cumulative reporting formats nor detailed structured reports for sequencing.",
         "alias": [
           "Report",
           "Test",
@@ -107,6 +113,10 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
           {
             "identity": "v2",
             "map": "ORU -> OBR"
@@ -126,7 +136,7 @@
         "path": "DiagnosticReport.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -165,7 +175,7 @@
         "path": "DiagnosticReport.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -186,7 +196,7 @@
         "path": "DiagnosticReport.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -206,6 +216,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -220,7 +238,7 @@
         "path": "DiagnosticReport.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -254,7 +272,7 @@
         "path": "DiagnosticReport.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -283,16 +301,19 @@
         "id": "DiagnosticReport:shr-environment-EnvironmentalExposuresPanel.extension",
         "path": "DiagnosticReport.extension",
         "slicing": {
-          "id": "156",
+          "id": "154",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -321,6 +342,7 @@
         "path": "DiagnosticReport.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -353,6 +375,7 @@
         "path": "DiagnosticReport.extension",
         "sliceName": "animalexposure",
         "definition": "The type of animals or pets the subject is exposed to.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -385,7 +408,7 @@
         "path": "DiagnosticReport.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -413,11 +436,14 @@
       {
         "id": "DiagnosticReport:shr-environment-EnvironmentalExposuresPanel.identifier",
         "path": "DiagnosticReport.identifier",
-        "short": "Id for external references to this report",
-        "definition": "The local ID assigned to the report by the order filler, usually by the Information System of the diagnostic service provider.",
+        "short": "Business identifier for report",
+        "definition": "Identifiers assigned to this report by the performer or other systems.",
+        "comment": "Usually assigned by the Information System of the diagnostic service provider (filler id).",
         "requirements": "Need to know what identifier to use when making queries about this report from the source laboratory, and for linking to the report outside FHIR context.",
         "alias": [
-          "ReportID"
+          "ReportID",
+          "Filler ID",
+          "Placer ID"
         ],
         "min": 0,
         "max": "*",
@@ -428,6 +454,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBR-51"
@@ -442,12 +472,65 @@
           }
         ]
       },
+      {
+        "id": "DiagnosticReport:shr-environment-EnvironmentalExposuresPanel.basedOn",
+        "path": "DiagnosticReport.basedOn",
+        "short": "What was requested",
+        "definition": "Details concerning a test or procedure requested.",
+        "comment": "Note: Usually there is one test request for each result, however in some circumstances multiple test requests may be represented using a single test result resource. Note that there are also cases where one request leads to multiple reports.",
+        "requirements": "This allows tracing of authorization for the report and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Request"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC? OBR-2/3?"
+          },
+          {
+            "identity": "rim",
+            "map": "outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "DiagnosticReport:shr-environment-EnvironmentalExposuresPanel.status",
         "path": "DiagnosticReport.status",
-        "short": "registered | partial | final | corrected | appended | cancelled | entered-in-error",
+        "short": "registered | partial | preliminary | final +",
         "definition": "The status of the diagnostic report as a whole.",
-        "comments": "This is labeled as \"Is Modifier\" because applications need to take appropriate action if a report is withdrawn.",
+        "comment": "This is labeled as \"Is Modifier\" because applications need to take appropriate action if a report is withdrawn.",
         "requirements": "Diagnostic services routinely issue provisional/incomplete reports, and sometimes withdraw previously released reports.",
         "min": 1,
         "max": "1",
@@ -459,6 +542,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "DiagnosticReportStatus"
+            }
+          ],
           "strength": "required",
           "description": "The status of the diagnostic report as a whole.",
           "valueSetReference": {
@@ -466,6 +555,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
           {
             "identity": "v2",
             "map": "OBR-25 (not 1:1 mapping)"
@@ -485,12 +578,12 @@
         "path": "DiagnosticReport.category",
         "short": "Service category",
         "definition": "A code that classifies the clinical discipline, department or diagnostic service that created the report (e.g. cardiology, biochemistry, hematology, MRI). This is used for searching, sorting and display purposes.",
-        "comments": "The level of granularity is defined by the category concepts in the value set. More fine-grained filtering can be performed using the metadata and/or terminology hierarchy in DiagnosticReport.code.",
+        "comment": "The level of granularity is defined by the category concepts in the value set. More fine-grained filtering can be performed using the metadata and/or terminology hierarchy in DiagnosticReport.code.",
         "alias": [
           "Department",
           "Sub-department",
-          "service",
-          "discipline"
+          "Service",
+          "Discipline"
         ],
         "min": 0,
         "max": "1",
@@ -527,6 +620,9 @@
         "path": "DiagnosticReport.code",
         "short": "Name/Code for this diagnostic report",
         "definition": "A code or name that describes this diagnostic report.",
+        "alias": [
+          "Type"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -536,6 +632,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "DiagnosticReportCodes"
+            }
+          ],
           "strength": "preferred",
           "description": "Codes that describe Diagnostic Reports.",
           "valueSetReference": {
@@ -543,6 +645,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
           {
             "identity": "v2",
             "map": "OBR-4 (HL7 v2 doesn't provide an easy way to indicate both the ordered test and the performed panel)"
@@ -560,7 +666,7 @@
       {
         "id": "DiagnosticReport:shr-environment-EnvironmentalExposuresPanel.subject",
         "path": "DiagnosticReport.subject",
-        "short": "The subject of the report, usually, but not always, the patient",
+        "short": "The subject of the report - usually, but not always, the patient",
         "definition": "The subject of the report. Usually, but not always, this is a patient. However diagnostic services also perform analyses on specimens collected from a variety of other sources.",
         "requirements": "SHALL know the subject context.",
         "alias": [
@@ -588,6 +694,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3 (no HL7 v2 mapping for Group or Device)"
@@ -603,20 +713,33 @@
         ]
       },
       {
-        "id": "DiagnosticReport:shr-environment-EnvironmentalExposuresPanel.encounter",
-        "path": "DiagnosticReport.encounter",
+        "id": "DiagnosticReport:shr-environment-EnvironmentalExposuresPanel.context",
+        "path": "DiagnosticReport.context",
         "short": "Health care event when test ordered",
-        "definition": "The link to the health care event (encounter) when the order was made.",
+        "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) which this DiagnosticReport per is about.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
+        "requirements": "Links the request to the Encounter context.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1-19"
@@ -634,13 +757,14 @@
       {
         "id": "DiagnosticReport:shr-environment-EnvironmentalExposuresPanel.effective[x]",
         "path": "DiagnosticReport.effective[x]",
-        "short": "Clinically Relevant time/time-period for report",
+        "short": "Clinically relevant time/time-period for report",
         "definition": "The time or time-period the observed values are related to. When the subject of the report is a patient, this is usually either the time of the procedure or of specimen collection(s), but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "If the diagnostic procedure was performed on the patient, this is the time it was performed. If there are specimens, the diagnostically relevant time can be derived from the specimen collection times, but the specimen information is not always available, and the exact relationship between the specimens and the diagnostically relevant time is not always automatic.",
+        "comment": "If the diagnostic procedure was performed on the patient, this is the time it was performed. If there are specimens, the diagnostically relevant time can be derived from the specimen collection times, but the specimen information is not always available, and the exact relationship between the specimens and the diagnostically relevant time is not always automatic.",
         "requirements": "Need to know where in the patient history to file/present this report.",
         "alias": [
           "Observation time",
-          "Effective Time"
+          "Effective Time",
+          "Occurrence"
         ],
         "min": 0,
         "max": "1",
@@ -654,6 +778,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBR-7"
@@ -673,7 +801,7 @@
         "path": "DiagnosticReport.issued",
         "short": "DateTime this version was released",
         "definition": "The date and time that this version of the report was released from the source diagnostic service.",
-        "comments": "May be different from the update time of the resource itself, because that is the status of the record (potentially a secondary copy), not the actual release time of the report.",
+        "comment": "May be different from the update time of the resource itself, because that is the status of the record (potentially a secondary copy), not the actual release time of the report.",
         "requirements": "Clinicians need to be able to check the date that the report was released.",
         "alias": [
           "Date Created",
@@ -706,10 +834,8 @@
       {
         "id": "DiagnosticReport:shr-environment-EnvironmentalExposuresPanel.performer",
         "path": "DiagnosticReport.performer",
-        "short": "Responsible Diagnostic Service",
-        "definition": "The diagnostic service that is responsible for issuing the report.",
-        "comments": "This is not necessarily the source of the atomic data items. It is the entity that takes responsibility for the clinical report.",
-        "requirements": "Need to know whom to contact if there are queries about the results. Also may need to track the source of reports for secondary data analysis.",
+        "short": "Participants in producing the report",
+        "definition": "Indicates who or what participated in producing the report.",
         "alias": [
           "Laboratory",
           "Service",
@@ -721,23 +847,32 @@
         "max": "*",
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
-          },
+            "code": "BackboneElement"
+          }
+        ],
+        "constraint": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
+            "key": "ele-1",
+            "severity": "error",
+            "human": "All FHIR elements must have a @value or children",
+            "expression": "children().count() > id.count()",
+            "xpath": "@value|f:*|h:div",
+            "source": "Element"
           }
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "PRT-8 (where this PRT-4-Participation = \"PO\")"
           },
           {
             "identity": "rim",
-            "map": "participation[typeCode=AUT].role[classCode=ASSIGN].scoper"
+            "map": ".participation[typeCode=PRF]"
           },
           {
             "identity": "w5",
@@ -746,36 +881,166 @@
         ]
       },
       {
-        "id": "DiagnosticReport:shr-environment-EnvironmentalExposuresPanel.request",
-        "path": "DiagnosticReport.request",
-        "short": "What was requested",
-        "definition": "Details concerning a test or procedure requested.",
-        "comments": "Note: Usually there is one test request for each result, however in some circumstances multiple test requests may be represented using a single test result resource. Note that there are also cases where one request leads to multiple reports.",
-        "requirements": "Need to be able to track completion of requests based on reports issued and also to report what diagnostic tests were requested (not always the same as what is delivered).",
+        "id": "DiagnosticReport:shr-environment-EnvironmentalExposuresPanel.performer.id",
+        "path": "DiagnosticReport.performer.id",
+        "representation": [
+          "xmlAttr"
+        ],
+        "short": "xml:id (or equivalent in JSON)",
+        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Element.id",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "DiagnosticReport:shr-environment-EnvironmentalExposuresPanel.performer.extension",
+        "path": "DiagnosticReport.performer.extension",
+        "short": "Additional Content defined by implementations",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content"
+        ],
         "min": 0,
         "max": "*",
+        "base": {
+          "path": "Element.extension",
+          "min": 0,
+          "max": "*"
+        },
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DiagnosticRequest"
+            "code": "Extension"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "DiagnosticReport:shr-environment-EnvironmentalExposuresPanel.performer.modifierExtension",
+        "path": "DiagnosticReport.performer.modifierExtension",
+        "short": "Extensions that cannot be ignored",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content",
+          "modifiers"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "BackboneElement.modifierExtension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "isModifier": true,
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "N/A"
+          }
+        ]
+      },
+      {
+        "id": "DiagnosticReport:shr-environment-EnvironmentalExposuresPanel.performer.role",
+        "path": "DiagnosticReport.performer.role",
+        "short": "Type of performer",
+        "definition": "Describes the type of participation (e.g.  a responsible party, author, or verifier).",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Role"
+            }
+          ],
+          "strength": "example",
+          "description": "Indicate a role of diagnostic report performer",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/performer-role"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer.role"
+          },
+          {
+            "identity": "v2",
+            "map": "PRT-8 (where this PRT-4-Participation = \"PO\")"
           },
+          {
+            "identity": "rim",
+            "map": ".functionCode"
+          }
+        ]
+      },
+      {
+        "id": "DiagnosticReport:shr-environment-EnvironmentalExposuresPanel.performer.actor",
+        "path": "DiagnosticReport.performer.actor",
+        "short": "Practitioner or Organization  participant",
+        "definition": "The reference to the  practitioner or organization involved in producing the report. For example, the diagnostic service that is responsible for issuing the report.",
+        "comment": "This is not necessarily the source of the atomic data items. It is the entity that takes responsibility for the clinical report.",
+        "requirements": "Need to know whom to contact if there are queries about the results. Also may need to track the source of reports for secondary data analysis.",
+        "min": 1,
+        "max": "1",
+        "type": [
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
           },
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer.actor"
+          },
           {
             "identity": "v2",
-            "map": "ORC? OBR-2/3?"
+            "map": "PRT-8 (where this PRT-4-Participation = \"PO\")"
           },
           {
             "identity": "rim",
-            "map": "outboundRelationship[typeCode=FLFS].target"
+            "map": ".role"
           }
         ]
       },
@@ -784,7 +1049,7 @@
         "path": "DiagnosticReport.specimen",
         "short": "Specimens this report is based on",
         "definition": "Details about the specimens on which this diagnostic report is based.",
-        "comments": "If the specimen is sufficiently specified with a code in the test result name, then this additional data may be redundant. If there are multiple specimens, these may be represented per Observation or group.",
+        "comment": "If the specimen is sufficiently specified with a code in the test result name, then this additional data may be redundant. If there are multiple specimens, these may be represented per observation or group.",
         "requirements": "Need to be able to report information about the collected specimens on which the report is based.",
         "min": 0,
         "max": "*",
@@ -846,7 +1111,7 @@
         "path": "DiagnosticReport.imagingStudy",
         "short": "Reference to full details of imaging associated with the diagnostic report",
         "definition": "One or more links to full details of any imaging performed during the diagnostic investigation. Typically, this is imaging performed by DICOM enabled modalities, but this is not required. A fully enabled PACS viewer can use this information to provide views of the source images.",
-        "comments": "ImagingStudy and ImageManifest and the image element are somewhat overlapping - typically, the list of image references in the image element will also be found in one of the imaging study resources. However each caters to different types of displays for different types of purposes. Neither, either, or both may be provided.",
+        "comment": "ImagingStudy and ImageManifest and the image element are somewhat overlapping - typically, the list of image references in the image element will also be found in one of the imaging study resources. However each caters to different types of displays for different types of purposes. Neither, either, or both may be provided.",
         "min": 0,
         "max": "*",
         "type": [
@@ -938,7 +1203,7 @@
         "path": "DiagnosticReport.image.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -967,7 +1232,7 @@
         "path": "DiagnosticReport.image.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -999,7 +1264,7 @@
         "path": "DiagnosticReport.image.comment",
         "short": "Comment about the image (e.g. explanation)",
         "definition": "A comment about the image. Typically, this is used to provide an explanation for why the image is included, or to draw the viewer's attention to important features.",
-        "comments": "The comment should be displayed with the image. It would be common for the report to include additional discussion of the image contents in other sections such as the conclusion.",
+        "comment": "The comment should be displayed with the image. It would be common for the report to include additional discussion of the image contents in other sections such as the conclusion.",
         "requirements": "The provider of the report should make a comment about each image included in the report.",
         "min": 0,
         "max": "1",
@@ -1077,8 +1342,14 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AdjunctDiagnosis"
+            }
+          ],
           "strength": "example",
-          "description": "Diagnoses codes provided as adjuncts to the report.",
+          "description": "Diagnosis codes provided as adjuncts to the report.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/clinical-findings"
           }
@@ -1099,8 +1370,8 @@
         "path": "DiagnosticReport.presentedForm",
         "short": "Entire report as issued",
         "definition": "Rich text representation of the entire result as issued by the diagnostic service. Multiple formats are allowed but they SHALL be semantically equivalent.",
-        "comments": "\"application/pdf\" is recommended as the most reliable and interoperable in this context.",
-        "requirements": "Gives Laboratory the ability to provide its own fully formatted report for clinical fidelity.",
+        "comment": "\"application/pdf\" is recommended as the most reliable and interoperable in this context.",
+        "requirements": "Gives laboratory the ability to provide its own fully formatted report for clinical fidelity.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1202,12 +1473,16 @@
         ]
       },
       {
-        "id": "DiagnosticReport:shr-environment-EnvironmentalExposuresPanel.encounter",
-        "path": "DiagnosticReport.encounter",
+        "id": "DiagnosticReport:shr-environment-EnvironmentalExposuresPanel.context",
+        "path": "DiagnosticReport.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-ExposureMethod-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-ExposureMethod-extension.json
old mode 100755
new mode 100644
index 19ababe..4efc199
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-ExposureMethod-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-ExposureMethod-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.environment.ExposureMethod"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ExposureMethod Extension",
   "title": "SHR ExposureMethod Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.039Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.006Z",
   "description": "How the exposure occurred, e.g. cutaneous contact, injection, ingestion, sexual contact, inhalation.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-ExposureReason-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-ExposureReason-extension.json
old mode 100755
new mode 100644
index 3995453..01d8b01
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-ExposureReason-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-ExposureReason-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.environment.ExposureReason"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ExposureReason Extension",
   "title": "SHR ExposureReason Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.039Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.006Z",
   "description": "Why the exposure occurred.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -170,7 +170,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-observation-ExposureReasonVS"
+            "reference": "http://standardhealthrecord.org/shr/observation/vs/ExposureReasonVS"
           }
         },
         "mapping": [
@@ -221,7 +221,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-observation-ExposureReasonVS"
+            "reference": "http://standardhealthrecord.org/shr/observation/vs/ExposureReasonVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-ExposureSourceOrVector-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-ExposureSourceOrVector-extension.json
old mode 100755
new mode 100644
index 9fc0fe6..0f84045
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-ExposureSourceOrVector-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-ExposureSourceOrVector-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.environment.ExposureSourceOrVector"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ExposureSourceOrVector Extension",
   "title": "SHR ExposureSourceOrVector Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.039Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.006Z",
   "description": "Where the substance originated. Vectors include animals (e.g., tick, mosquito, cats, livestock) capable of transmitting an infectious agent among vertebrates. Sources could include food, contaminated drinking water, air, radon gas in the home, etc.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-ExposureToSubstance.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-ExposureToSubstance.json
old mode 100755
new mode 100644
index 63d0092..8ef1aed
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-ExposureToSubstance.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-ExposureToSubstance.json
@@ -3,7 +3,7 @@
   "id": "shr-environment-ExposureToSubstance",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR ExposureToSubstance Profile</b></p>\n  <p>A statement about exposure to a substance, type of substance, or disease vector potentially affecting health, including pollutants, blood products, pets, recreational drugs, sexual transmitted diseases, foods, toxins, pathogens, or prenatal exposures to teratogens. Can be used to assert or deny such exposures.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.ExposureToSubstance maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR ExposureToSubstance Profile</b></p>\n  <p>A statement about exposure to a substance, type of substance, or disease vector potentially affecting health, including pollutants, blood products, pets, recreational drugs, sexual transmitted diseases, foods, toxins, pathogens, or prenatal exposures to teratogens. Can be used to assert or deny such exposures.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.ExposureToSubstance maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-environment-ExposureToSubstance",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.environment.ExposureToSubstance"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ExposureToSubstance Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.419Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.086Z",
   "description": "A statement about exposure to a substance, type of substance, or disease vector potentially affecting health, including pollutants, blood products, pets, recreational drugs, sexual transmitted diseases, foods, toxins, pathogens, or prenatal exposures to teratogens. Can be used to assert or deny such exposures.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR ExposureToSubstance Profile",
         "definition": "A statement about exposure to a substance, type of substance, or disease vector potentially affecting health, including pollutants, blood products, pets, recreational drugs, sexual transmitted diseases, foods, toxins, pathogens, or prenatal exposures to teratogens. Can be used to assert or deny such exposures.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-environment-ExposureToSubstance.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "111",
+          "id": "109",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -398,6 +435,7 @@
         "path": "Observation.extension",
         "sliceName": "setting",
         "definition": "Description of the place or type of surroundings where something is positioned or where an event takes place.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -430,6 +468,7 @@
         "path": "Observation.extension",
         "sliceName": "location",
         "definition": "A position, site, or point in space where something can be found.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -462,6 +501,7 @@
         "path": "Observation.extension",
         "sliceName": "frequency",
         "definition": "How many occurrences of an event per unit of time.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -494,6 +534,7 @@
         "path": "Observation.extension",
         "sliceName": "substance",
         "definition": "Any matter of defined composition that has discrete existence, whose origin may be biological, mineral or chemical.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -526,6 +567,7 @@
         "path": "Observation.extension",
         "sliceName": "generalizedlikelihood",
         "definition": "Quantitative or qualitative measure of likelihood.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -558,6 +600,7 @@
         "path": "Observation.extension",
         "sliceName": "exposuresourceorvector",
         "definition": "Where the substance originated. Vectors include animals (e.g., tick, mosquito, cats, livestock) capable of transmitting an infectious agent among vertebrates. Sources could include food, contaminated drinking water, air, radon gas in the home, etc.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -590,6 +633,7 @@
         "path": "Observation.extension",
         "sliceName": "exposurereason",
         "definition": "Why the exposure occurred.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -622,6 +666,7 @@
         "path": "Observation.extension",
         "sliceName": "exposuremethod",
         "definition": "How the exposure occurred, e.g. cutaneous contact, injection, ingestion, sexual contact, inhalation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -654,6 +699,7 @@
         "path": "Observation.extension",
         "sliceName": "routeintobody",
         "definition": "The way a substance enters an organism after contact, particularly, the route of drug administration.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -686,6 +732,7 @@
         "path": "Observation.extension",
         "sliceName": "test",
         "definition": "A laboratory, radiologic, or other clinical test or measurement used to determine the presence, absence, or degree of a condition, or assess the function or health of an individual. This includes patient-generated data, such as pedometer readings.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -717,16 +764,19 @@
         "id": "Observation:shr-environment-ExposureToSubstance.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "112",
+          "id": "110",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -756,6 +806,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -786,8 +837,8 @@
       {
         "id": "Observation:shr-environment-ExposureToSubstance.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -796,7 +847,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -811,6 +867,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-environment-ExposureToSubstance.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-environment-ExposureToSubstance.status",
         "extension": [
@@ -822,6 +935,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -833,6 +947,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -840,6 +960,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -858,17 +986,20 @@
         "id": "Observation:shr-environment-ExposureToSubstance.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "110",
+          "id": "108",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 1,
         "max": "*",
         "type": [
@@ -878,8 +1009,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -943,6 +1080,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -953,6 +1093,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -960,6 +1106,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -968,6 +1122,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -979,7 +1137,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -1003,6 +1161,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -1018,20 +1180,32 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-ExposureToSubstance.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-environment-ExposureToSubstance.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -1051,8 +1225,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -1066,6 +1243,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -1085,7 +1266,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -1137,6 +1318,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -1156,8 +1341,8 @@
         "path": "Observation.value[x]",
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1170,6 +1355,9 @@
           {
             "code": "string"
           },
+          {
+            "code": "boolean"
+          },
           {
             "code": "Range"
           },
@@ -1197,6 +1385,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1204,6 +1400,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1212,7 +1412,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1225,6 +1425,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1232,6 +1438,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -1259,6 +1469,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1266,6 +1482,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1273,6 +1493,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1290,6 +1514,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -1305,8 +1533,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1315,6 +1542,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -1322,6 +1555,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -1329,6 +1566,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1337,7 +1578,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1348,6 +1589,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1370,7 +1617,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1380,6 +1627,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1387,6 +1638,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1395,7 +1650,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1409,6 +1664,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1416,6 +1675,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1424,7 +1687,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1493,7 +1756,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1522,7 +1785,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1604,30 +1867,82 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-ExposureToSubstance.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-environment-ExposureToSubstance.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-environment-ExposureToSubstance.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1683,8 +1998,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1746,7 +2061,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1775,7 +2090,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1807,7 +2122,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1817,6 +2132,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1867,7 +2188,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1930,7 +2251,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1959,7 +2280,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -2001,6 +2322,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -2008,6 +2335,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -2027,8 +2358,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -2065,6 +2396,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -2072,6 +2407,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -2080,7 +2419,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -2093,6 +2432,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -2115,7 +2460,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -2128,6 +2473,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -2135,6 +2486,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -2142,6 +2497,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -2150,7 +2509,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -2388,9 +2747,12 @@
         "id": "Observation:shr-environment-ExposureToSubstance.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "110",
+          "id": "108",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -2481,12 +2843,16 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-ExposureToSubstance.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-environment-ExposureToSubstance.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-FinancialSituationPanel.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-FinancialSituationPanel.json
old mode 100755
new mode 100644
index 319e486..66acedb
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-FinancialSituationPanel.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-FinancialSituationPanel.json
@@ -3,7 +3,7 @@
   "id": "shr-environment-FinancialSituationPanel",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR FinancialSituationPanel Profile</b></p>\n  <p>Measures of the ability of the subject to obtain and pay for the necessities of life.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.FinancialSituationPanel maps to DiagnosticReport:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  CodeableConcept maps to codedDiagnosis\n  Observation maps to result\n  TBD &quot;Specimen&quot; maps to specimen\n  Interpretation maps to conclusion\n  ObservationCategory maps to category\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR FinancialSituationPanel Profile</b></p>\n  <p>Measures of the ability of the subject to obtain and pay for the necessities of life.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.FinancialSituationPanel maps to DiagnosticReport:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  CodeableConcept maps to codedDiagnosis\n  Observation maps to result\n  &lt;TBD &quot;Specimen&quot;&gt; maps to specimen\n  Interpretation maps to conclusion\n  ObservationCategory maps to category\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-environment-FinancialSituationPanel",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.environment.FinancialSituationPanel"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR FinancialSituationPanel Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.460Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,15 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.090Z",
   "description": "Measures of the ability of the subject to obtain and pay for the necessities of life.",
   "purpose": "To support reporting for any diagnostic report into a clinical data repository.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -58,7 +64,7 @@
         "path": "DiagnosticReport",
         "short": "SHR FinancialSituationPanel Profile",
         "definition": "Measures of the ability of the subject to obtain and pay for the necessities of life.",
-        "comments": "This is intended to capture a single report, and is not suitable for use in displaying summary information that covers multiple reports.  For example, this resource has not been designed for laboratory cumulative reporting formats nor detailed structured reports for sequencing.",
+        "comment": "This is intended to capture a single report, and is not suitable for use in displaying summary information that covers multiple reports.  For example, this resource has not been designed for laboratory cumulative reporting formats nor detailed structured reports for sequencing.",
         "alias": [
           "Report",
           "Test",
@@ -108,6 +114,10 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
           {
             "identity": "v2",
             "map": "ORU -> OBR"
@@ -127,7 +137,7 @@
         "path": "DiagnosticReport.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -166,7 +176,7 @@
         "path": "DiagnosticReport.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -187,7 +197,7 @@
         "path": "DiagnosticReport.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -207,6 +217,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -221,7 +239,7 @@
         "path": "DiagnosticReport.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -255,7 +273,7 @@
         "path": "DiagnosticReport.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -284,16 +302,19 @@
         "id": "DiagnosticReport:shr-environment-FinancialSituationPanel.extension",
         "path": "DiagnosticReport.extension",
         "slicing": {
-          "id": "113",
+          "id": "111",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -322,6 +343,7 @@
         "path": "DiagnosticReport.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -354,6 +376,7 @@
         "path": "DiagnosticReport.extension",
         "sliceName": "annualincome",
         "definition": "The amount of earnings made by a family unit in one year, estimated or self-reported.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -386,6 +409,7 @@
         "path": "DiagnosticReport.extension",
         "sliceName": "incomesource",
         "definition": "Where the household income comes from.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -418,6 +442,7 @@
         "path": "DiagnosticReport.extension",
         "sliceName": "incomestability",
         "definition": "Whether the subject regards his or her source of income as dependable.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -450,6 +475,7 @@
         "path": "DiagnosticReport.extension",
         "sliceName": "canaffordfood",
         "definition": "How often can the subject afford food?",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -482,6 +508,7 @@
         "path": "DiagnosticReport.extension",
         "sliceName": "canaffordhousing",
         "definition": "How often can the subject afford housing?",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -514,6 +541,7 @@
         "path": "DiagnosticReport.extension",
         "sliceName": "canaffordclothing",
         "definition": "How often can the subject afford clothing?",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -546,6 +574,7 @@
         "path": "DiagnosticReport.extension",
         "sliceName": "canaffordutilities",
         "definition": "How often can the subject afford utilities?",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -578,6 +607,7 @@
         "path": "DiagnosticReport.extension",
         "sliceName": "canaffordtransportation",
         "definition": "How often can the subject afford transportation?",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -610,6 +640,7 @@
         "path": "DiagnosticReport.extension",
         "sliceName": "canaffordmedication",
         "definition": "How often can the subject afford medications?",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -642,6 +673,7 @@
         "path": "DiagnosticReport.extension",
         "sliceName": "canafforddentalcare",
         "definition": "How often can the subject afford dental care?",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -674,6 +706,7 @@
         "path": "DiagnosticReport.extension",
         "sliceName": "canaffordchildcare",
         "definition": "How often can the subject afford child care?",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -706,6 +739,7 @@
         "path": "DiagnosticReport.extension",
         "sliceName": "noncashbenefit",
         "definition": "Government benefits received by the focal subject, other than cash benefits.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -738,7 +772,7 @@
         "path": "DiagnosticReport.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -766,11 +800,14 @@
       {
         "id": "DiagnosticReport:shr-environment-FinancialSituationPanel.identifier",
         "path": "DiagnosticReport.identifier",
-        "short": "Id for external references to this report",
-        "definition": "The local ID assigned to the report by the order filler, usually by the Information System of the diagnostic service provider.",
+        "short": "Business identifier for report",
+        "definition": "Identifiers assigned to this report by the performer or other systems.",
+        "comment": "Usually assigned by the Information System of the diagnostic service provider (filler id).",
         "requirements": "Need to know what identifier to use when making queries about this report from the source laboratory, and for linking to the report outside FHIR context.",
         "alias": [
-          "ReportID"
+          "ReportID",
+          "Filler ID",
+          "Placer ID"
         ],
         "min": 0,
         "max": "*",
@@ -781,6 +818,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBR-51"
@@ -795,12 +836,65 @@
           }
         ]
       },
+      {
+        "id": "DiagnosticReport:shr-environment-FinancialSituationPanel.basedOn",
+        "path": "DiagnosticReport.basedOn",
+        "short": "What was requested",
+        "definition": "Details concerning a test or procedure requested.",
+        "comment": "Note: Usually there is one test request for each result, however in some circumstances multiple test requests may be represented using a single test result resource. Note that there are also cases where one request leads to multiple reports.",
+        "requirements": "This allows tracing of authorization for the report and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Request"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC? OBR-2/3?"
+          },
+          {
+            "identity": "rim",
+            "map": "outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "DiagnosticReport:shr-environment-FinancialSituationPanel.status",
         "path": "DiagnosticReport.status",
-        "short": "registered | partial | final | corrected | appended | cancelled | entered-in-error",
+        "short": "registered | partial | preliminary | final +",
         "definition": "The status of the diagnostic report as a whole.",
-        "comments": "This is labeled as \"Is Modifier\" because applications need to take appropriate action if a report is withdrawn.",
+        "comment": "This is labeled as \"Is Modifier\" because applications need to take appropriate action if a report is withdrawn.",
         "requirements": "Diagnostic services routinely issue provisional/incomplete reports, and sometimes withdraw previously released reports.",
         "min": 1,
         "max": "1",
@@ -812,6 +906,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "DiagnosticReportStatus"
+            }
+          ],
           "strength": "required",
           "description": "The status of the diagnostic report as a whole.",
           "valueSetReference": {
@@ -819,6 +919,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
           {
             "identity": "v2",
             "map": "OBR-25 (not 1:1 mapping)"
@@ -838,12 +942,12 @@
         "path": "DiagnosticReport.category",
         "short": "Service category",
         "definition": "A code that classifies the clinical discipline, department or diagnostic service that created the report (e.g. cardiology, biochemistry, hematology, MRI). This is used for searching, sorting and display purposes.",
-        "comments": "The level of granularity is defined by the category concepts in the value set. More fine-grained filtering can be performed using the metadata and/or terminology hierarchy in DiagnosticReport.code.",
+        "comment": "The level of granularity is defined by the category concepts in the value set. More fine-grained filtering can be performed using the metadata and/or terminology hierarchy in DiagnosticReport.code.",
         "alias": [
           "Department",
           "Sub-department",
-          "service",
-          "discipline"
+          "Service",
+          "Discipline"
         ],
         "min": 0,
         "max": "1",
@@ -880,6 +984,9 @@
         "path": "DiagnosticReport.code",
         "short": "Name/Code for this diagnostic report",
         "definition": "A code or name that describes this diagnostic report.",
+        "alias": [
+          "Type"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -889,6 +996,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "DiagnosticReportCodes"
+            }
+          ],
           "strength": "preferred",
           "description": "Codes that describe Diagnostic Reports.",
           "valueSetReference": {
@@ -896,6 +1009,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
           {
             "identity": "v2",
             "map": "OBR-4 (HL7 v2 doesn't provide an easy way to indicate both the ordered test and the performed panel)"
@@ -913,7 +1030,7 @@
       {
         "id": "DiagnosticReport:shr-environment-FinancialSituationPanel.subject",
         "path": "DiagnosticReport.subject",
-        "short": "The subject of the report, usually, but not always, the patient",
+        "short": "The subject of the report - usually, but not always, the patient",
         "definition": "The subject of the report. Usually, but not always, this is a patient. However diagnostic services also perform analyses on specimens collected from a variety of other sources.",
         "requirements": "SHALL know the subject context.",
         "alias": [
@@ -941,6 +1058,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3 (no HL7 v2 mapping for Group or Device)"
@@ -956,20 +1077,33 @@
         ]
       },
       {
-        "id": "DiagnosticReport:shr-environment-FinancialSituationPanel.encounter",
-        "path": "DiagnosticReport.encounter",
+        "id": "DiagnosticReport:shr-environment-FinancialSituationPanel.context",
+        "path": "DiagnosticReport.context",
         "short": "Health care event when test ordered",
-        "definition": "The link to the health care event (encounter) when the order was made.",
+        "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) which this DiagnosticReport per is about.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
+        "requirements": "Links the request to the Encounter context.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1-19"
@@ -987,13 +1121,14 @@
       {
         "id": "DiagnosticReport:shr-environment-FinancialSituationPanel.effective[x]",
         "path": "DiagnosticReport.effective[x]",
-        "short": "Clinically Relevant time/time-period for report",
+        "short": "Clinically relevant time/time-period for report",
         "definition": "The time or time-period the observed values are related to. When the subject of the report is a patient, this is usually either the time of the procedure or of specimen collection(s), but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "If the diagnostic procedure was performed on the patient, this is the time it was performed. If there are specimens, the diagnostically relevant time can be derived from the specimen collection times, but the specimen information is not always available, and the exact relationship between the specimens and the diagnostically relevant time is not always automatic.",
+        "comment": "If the diagnostic procedure was performed on the patient, this is the time it was performed. If there are specimens, the diagnostically relevant time can be derived from the specimen collection times, but the specimen information is not always available, and the exact relationship between the specimens and the diagnostically relevant time is not always automatic.",
         "requirements": "Need to know where in the patient history to file/present this report.",
         "alias": [
           "Observation time",
-          "Effective Time"
+          "Effective Time",
+          "Occurrence"
         ],
         "min": 0,
         "max": "1",
@@ -1007,6 +1142,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBR-7"
@@ -1026,7 +1165,7 @@
         "path": "DiagnosticReport.issued",
         "short": "DateTime this version was released",
         "definition": "The date and time that this version of the report was released from the source diagnostic service.",
-        "comments": "May be different from the update time of the resource itself, because that is the status of the record (potentially a secondary copy), not the actual release time of the report.",
+        "comment": "May be different from the update time of the resource itself, because that is the status of the record (potentially a secondary copy), not the actual release time of the report.",
         "requirements": "Clinicians need to be able to check the date that the report was released.",
         "alias": [
           "Date Created",
@@ -1059,10 +1198,8 @@
       {
         "id": "DiagnosticReport:shr-environment-FinancialSituationPanel.performer",
         "path": "DiagnosticReport.performer",
-        "short": "Responsible Diagnostic Service",
-        "definition": "The diagnostic service that is responsible for issuing the report.",
-        "comments": "This is not necessarily the source of the atomic data items. It is the entity that takes responsibility for the clinical report.",
-        "requirements": "Need to know whom to contact if there are queries about the results. Also may need to track the source of reports for secondary data analysis.",
+        "short": "Participants in producing the report",
+        "definition": "Indicates who or what participated in producing the report.",
         "alias": [
           "Laboratory",
           "Service",
@@ -1074,23 +1211,32 @@
         "max": "*",
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
-          },
+            "code": "BackboneElement"
+          }
+        ],
+        "constraint": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
+            "key": "ele-1",
+            "severity": "error",
+            "human": "All FHIR elements must have a @value or children",
+            "expression": "children().count() > id.count()",
+            "xpath": "@value|f:*|h:div",
+            "source": "Element"
           }
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "PRT-8 (where this PRT-4-Participation = \"PO\")"
           },
           {
             "identity": "rim",
-            "map": "participation[typeCode=AUT].role[classCode=ASSIGN].scoper"
+            "map": ".participation[typeCode=PRF]"
           },
           {
             "identity": "w5",
@@ -1099,36 +1245,166 @@
         ]
       },
       {
-        "id": "DiagnosticReport:shr-environment-FinancialSituationPanel.request",
-        "path": "DiagnosticReport.request",
-        "short": "What was requested",
-        "definition": "Details concerning a test or procedure requested.",
-        "comments": "Note: Usually there is one test request for each result, however in some circumstances multiple test requests may be represented using a single test result resource. Note that there are also cases where one request leads to multiple reports.",
-        "requirements": "Need to be able to track completion of requests based on reports issued and also to report what diagnostic tests were requested (not always the same as what is delivered).",
+        "id": "DiagnosticReport:shr-environment-FinancialSituationPanel.performer.id",
+        "path": "DiagnosticReport.performer.id",
+        "representation": [
+          "xmlAttr"
+        ],
+        "short": "xml:id (or equivalent in JSON)",
+        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Element.id",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "DiagnosticReport:shr-environment-FinancialSituationPanel.performer.extension",
+        "path": "DiagnosticReport.performer.extension",
+        "short": "Additional Content defined by implementations",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content"
+        ],
         "min": 0,
         "max": "*",
+        "base": {
+          "path": "Element.extension",
+          "min": 0,
+          "max": "*"
+        },
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DiagnosticRequest"
+            "code": "Extension"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "DiagnosticReport:shr-environment-FinancialSituationPanel.performer.modifierExtension",
+        "path": "DiagnosticReport.performer.modifierExtension",
+        "short": "Extensions that cannot be ignored",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content",
+          "modifiers"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "BackboneElement.modifierExtension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "isModifier": true,
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "N/A"
+          }
+        ]
+      },
+      {
+        "id": "DiagnosticReport:shr-environment-FinancialSituationPanel.performer.role",
+        "path": "DiagnosticReport.performer.role",
+        "short": "Type of performer",
+        "definition": "Describes the type of participation (e.g.  a responsible party, author, or verifier).",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Role"
+            }
+          ],
+          "strength": "example",
+          "description": "Indicate a role of diagnostic report performer",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/performer-role"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer.role"
+          },
+          {
+            "identity": "v2",
+            "map": "PRT-8 (where this PRT-4-Participation = \"PO\")"
           },
+          {
+            "identity": "rim",
+            "map": ".functionCode"
+          }
+        ]
+      },
+      {
+        "id": "DiagnosticReport:shr-environment-FinancialSituationPanel.performer.actor",
+        "path": "DiagnosticReport.performer.actor",
+        "short": "Practitioner or Organization  participant",
+        "definition": "The reference to the  practitioner or organization involved in producing the report. For example, the diagnostic service that is responsible for issuing the report.",
+        "comment": "This is not necessarily the source of the atomic data items. It is the entity that takes responsibility for the clinical report.",
+        "requirements": "Need to know whom to contact if there are queries about the results. Also may need to track the source of reports for secondary data analysis.",
+        "min": 1,
+        "max": "1",
+        "type": [
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
           },
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer.actor"
+          },
           {
             "identity": "v2",
-            "map": "ORC? OBR-2/3?"
+            "map": "PRT-8 (where this PRT-4-Participation = \"PO\")"
           },
           {
             "identity": "rim",
-            "map": "outboundRelationship[typeCode=FLFS].target"
+            "map": ".role"
           }
         ]
       },
@@ -1137,7 +1413,7 @@
         "path": "DiagnosticReport.specimen",
         "short": "Specimens this report is based on",
         "definition": "Details about the specimens on which this diagnostic report is based.",
-        "comments": "If the specimen is sufficiently specified with a code in the test result name, then this additional data may be redundant. If there are multiple specimens, these may be represented per Observation or group.",
+        "comment": "If the specimen is sufficiently specified with a code in the test result name, then this additional data may be redundant. If there are multiple specimens, these may be represented per observation or group.",
         "requirements": "Need to be able to report information about the collected specimens on which the report is based.",
         "min": 0,
         "max": "*",
@@ -1199,7 +1475,7 @@
         "path": "DiagnosticReport.imagingStudy",
         "short": "Reference to full details of imaging associated with the diagnostic report",
         "definition": "One or more links to full details of any imaging performed during the diagnostic investigation. Typically, this is imaging performed by DICOM enabled modalities, but this is not required. A fully enabled PACS viewer can use this information to provide views of the source images.",
-        "comments": "ImagingStudy and ImageManifest and the image element are somewhat overlapping - typically, the list of image references in the image element will also be found in one of the imaging study resources. However each caters to different types of displays for different types of purposes. Neither, either, or both may be provided.",
+        "comment": "ImagingStudy and ImageManifest and the image element are somewhat overlapping - typically, the list of image references in the image element will also be found in one of the imaging study resources. However each caters to different types of displays for different types of purposes. Neither, either, or both may be provided.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1291,7 +1567,7 @@
         "path": "DiagnosticReport.image.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1320,7 +1596,7 @@
         "path": "DiagnosticReport.image.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1352,7 +1628,7 @@
         "path": "DiagnosticReport.image.comment",
         "short": "Comment about the image (e.g. explanation)",
         "definition": "A comment about the image. Typically, this is used to provide an explanation for why the image is included, or to draw the viewer's attention to important features.",
-        "comments": "The comment should be displayed with the image. It would be common for the report to include additional discussion of the image contents in other sections such as the conclusion.",
+        "comment": "The comment should be displayed with the image. It would be common for the report to include additional discussion of the image contents in other sections such as the conclusion.",
         "requirements": "The provider of the report should make a comment about each image included in the report.",
         "min": 0,
         "max": "1",
@@ -1438,8 +1714,14 @@
           ]
         },
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AdjunctDiagnosis"
+            }
+          ],
           "strength": "example",
-          "description": "Diagnoses codes provided as adjuncts to the report.",
+          "description": "Diagnosis codes provided as adjuncts to the report.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/clinical-findings"
           }
@@ -1460,8 +1742,8 @@
         "path": "DiagnosticReport.presentedForm",
         "short": "Entire report as issued",
         "definition": "Rich text representation of the entire result as issued by the diagnostic service. Multiple formats are allowed but they SHALL be semantically equivalent.",
-        "comments": "\"application/pdf\" is recommended as the most reliable and interoperable in this context.",
-        "requirements": "Gives Laboratory the ability to provide its own fully formatted report for clinical fidelity.",
+        "comment": "\"application/pdf\" is recommended as the most reliable and interoperable in this context.",
+        "requirements": "Gives laboratory the ability to provide its own fully formatted report for clinical fidelity.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1739,12 +2021,16 @@
         ]
       },
       {
-        "id": "DiagnosticReport:shr-environment-FinancialSituationPanel.encounter",
-        "path": "DiagnosticReport.encounter",
+        "id": "DiagnosticReport:shr-environment-FinancialSituationPanel.context",
+        "path": "DiagnosticReport.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-HomeEnvironmentRisk-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-HomeEnvironmentRisk-extension.json
old mode 100755
new mode 100644
index a3f5664..bf090c5
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-HomeEnvironmentRisk-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-HomeEnvironmentRisk-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.environment.HomeEnvironmentRisk"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR HomeEnvironmentRisk Extension",
   "title": "SHR HomeEnvironmentRisk Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.010Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.222Z",
   "description": "A risk experienced in the home environment.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-HomeEnvironmentRisk.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-HomeEnvironmentRisk.json
old mode 100755
new mode 100644
index 3cb0108..3cdadcf
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-HomeEnvironmentRisk.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-HomeEnvironmentRisk.json
@@ -3,7 +3,7 @@
   "id": "shr-environment-HomeEnvironmentRisk",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR HomeEnvironmentRisk Profile</b></p>\n  <p>A risk experienced in the home environment.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.HomeEnvironmentRisk maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR HomeEnvironmentRisk Profile</b></p>\n  <p>A risk experienced in the home environment.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.HomeEnvironmentRisk maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-environment-HomeEnvironmentRisk",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.environment.HomeEnvironmentRisk"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR HomeEnvironmentRisk Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.189Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.264Z",
   "description": "A risk experienced in the home environment.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR HomeEnvironmentRisk Profile",
         "definition": "A risk experienced in the home environment.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-environment-HomeEnvironmentRisk.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "177",
+          "id": "175",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -398,6 +435,7 @@
         "path": "Observation.extension",
         "sliceName": "details",
         "definition": "Particulars considered individually and in relation to a whole.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -429,16 +467,19 @@
         "id": "Observation:shr-environment-HomeEnvironmentRisk.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "178",
+          "id": "176",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -468,6 +509,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -498,8 +540,8 @@
       {
         "id": "Observation:shr-environment-HomeEnvironmentRisk.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -508,7 +550,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -523,6 +570,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-environment-HomeEnvironmentRisk.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-environment-HomeEnvironmentRisk.status",
         "extension": [
@@ -534,6 +638,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -545,6 +650,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -552,6 +663,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -571,8 +690,8 @@
         "path": "Observation.category",
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 0,
         "max": "*",
         "type": [
@@ -582,8 +701,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -605,6 +730,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -615,6 +743,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -622,6 +756,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -630,6 +772,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -641,7 +787,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -665,6 +811,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -680,20 +830,32 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-HomeEnvironmentRisk.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-environment-HomeEnvironmentRisk.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -713,8 +875,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -728,6 +893,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -747,7 +916,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -799,6 +968,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -817,17 +990,20 @@
         "id": "Observation:shr-environment-HomeEnvironmentRisk.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "176",
+          "id": "174",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 1,
         "max": "1",
         "type": [
@@ -841,6 +1017,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -848,6 +1032,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -869,7 +1057,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-environment-HomeEnvironmentRiskVS"
+            "reference": "http://standardhealthrecord.org/shr/environment/vs/HomeEnvironmentRiskVS"
           }
         }
       },
@@ -878,7 +1066,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -891,6 +1079,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -898,6 +1092,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -925,6 +1123,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -932,6 +1136,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -939,6 +1147,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -956,6 +1168,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -971,8 +1187,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -981,6 +1196,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -988,6 +1209,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -995,6 +1220,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1003,7 +1232,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1014,6 +1243,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1036,7 +1271,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1046,6 +1281,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1053,6 +1292,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1061,7 +1304,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1075,6 +1318,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1082,6 +1329,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1090,7 +1341,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1159,7 +1410,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1188,7 +1439,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1270,30 +1521,82 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-HomeEnvironmentRisk.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-environment-HomeEnvironmentRisk.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-environment-HomeEnvironmentRisk.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1349,8 +1652,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1412,7 +1715,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1441,7 +1744,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1473,7 +1776,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1483,6 +1786,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1533,7 +1842,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1596,7 +1905,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1625,7 +1934,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1667,6 +1976,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1674,6 +1989,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1693,8 +2012,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1731,6 +2050,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1738,6 +2061,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1746,7 +2073,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1759,6 +2086,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1781,7 +2114,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1794,6 +2127,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1801,6 +2140,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1808,6 +2151,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1816,7 +2163,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1951,12 +2298,16 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-HomeEnvironmentRisk.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-environment-HomeEnvironmentRisk.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
@@ -2005,9 +2356,12 @@
         "id": "Observation:shr-environment-HomeEnvironmentRisk.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "176",
+          "id": "174",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -2033,7 +2387,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-environment-HomeEnvironmentRiskVS"
+            "reference": "http://standardhealthrecord.org/shr/environment/vs/HomeEnvironmentRiskVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-HouseholdSituationPanel.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-HouseholdSituationPanel.json
old mode 100755
new mode 100644
index c1b094b..f175c17
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-HouseholdSituationPanel.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-HouseholdSituationPanel.json
@@ -3,7 +3,7 @@
   "id": "shr-environment-HouseholdSituationPanel",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR HouseholdSituationPanel Profile</b></p>\n  <p>Information about the makeup of the household of the subject.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.HouseholdSituationPanel maps to DiagnosticReport:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  CodeableConcept maps to codedDiagnosis\n  Observation maps to result\n  TBD &quot;Specimen&quot; maps to specimen\n  Interpretation maps to conclusion\n  ObservationCategory maps to category\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR HouseholdSituationPanel Profile</b></p>\n  <p>Information about the makeup of the household of the subject.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.HouseholdSituationPanel maps to DiagnosticReport:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  CodeableConcept maps to codedDiagnosis\n  Observation maps to result\n  &lt;TBD &quot;Specimen&quot;&gt; maps to specimen\n  Interpretation maps to conclusion\n  ObservationCategory maps to category\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-environment-HouseholdSituationPanel",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.environment.HouseholdSituationPanel"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR HouseholdSituationPanel Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.850Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,15 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.184Z",
   "description": "Information about the makeup of the household of the subject.",
   "purpose": "To support reporting for any diagnostic report into a clinical data repository.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -58,7 +64,7 @@
         "path": "DiagnosticReport",
         "short": "SHR HouseholdSituationPanel Profile",
         "definition": "Information about the makeup of the household of the subject.",
-        "comments": "This is intended to capture a single report, and is not suitable for use in displaying summary information that covers multiple reports.  For example, this resource has not been designed for laboratory cumulative reporting formats nor detailed structured reports for sequencing.",
+        "comment": "This is intended to capture a single report, and is not suitable for use in displaying summary information that covers multiple reports.  For example, this resource has not been designed for laboratory cumulative reporting formats nor detailed structured reports for sequencing.",
         "alias": [
           "Report",
           "Test",
@@ -108,6 +114,10 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
           {
             "identity": "v2",
             "map": "ORU -> OBR"
@@ -127,7 +137,7 @@
         "path": "DiagnosticReport.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -166,7 +176,7 @@
         "path": "DiagnosticReport.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -187,7 +197,7 @@
         "path": "DiagnosticReport.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -207,6 +217,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -221,7 +239,7 @@
         "path": "DiagnosticReport.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -255,7 +273,7 @@
         "path": "DiagnosticReport.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -284,16 +302,19 @@
         "id": "DiagnosticReport:shr-environment-HouseholdSituationPanel.extension",
         "path": "DiagnosticReport.extension",
         "slicing": {
-          "id": "149",
+          "id": "147",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -322,6 +343,7 @@
         "path": "DiagnosticReport.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -354,6 +376,7 @@
         "path": "DiagnosticReport.extension",
         "sliceName": "householdsize",
         "definition": "The number of people living together with mutual financial dependency. Besides the subject, the household size may include spouse or partner, dependent children including adopted and foster children, dependent parents, dependent siblings and other relatives, but not roommates, ex-spouses, non-dependent children, and unborn children. If the subject lives alone, the household size is 1.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -386,6 +409,7 @@
         "path": "DiagnosticReport.extension",
         "sliceName": "coinhabitant",
         "definition": "A person living with the subject.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -418,6 +442,7 @@
         "path": "DiagnosticReport.extension",
         "sliceName": "numberofdependents",
         "definition": "The number of dependents supported by the subject.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -450,7 +475,7 @@
         "path": "DiagnosticReport.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -478,11 +503,14 @@
       {
         "id": "DiagnosticReport:shr-environment-HouseholdSituationPanel.identifier",
         "path": "DiagnosticReport.identifier",
-        "short": "Id for external references to this report",
-        "definition": "The local ID assigned to the report by the order filler, usually by the Information System of the diagnostic service provider.",
+        "short": "Business identifier for report",
+        "definition": "Identifiers assigned to this report by the performer or other systems.",
+        "comment": "Usually assigned by the Information System of the diagnostic service provider (filler id).",
         "requirements": "Need to know what identifier to use when making queries about this report from the source laboratory, and for linking to the report outside FHIR context.",
         "alias": [
-          "ReportID"
+          "ReportID",
+          "Filler ID",
+          "Placer ID"
         ],
         "min": 0,
         "max": "*",
@@ -493,6 +521,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBR-51"
@@ -507,12 +539,65 @@
           }
         ]
       },
+      {
+        "id": "DiagnosticReport:shr-environment-HouseholdSituationPanel.basedOn",
+        "path": "DiagnosticReport.basedOn",
+        "short": "What was requested",
+        "definition": "Details concerning a test or procedure requested.",
+        "comment": "Note: Usually there is one test request for each result, however in some circumstances multiple test requests may be represented using a single test result resource. Note that there are also cases where one request leads to multiple reports.",
+        "requirements": "This allows tracing of authorization for the report and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Request"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC? OBR-2/3?"
+          },
+          {
+            "identity": "rim",
+            "map": "outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "DiagnosticReport:shr-environment-HouseholdSituationPanel.status",
         "path": "DiagnosticReport.status",
-        "short": "registered | partial | final | corrected | appended | cancelled | entered-in-error",
+        "short": "registered | partial | preliminary | final +",
         "definition": "The status of the diagnostic report as a whole.",
-        "comments": "This is labeled as \"Is Modifier\" because applications need to take appropriate action if a report is withdrawn.",
+        "comment": "This is labeled as \"Is Modifier\" because applications need to take appropriate action if a report is withdrawn.",
         "requirements": "Diagnostic services routinely issue provisional/incomplete reports, and sometimes withdraw previously released reports.",
         "min": 1,
         "max": "1",
@@ -524,6 +609,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "DiagnosticReportStatus"
+            }
+          ],
           "strength": "required",
           "description": "The status of the diagnostic report as a whole.",
           "valueSetReference": {
@@ -531,6 +622,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
           {
             "identity": "v2",
             "map": "OBR-25 (not 1:1 mapping)"
@@ -550,12 +645,12 @@
         "path": "DiagnosticReport.category",
         "short": "Service category",
         "definition": "A code that classifies the clinical discipline, department or diagnostic service that created the report (e.g. cardiology, biochemistry, hematology, MRI). This is used for searching, sorting and display purposes.",
-        "comments": "The level of granularity is defined by the category concepts in the value set. More fine-grained filtering can be performed using the metadata and/or terminology hierarchy in DiagnosticReport.code.",
+        "comment": "The level of granularity is defined by the category concepts in the value set. More fine-grained filtering can be performed using the metadata and/or terminology hierarchy in DiagnosticReport.code.",
         "alias": [
           "Department",
           "Sub-department",
-          "service",
-          "discipline"
+          "Service",
+          "Discipline"
         ],
         "min": 0,
         "max": "1",
@@ -592,6 +687,9 @@
         "path": "DiagnosticReport.code",
         "short": "Name/Code for this diagnostic report",
         "definition": "A code or name that describes this diagnostic report.",
+        "alias": [
+          "Type"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -601,6 +699,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "DiagnosticReportCodes"
+            }
+          ],
           "strength": "preferred",
           "description": "Codes that describe Diagnostic Reports.",
           "valueSetReference": {
@@ -608,6 +712,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
           {
             "identity": "v2",
             "map": "OBR-4 (HL7 v2 doesn't provide an easy way to indicate both the ordered test and the performed panel)"
@@ -625,7 +733,7 @@
       {
         "id": "DiagnosticReport:shr-environment-HouseholdSituationPanel.subject",
         "path": "DiagnosticReport.subject",
-        "short": "The subject of the report, usually, but not always, the patient",
+        "short": "The subject of the report - usually, but not always, the patient",
         "definition": "The subject of the report. Usually, but not always, this is a patient. However diagnostic services also perform analyses on specimens collected from a variety of other sources.",
         "requirements": "SHALL know the subject context.",
         "alias": [
@@ -653,6 +761,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3 (no HL7 v2 mapping for Group or Device)"
@@ -668,20 +780,33 @@
         ]
       },
       {
-        "id": "DiagnosticReport:shr-environment-HouseholdSituationPanel.encounter",
-        "path": "DiagnosticReport.encounter",
+        "id": "DiagnosticReport:shr-environment-HouseholdSituationPanel.context",
+        "path": "DiagnosticReport.context",
         "short": "Health care event when test ordered",
-        "definition": "The link to the health care event (encounter) when the order was made.",
+        "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) which this DiagnosticReport per is about.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
+        "requirements": "Links the request to the Encounter context.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1-19"
@@ -699,13 +824,14 @@
       {
         "id": "DiagnosticReport:shr-environment-HouseholdSituationPanel.effective[x]",
         "path": "DiagnosticReport.effective[x]",
-        "short": "Clinically Relevant time/time-period for report",
+        "short": "Clinically relevant time/time-period for report",
         "definition": "The time or time-period the observed values are related to. When the subject of the report is a patient, this is usually either the time of the procedure or of specimen collection(s), but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "If the diagnostic procedure was performed on the patient, this is the time it was performed. If there are specimens, the diagnostically relevant time can be derived from the specimen collection times, but the specimen information is not always available, and the exact relationship between the specimens and the diagnostically relevant time is not always automatic.",
+        "comment": "If the diagnostic procedure was performed on the patient, this is the time it was performed. If there are specimens, the diagnostically relevant time can be derived from the specimen collection times, but the specimen information is not always available, and the exact relationship between the specimens and the diagnostically relevant time is not always automatic.",
         "requirements": "Need to know where in the patient history to file/present this report.",
         "alias": [
           "Observation time",
-          "Effective Time"
+          "Effective Time",
+          "Occurrence"
         ],
         "min": 0,
         "max": "1",
@@ -719,6 +845,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBR-7"
@@ -738,7 +868,7 @@
         "path": "DiagnosticReport.issued",
         "short": "DateTime this version was released",
         "definition": "The date and time that this version of the report was released from the source diagnostic service.",
-        "comments": "May be different from the update time of the resource itself, because that is the status of the record (potentially a secondary copy), not the actual release time of the report.",
+        "comment": "May be different from the update time of the resource itself, because that is the status of the record (potentially a secondary copy), not the actual release time of the report.",
         "requirements": "Clinicians need to be able to check the date that the report was released.",
         "alias": [
           "Date Created",
@@ -771,10 +901,8 @@
       {
         "id": "DiagnosticReport:shr-environment-HouseholdSituationPanel.performer",
         "path": "DiagnosticReport.performer",
-        "short": "Responsible Diagnostic Service",
-        "definition": "The diagnostic service that is responsible for issuing the report.",
-        "comments": "This is not necessarily the source of the atomic data items. It is the entity that takes responsibility for the clinical report.",
-        "requirements": "Need to know whom to contact if there are queries about the results. Also may need to track the source of reports for secondary data analysis.",
+        "short": "Participants in producing the report",
+        "definition": "Indicates who or what participated in producing the report.",
         "alias": [
           "Laboratory",
           "Service",
@@ -786,23 +914,32 @@
         "max": "*",
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
-          },
+            "code": "BackboneElement"
+          }
+        ],
+        "constraint": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
+            "key": "ele-1",
+            "severity": "error",
+            "human": "All FHIR elements must have a @value or children",
+            "expression": "children().count() > id.count()",
+            "xpath": "@value|f:*|h:div",
+            "source": "Element"
           }
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "PRT-8 (where this PRT-4-Participation = \"PO\")"
           },
           {
             "identity": "rim",
-            "map": "participation[typeCode=AUT].role[classCode=ASSIGN].scoper"
+            "map": ".participation[typeCode=PRF]"
           },
           {
             "identity": "w5",
@@ -811,36 +948,166 @@
         ]
       },
       {
-        "id": "DiagnosticReport:shr-environment-HouseholdSituationPanel.request",
-        "path": "DiagnosticReport.request",
-        "short": "What was requested",
-        "definition": "Details concerning a test or procedure requested.",
-        "comments": "Note: Usually there is one test request for each result, however in some circumstances multiple test requests may be represented using a single test result resource. Note that there are also cases where one request leads to multiple reports.",
-        "requirements": "Need to be able to track completion of requests based on reports issued and also to report what diagnostic tests were requested (not always the same as what is delivered).",
+        "id": "DiagnosticReport:shr-environment-HouseholdSituationPanel.performer.id",
+        "path": "DiagnosticReport.performer.id",
+        "representation": [
+          "xmlAttr"
+        ],
+        "short": "xml:id (or equivalent in JSON)",
+        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Element.id",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "DiagnosticReport:shr-environment-HouseholdSituationPanel.performer.extension",
+        "path": "DiagnosticReport.performer.extension",
+        "short": "Additional Content defined by implementations",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content"
+        ],
         "min": 0,
         "max": "*",
+        "base": {
+          "path": "Element.extension",
+          "min": 0,
+          "max": "*"
+        },
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DiagnosticRequest"
+            "code": "Extension"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "DiagnosticReport:shr-environment-HouseholdSituationPanel.performer.modifierExtension",
+        "path": "DiagnosticReport.performer.modifierExtension",
+        "short": "Extensions that cannot be ignored",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content",
+          "modifiers"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "BackboneElement.modifierExtension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "isModifier": true,
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "N/A"
+          }
+        ]
+      },
+      {
+        "id": "DiagnosticReport:shr-environment-HouseholdSituationPanel.performer.role",
+        "path": "DiagnosticReport.performer.role",
+        "short": "Type of performer",
+        "definition": "Describes the type of participation (e.g.  a responsible party, author, or verifier).",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Role"
+            }
+          ],
+          "strength": "example",
+          "description": "Indicate a role of diagnostic report performer",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/performer-role"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer.role"
+          },
+          {
+            "identity": "v2",
+            "map": "PRT-8 (where this PRT-4-Participation = \"PO\")"
           },
+          {
+            "identity": "rim",
+            "map": ".functionCode"
+          }
+        ]
+      },
+      {
+        "id": "DiagnosticReport:shr-environment-HouseholdSituationPanel.performer.actor",
+        "path": "DiagnosticReport.performer.actor",
+        "short": "Practitioner or Organization  participant",
+        "definition": "The reference to the  practitioner or organization involved in producing the report. For example, the diagnostic service that is responsible for issuing the report.",
+        "comment": "This is not necessarily the source of the atomic data items. It is the entity that takes responsibility for the clinical report.",
+        "requirements": "Need to know whom to contact if there are queries about the results. Also may need to track the source of reports for secondary data analysis.",
+        "min": 1,
+        "max": "1",
+        "type": [
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
           },
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer.actor"
+          },
           {
             "identity": "v2",
-            "map": "ORC? OBR-2/3?"
+            "map": "PRT-8 (where this PRT-4-Participation = \"PO\")"
           },
           {
             "identity": "rim",
-            "map": "outboundRelationship[typeCode=FLFS].target"
+            "map": ".role"
           }
         ]
       },
@@ -849,7 +1116,7 @@
         "path": "DiagnosticReport.specimen",
         "short": "Specimens this report is based on",
         "definition": "Details about the specimens on which this diagnostic report is based.",
-        "comments": "If the specimen is sufficiently specified with a code in the test result name, then this additional data may be redundant. If there are multiple specimens, these may be represented per Observation or group.",
+        "comment": "If the specimen is sufficiently specified with a code in the test result name, then this additional data may be redundant. If there are multiple specimens, these may be represented per observation or group.",
         "requirements": "Need to be able to report information about the collected specimens on which the report is based.",
         "min": 0,
         "max": "*",
@@ -911,7 +1178,7 @@
         "path": "DiagnosticReport.imagingStudy",
         "short": "Reference to full details of imaging associated with the diagnostic report",
         "definition": "One or more links to full details of any imaging performed during the diagnostic investigation. Typically, this is imaging performed by DICOM enabled modalities, but this is not required. A fully enabled PACS viewer can use this information to provide views of the source images.",
-        "comments": "ImagingStudy and ImageManifest and the image element are somewhat overlapping - typically, the list of image references in the image element will also be found in one of the imaging study resources. However each caters to different types of displays for different types of purposes. Neither, either, or both may be provided.",
+        "comment": "ImagingStudy and ImageManifest and the image element are somewhat overlapping - typically, the list of image references in the image element will also be found in one of the imaging study resources. However each caters to different types of displays for different types of purposes. Neither, either, or both may be provided.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1003,7 +1270,7 @@
         "path": "DiagnosticReport.image.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1032,7 +1299,7 @@
         "path": "DiagnosticReport.image.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1064,7 +1331,7 @@
         "path": "DiagnosticReport.image.comment",
         "short": "Comment about the image (e.g. explanation)",
         "definition": "A comment about the image. Typically, this is used to provide an explanation for why the image is included, or to draw the viewer's attention to important features.",
-        "comments": "The comment should be displayed with the image. It would be common for the report to include additional discussion of the image contents in other sections such as the conclusion.",
+        "comment": "The comment should be displayed with the image. It would be common for the report to include additional discussion of the image contents in other sections such as the conclusion.",
         "requirements": "The provider of the report should make a comment about each image included in the report.",
         "min": 0,
         "max": "1",
@@ -1142,8 +1409,14 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AdjunctDiagnosis"
+            }
+          ],
           "strength": "example",
-          "description": "Diagnoses codes provided as adjuncts to the report.",
+          "description": "Diagnosis codes provided as adjuncts to the report.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/clinical-findings"
           }
@@ -1164,8 +1437,8 @@
         "path": "DiagnosticReport.presentedForm",
         "short": "Entire report as issued",
         "definition": "Rich text representation of the entire result as issued by the diagnostic service. Multiple formats are allowed but they SHALL be semantically equivalent.",
-        "comments": "\"application/pdf\" is recommended as the most reliable and interoperable in this context.",
-        "requirements": "Gives Laboratory the ability to provide its own fully formatted report for clinical fidelity.",
+        "comment": "\"application/pdf\" is recommended as the most reliable and interoperable in this context.",
+        "requirements": "Gives laboratory the ability to provide its own fully formatted report for clinical fidelity.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1299,12 +1572,16 @@
         ]
       },
       {
-        "id": "DiagnosticReport:shr-environment-HouseholdSituationPanel.encounter",
-        "path": "DiagnosticReport.encounter",
+        "id": "DiagnosticReport:shr-environment-HouseholdSituationPanel.context",
+        "path": "DiagnosticReport.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-HouseholdSize-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-HouseholdSize-extension.json
old mode 100755
new mode 100644
index 4dfc0e2..bb49086
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-HouseholdSize-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-HouseholdSize-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.environment.HouseholdSize"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR HouseholdSize Extension",
   "title": "SHR HouseholdSize Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.861Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.184Z",
   "description": "The number of people living together with mutual financial dependency. Besides the subject, the household size may include spouse or partner, dependent children including adopted and foster children, dependent parents, dependent siblings and other relatives, but not roommates, ex-spouses, non-dependent children, and unborn children. If the subject lives alone, the household size is 1.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-HouseholdSize.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-HouseholdSize.json
old mode 100755
new mode 100644
index 6ea8eaf..6cdf265
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-HouseholdSize.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-HouseholdSize.json
@@ -3,7 +3,7 @@
   "id": "shr-environment-HouseholdSize",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR HouseholdSize Profile</b></p>\n  <p>The number of people living together with mutual financial dependency. Besides the subject, the household size may include spouse or partner, dependent children including adopted and foster children, dependent parents, dependent siblings and other relatives, but not roommates, ex-spouses, non-dependent children, and unborn children. If the subject lives alone, the household size is 1.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.HouseholdSize maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR HouseholdSize Profile</b></p>\n  <p>The number of people living together with mutual financial dependency. Besides the subject, the household size may include spouse or partner, dependent children including adopted and foster children, dependent parents, dependent siblings and other relatives, but not roommates, ex-spouses, non-dependent children, and unborn children. If the subject lives alone, the household size is 1.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.HouseholdSize maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-environment-HouseholdSize",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.environment.HouseholdSize"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR HouseholdSize Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.867Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.190Z",
   "description": "The number of people living together with mutual financial dependency. Besides the subject, the household size may include spouse or partner, dependent children including adopted and foster children, dependent parents, dependent siblings and other relatives, but not roommates, ex-spouses, non-dependent children, and unborn children. If the subject lives alone, the household size is 1.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR HouseholdSize Profile",
         "definition": "The number of people living together with mutual financial dependency. Besides the subject, the household size may include spouse or partner, dependent children including adopted and foster children, dependent parents, dependent siblings and other relatives, but not roommates, ex-spouses, non-dependent children, and unborn children. If the subject lives alone, the household size is 1.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-environment-HouseholdSize.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "150",
+          "id": "148",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "positiveint",
         "definition": "SHR positiveInt Extension",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -398,6 +435,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -429,16 +467,19 @@
         "id": "Observation:shr-environment-HouseholdSize.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "151",
+          "id": "149",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -468,6 +509,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -498,8 +540,8 @@
       {
         "id": "Observation:shr-environment-HouseholdSize.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -508,7 +550,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -523,6 +570,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-environment-HouseholdSize.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-environment-HouseholdSize.status",
         "extension": [
@@ -534,6 +638,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -545,6 +650,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -552,6 +663,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -571,8 +690,8 @@
         "path": "Observation.category",
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 0,
         "max": "*",
         "type": [
@@ -582,8 +701,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -605,6 +730,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -623,6 +751,12 @@
         },
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -630,6 +764,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -638,6 +780,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -649,7 +795,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -673,6 +819,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -688,20 +838,32 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-HouseholdSize.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-environment-HouseholdSize.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -721,8 +883,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -736,6 +901,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -755,7 +924,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -807,6 +976,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -826,8 +999,8 @@
         "path": "Observation.value[x]",
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -840,6 +1013,9 @@
           {
             "code": "string"
           },
+          {
+            "code": "boolean"
+          },
           {
             "code": "Range"
           },
@@ -867,6 +1043,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -874,6 +1058,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -882,7 +1070,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -895,6 +1083,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -902,6 +1096,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -929,6 +1127,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -936,6 +1140,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -943,6 +1151,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -960,6 +1172,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -975,8 +1191,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -985,6 +1200,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -992,6 +1213,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -999,6 +1224,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1007,7 +1236,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1018,6 +1247,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1040,7 +1275,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1050,6 +1285,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1057,6 +1296,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1065,7 +1308,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1079,6 +1322,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1086,6 +1333,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1094,7 +1345,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1163,7 +1414,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1192,7 +1443,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1274,30 +1525,82 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-HouseholdSize.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-environment-HouseholdSize.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-environment-HouseholdSize.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1353,8 +1656,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1416,7 +1719,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1445,7 +1748,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1477,7 +1780,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1487,6 +1790,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1537,7 +1846,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1600,7 +1909,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1629,7 +1938,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1671,6 +1980,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1678,6 +1993,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1697,8 +2016,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1735,6 +2054,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1742,6 +2065,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1750,7 +2077,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1763,6 +2090,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1785,7 +2118,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1798,6 +2131,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1805,6 +2144,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1812,6 +2155,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1820,7 +2167,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1963,12 +2310,16 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-HouseholdSize.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-environment-HouseholdSize.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-HousingSecurity-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-HousingSecurity-extension.json
old mode 100755
new mode 100644
index 6943c48..82e5941
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-HousingSecurity-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-HousingSecurity-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.environment.HousingSecurity"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR HousingSecurity Extension",
   "title": "SHR HousingSecurity Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.009Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.221Z",
   "description": "Whether the subject is at-risk of losing their housing or in a stable housing situation.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-HousingSecurity.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-HousingSecurity.json
old mode 100755
new mode 100644
index 276564b..d011aec
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-HousingSecurity.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-HousingSecurity.json
@@ -3,7 +3,7 @@
   "id": "shr-environment-HousingSecurity",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR HousingSecurity Profile</b></p>\n  <p>Whether the subject is at-risk of losing their housing or in a stable housing situation.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.HousingSecurity maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR HousingSecurity Profile</b></p>\n  <p>Whether the subject is at-risk of losing their housing or in a stable housing situation.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.HousingSecurity maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-environment-HousingSecurity",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.environment.HousingSecurity"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR HousingSecurity Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.051Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.235Z",
   "description": "Whether the subject is at-risk of losing their housing or in a stable housing situation.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR HousingSecurity Profile",
         "definition": "Whether the subject is at-risk of losing their housing or in a stable housing situation.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-environment-HousingSecurity.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "165",
+          "id": "163",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -398,6 +435,7 @@
         "path": "Observation.extension",
         "sliceName": "details",
         "definition": "Particulars considered individually and in relation to a whole.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -429,16 +467,19 @@
         "id": "Observation:shr-environment-HousingSecurity.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "166",
+          "id": "164",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -468,6 +509,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -498,8 +540,8 @@
       {
         "id": "Observation:shr-environment-HousingSecurity.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -508,7 +550,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -523,6 +570,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-environment-HousingSecurity.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-environment-HousingSecurity.status",
         "extension": [
@@ -534,6 +638,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -545,6 +650,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -552,6 +663,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -571,8 +690,8 @@
         "path": "Observation.category",
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 0,
         "max": "*",
         "type": [
@@ -582,8 +701,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -605,6 +730,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -615,6 +743,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -622,6 +756,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -630,6 +772,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -641,7 +787,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -665,6 +811,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -680,20 +830,32 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-HousingSecurity.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-environment-HousingSecurity.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -713,8 +875,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -728,6 +893,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -747,7 +916,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -799,6 +968,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -817,17 +990,20 @@
         "id": "Observation:shr-environment-HousingSecurity.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "164",
+          "id": "162",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 1,
         "max": "1",
         "type": [
@@ -841,6 +1017,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -848,6 +1032,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -869,7 +1057,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-environment-ResourceStabilityVS"
+            "reference": "http://standardhealthrecord.org/shr/environment/vs/ResourceStabilityVS"
           }
         }
       },
@@ -878,7 +1066,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -891,6 +1079,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -898,6 +1092,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -925,6 +1123,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -932,6 +1136,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -939,6 +1147,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -956,6 +1168,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -971,8 +1187,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -981,6 +1196,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -988,6 +1209,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -995,6 +1220,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1003,7 +1232,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1014,6 +1243,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1036,7 +1271,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1046,6 +1281,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1053,6 +1292,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1061,7 +1304,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1075,6 +1318,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1082,6 +1329,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1090,7 +1341,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1159,7 +1410,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1188,7 +1439,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1270,30 +1521,82 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-HousingSecurity.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-environment-HousingSecurity.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-environment-HousingSecurity.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1349,8 +1652,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1412,7 +1715,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1441,7 +1744,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1473,7 +1776,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1483,6 +1786,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1533,7 +1842,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1596,7 +1905,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1625,7 +1934,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1667,6 +1976,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1674,6 +1989,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1693,8 +2012,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1731,6 +2050,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1738,6 +2061,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1746,7 +2073,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1759,6 +2086,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1781,7 +2114,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1794,6 +2127,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1801,6 +2140,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1808,6 +2151,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1816,7 +2163,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1951,12 +2298,16 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-HousingSecurity.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-environment-HousingSecurity.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
@@ -2005,9 +2356,12 @@
         "id": "Observation:shr-environment-HousingSecurity.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "164",
+          "id": "162",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -2033,7 +2387,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-environment-ResourceStabilityVS"
+            "reference": "http://standardhealthrecord.org/shr/environment/vs/ResourceStabilityVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-IncomeSource-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-IncomeSource-extension.json
old mode 100755
new mode 100644
index e3a51fa..b47d9f9
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-IncomeSource-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-IncomeSource-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.environment.IncomeSource"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR IncomeSource Extension",
   "title": "SHR IncomeSource Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.471Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.091Z",
   "description": "Where the household income comes from.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-IncomeSource.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-IncomeSource.json
old mode 100755
new mode 100644
index 1381eca..3dbd6c1
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-IncomeSource.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-IncomeSource.json
@@ -3,7 +3,7 @@
   "id": "shr-environment-IncomeSource",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR IncomeSource Profile</b></p>\n  <p>Where the household income comes from.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.IncomeSource maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR IncomeSource Profile</b></p>\n  <p>Where the household income comes from.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.IncomeSource maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-environment-IncomeSource",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.environment.IncomeSource"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR IncomeSource Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.510Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.106Z",
   "description": "Where the household income comes from.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR IncomeSource Profile",
         "definition": "Where the household income comes from.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-environment-IncomeSource.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "117",
+          "id": "115",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -397,16 +434,19 @@
         "id": "Observation:shr-environment-IncomeSource.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "118",
+          "id": "116",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -436,6 +476,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -466,8 +507,8 @@
       {
         "id": "Observation:shr-environment-IncomeSource.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -476,7 +517,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -491,6 +537,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-environment-IncomeSource.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-environment-IncomeSource.status",
         "extension": [
@@ -502,6 +605,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -513,6 +617,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -520,6 +630,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -539,8 +657,8 @@
         "path": "Observation.category",
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 0,
         "max": "*",
         "type": [
@@ -550,8 +668,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -573,6 +697,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -591,6 +718,12 @@
         },
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -598,6 +731,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -606,6 +747,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -617,7 +762,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -641,6 +786,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -656,20 +805,32 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-IncomeSource.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-environment-IncomeSource.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -689,8 +850,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -704,6 +868,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -723,7 +891,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -775,6 +943,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -793,17 +965,20 @@
         "id": "Observation:shr-environment-IncomeSource.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "116",
+          "id": "114",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 1,
         "max": "1",
         "type": [
@@ -817,6 +992,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -824,6 +1007,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -845,7 +1032,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-environment-IncomeSourceVS"
+            "reference": "http://standardhealthrecord.org/shr/environment/vs/IncomeSourceVS"
           }
         }
       },
@@ -854,7 +1041,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -867,6 +1054,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -874,6 +1067,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -901,6 +1098,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -908,6 +1111,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -915,6 +1122,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -932,6 +1143,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -947,8 +1162,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -957,6 +1171,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -964,6 +1184,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -971,6 +1195,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -979,7 +1207,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -990,6 +1218,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1012,7 +1246,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1022,6 +1256,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1029,6 +1267,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1037,7 +1279,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1051,6 +1293,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1058,6 +1304,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1066,7 +1316,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1135,7 +1385,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1164,7 +1414,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1246,30 +1496,82 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-IncomeSource.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-environment-IncomeSource.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-environment-IncomeSource.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1325,8 +1627,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1388,7 +1690,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1417,7 +1719,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1449,7 +1751,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1459,6 +1761,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1509,7 +1817,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1572,7 +1880,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1601,7 +1909,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1643,6 +1951,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1650,6 +1964,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1669,8 +1987,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1707,6 +2025,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1714,6 +2036,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1722,7 +2048,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1735,6 +2061,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1757,7 +2089,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1770,6 +2102,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1777,6 +2115,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1784,6 +2126,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1792,7 +2138,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1919,12 +2265,16 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-IncomeSource.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-environment-IncomeSource.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
@@ -1973,9 +2323,12 @@
         "id": "Observation:shr-environment-IncomeSource.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "116",
+          "id": "114",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -2001,7 +2354,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-environment-IncomeSourceVS"
+            "reference": "http://standardhealthrecord.org/shr/environment/vs/IncomeSourceVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-IncomeStability-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-IncomeStability-extension.json
old mode 100755
new mode 100644
index 9134d67..299c622
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-IncomeStability-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-IncomeStability-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.environment.IncomeStability"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR IncomeStability Extension",
   "title": "SHR IncomeStability Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.471Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.091Z",
   "description": "Whether the subject regards his or her source of income as dependable.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-IncomeStability.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-IncomeStability.json
old mode 100755
new mode 100644
index 5aec58a..a1b8de8
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-IncomeStability.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-IncomeStability.json
@@ -3,7 +3,7 @@
   "id": "shr-environment-IncomeStability",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR IncomeStability Profile</b></p>\n  <p>Whether the subject regards his or her source of income as dependable.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.IncomeStability maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR IncomeStability Profile</b></p>\n  <p>Whether the subject regards his or her source of income as dependable.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.IncomeStability maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-environment-IncomeStability",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.environment.IncomeStability"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR IncomeStability Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.541Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.113Z",
   "description": "Whether the subject regards his or her source of income as dependable.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR IncomeStability Profile",
         "definition": "Whether the subject regards his or her source of income as dependable.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-environment-IncomeStability.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "120",
+          "id": "118",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -397,16 +434,19 @@
         "id": "Observation:shr-environment-IncomeStability.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "121",
+          "id": "119",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -436,6 +476,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -466,8 +507,8 @@
       {
         "id": "Observation:shr-environment-IncomeStability.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -476,7 +517,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -491,6 +537,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-environment-IncomeStability.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-environment-IncomeStability.status",
         "extension": [
@@ -502,6 +605,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -513,6 +617,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -520,6 +630,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -539,8 +657,8 @@
         "path": "Observation.category",
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 0,
         "max": "*",
         "type": [
@@ -550,8 +668,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -573,6 +697,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -591,6 +718,12 @@
         },
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -598,6 +731,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -606,6 +747,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -617,7 +762,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -641,6 +786,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -656,20 +805,32 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-IncomeStability.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-environment-IncomeStability.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -689,8 +850,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -704,6 +868,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -723,7 +891,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -775,6 +943,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -793,17 +965,20 @@
         "id": "Observation:shr-environment-IncomeStability.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "119",
+          "id": "117",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 1,
         "max": "1",
         "type": [
@@ -817,6 +992,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -824,6 +1007,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -845,7 +1032,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-environment-ResourceStabilityVS"
+            "reference": "http://standardhealthrecord.org/shr/environment/vs/ResourceStabilityVS"
           }
         }
       },
@@ -854,7 +1041,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -867,6 +1054,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -874,6 +1067,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -901,6 +1098,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -908,6 +1111,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -915,6 +1122,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -932,6 +1143,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -947,8 +1162,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -957,6 +1171,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -964,6 +1184,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -971,6 +1195,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -979,7 +1207,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -990,6 +1218,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1012,7 +1246,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1022,6 +1256,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1029,6 +1267,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1037,7 +1279,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1051,6 +1293,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1058,6 +1304,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1066,7 +1316,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1135,7 +1385,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1164,7 +1414,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1246,30 +1496,82 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-IncomeStability.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-environment-IncomeStability.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-environment-IncomeStability.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1325,8 +1627,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1388,7 +1690,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1417,7 +1719,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1449,7 +1751,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1459,6 +1761,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1509,7 +1817,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1572,7 +1880,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1601,7 +1909,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1643,6 +1951,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1650,6 +1964,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1669,8 +1987,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1707,6 +2025,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1714,6 +2036,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1722,7 +2048,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1735,6 +2061,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1757,7 +2089,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1770,6 +2102,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1777,6 +2115,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1784,6 +2126,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1792,7 +2138,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1919,12 +2265,16 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-IncomeStability.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-environment-IncomeStability.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
@@ -1973,9 +2323,12 @@
         "id": "Observation:shr-environment-IncomeStability.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "119",
+          "id": "117",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -2001,7 +2354,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-environment-ResourceStabilityVS"
+            "reference": "http://standardhealthrecord.org/shr/environment/vs/ResourceStabilityVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-NonCashBenefit-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-NonCashBenefit-extension.json
old mode 100755
new mode 100644
index c5f32f3..2ada85f
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-NonCashBenefit-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-NonCashBenefit-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.environment.NonCashBenefit"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR NonCashBenefit Extension",
   "title": "SHR NonCashBenefit Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.473Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.092Z",
   "description": "Government benefits received by the focal subject, other than cash benefits.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-NonCashBenefit.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-NonCashBenefit.json
old mode 100755
new mode 100644
index 760cac9..8075b8c
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-NonCashBenefit.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-NonCashBenefit.json
@@ -3,7 +3,7 @@
   "id": "shr-environment-NonCashBenefit",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR NonCashBenefit Profile</b></p>\n  <p>Government benefits received by the focal subject, other than cash benefits.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.NonCashBenefit maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR NonCashBenefit Profile</b></p>\n  <p>Government benefits received by the focal subject, other than cash benefits.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.NonCashBenefit maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-environment-NonCashBenefit",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.environment.NonCashBenefit"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR NonCashBenefit Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.821Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.180Z",
   "description": "Government benefits received by the focal subject, other than cash benefits.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR NonCashBenefit Profile",
         "definition": "Government benefits received by the focal subject, other than cash benefits.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-environment-NonCashBenefit.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "147",
+          "id": "145",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -398,6 +435,7 @@
         "path": "Observation.extension",
         "sliceName": "effectivetimeperiod",
         "definition": "The date and time span for which something is active, valid, or in force.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -429,16 +467,19 @@
         "id": "Observation:shr-environment-NonCashBenefit.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "148",
+          "id": "146",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -468,6 +509,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -498,8 +540,8 @@
       {
         "id": "Observation:shr-environment-NonCashBenefit.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -508,7 +550,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -523,6 +570,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-environment-NonCashBenefit.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-environment-NonCashBenefit.status",
         "extension": [
@@ -534,6 +638,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -545,6 +650,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -552,6 +663,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -571,8 +690,8 @@
         "path": "Observation.category",
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 0,
         "max": "*",
         "type": [
@@ -582,8 +701,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -605,6 +730,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -615,6 +743,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -622,6 +756,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -630,6 +772,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -641,7 +787,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -665,6 +811,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -680,20 +830,32 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-NonCashBenefit.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-environment-NonCashBenefit.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -713,8 +875,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -728,6 +893,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -747,7 +916,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -799,6 +968,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -817,17 +990,20 @@
         "id": "Observation:shr-environment-NonCashBenefit.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "146",
+          "id": "144",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 1,
         "max": "1",
         "type": [
@@ -841,6 +1017,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -848,6 +1032,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -869,7 +1057,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-environment-NonCashBenefitVS"
+            "reference": "http://standardhealthrecord.org/shr/environment/vs/NonCashBenefitVS"
           }
         }
       },
@@ -878,7 +1066,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -891,6 +1079,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -898,6 +1092,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -925,6 +1123,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -932,6 +1136,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -939,6 +1147,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -956,6 +1168,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -971,8 +1187,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -981,6 +1196,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -988,6 +1209,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -995,6 +1220,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1003,7 +1232,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1014,6 +1243,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1036,7 +1271,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1046,6 +1281,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1053,6 +1292,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1061,7 +1304,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1075,6 +1318,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1082,6 +1329,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1090,7 +1341,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1159,7 +1410,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1188,7 +1439,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1270,30 +1521,82 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-NonCashBenefit.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-environment-NonCashBenefit.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-environment-NonCashBenefit.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1349,8 +1652,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1412,7 +1715,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1441,7 +1744,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1473,7 +1776,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1483,6 +1786,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1533,7 +1842,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1596,7 +1905,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1625,7 +1934,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1667,6 +1976,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1674,6 +1989,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1693,8 +2012,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1731,6 +2050,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1738,6 +2061,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1746,7 +2073,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1759,6 +2086,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1781,7 +2114,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1794,6 +2127,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1801,6 +2140,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1808,6 +2151,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1816,7 +2163,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1951,12 +2298,16 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-NonCashBenefit.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-environment-NonCashBenefit.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
@@ -2005,9 +2356,12 @@
         "id": "Observation:shr-environment-NonCashBenefit.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "146",
+          "id": "144",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -2033,7 +2387,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-environment-NonCashBenefitVS"
+            "reference": "http://standardhealthrecord.org/shr/environment/vs/NonCashBenefitVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-NumberOfDependents-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-NumberOfDependents-extension.json
old mode 100755
new mode 100644
index a7854f3..b42c093
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-NumberOfDependents-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-NumberOfDependents-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.environment.NumberOfDependents"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR NumberOfDependents Extension",
   "title": "SHR NumberOfDependents Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.861Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.185Z",
   "description": "The number of dependents supported by the subject.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-NumberOfDependents.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-NumberOfDependents.json
old mode 100755
new mode 100644
index 4194c76..f97f114
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-NumberOfDependents.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-NumberOfDependents.json
@@ -3,7 +3,7 @@
   "id": "shr-environment-NumberOfDependents",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR NumberOfDependents Profile</b></p>\n  <p>The number of dependents supported by the subject.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.NumberOfDependents maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR NumberOfDependents Profile</b></p>\n  <p>The number of dependents supported by the subject.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.NumberOfDependents maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-environment-NumberOfDependents",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.environment.NumberOfDependents"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR NumberOfDependents Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.925Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.206Z",
   "description": "The number of dependents supported by the subject.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR NumberOfDependents Profile",
         "definition": "The number of dependents supported by the subject.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-environment-NumberOfDependents.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "154",
+          "id": "152",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "unsignedint",
         "definition": "SHR unsignedInt Extension",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -398,6 +435,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -429,16 +467,19 @@
         "id": "Observation:shr-environment-NumberOfDependents.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "155",
+          "id": "153",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -468,6 +509,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -498,8 +540,8 @@
       {
         "id": "Observation:shr-environment-NumberOfDependents.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -508,7 +550,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -523,6 +570,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-environment-NumberOfDependents.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-environment-NumberOfDependents.status",
         "extension": [
@@ -534,6 +638,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -545,6 +650,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -552,6 +663,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -571,8 +690,8 @@
         "path": "Observation.category",
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 0,
         "max": "*",
         "type": [
@@ -582,8 +701,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -605,6 +730,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -623,6 +751,12 @@
         },
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -630,6 +764,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -638,6 +780,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -649,7 +795,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -673,6 +819,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -688,20 +838,32 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-NumberOfDependents.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-environment-NumberOfDependents.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -721,8 +883,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -736,6 +901,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -755,7 +924,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -807,6 +976,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -826,8 +999,8 @@
         "path": "Observation.value[x]",
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -840,6 +1013,9 @@
           {
             "code": "string"
           },
+          {
+            "code": "boolean"
+          },
           {
             "code": "Range"
           },
@@ -867,6 +1043,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -874,6 +1058,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -882,7 +1070,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -895,6 +1083,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -902,6 +1096,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -929,6 +1127,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -936,6 +1140,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -943,6 +1151,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -960,6 +1172,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -975,8 +1191,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -985,6 +1200,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -992,6 +1213,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -999,6 +1224,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1007,7 +1236,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1018,6 +1247,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1040,7 +1275,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1050,6 +1285,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1057,6 +1296,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1065,7 +1308,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1079,6 +1322,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1086,6 +1333,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1094,7 +1345,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1163,7 +1414,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1192,7 +1443,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1274,30 +1525,82 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-NumberOfDependents.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-environment-NumberOfDependents.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-environment-NumberOfDependents.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1353,8 +1656,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1416,7 +1719,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1445,7 +1748,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1477,7 +1780,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1487,6 +1790,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1537,7 +1846,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1600,7 +1909,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1629,7 +1938,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1671,6 +1980,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1678,6 +1993,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1697,8 +2016,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1735,6 +2054,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1742,6 +2065,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1750,7 +2077,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1763,6 +2090,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1785,7 +2118,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1798,6 +2131,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1805,6 +2144,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1812,6 +2155,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1820,7 +2167,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1963,12 +2310,16 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-NumberOfDependents.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-environment-NumberOfDependents.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-PhysicalSafety-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-PhysicalSafety-extension.json
old mode 100755
new mode 100644
index a331cfa..4990fc2
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-PhysicalSafety-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-PhysicalSafety-extension.json
@@ -3,7 +3,7 @@
   "id": "shr-environment-PhysicalSafety-extension",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR PhysicalSafety Extension</b></p>\n  <p>How often the subject feels physically safe in the subject&#039;s home environment.</p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR PhysicalSafety Extension</b></p>\n  <p>How often the subject feels physically safe in the subject's home environment.</p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-environment-PhysicalSafety-extension",
   "identifier": [
@@ -12,9 +12,11 @@
       "value": "shr.environment.PhysicalSafety"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR PhysicalSafety Extension",
   "title": "SHR PhysicalSafety Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.010Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.222Z",
   "description": "How often the subject feels physically safe in the subject's home environment.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-PhysicalSafety.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-PhysicalSafety.json
old mode 100755
new mode 100644
index 54fbc2f..2f927d4
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-PhysicalSafety.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-PhysicalSafety.json
@@ -3,7 +3,7 @@
   "id": "shr-environment-PhysicalSafety",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR PhysicalSafety Profile</b></p>\n  <p>How often the subject feels physically safe in the subject&#039;s home environment.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.PhysicalSafety maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR PhysicalSafety Profile</b></p>\n  <p>How often the subject feels physically safe in the subject's home environment.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.PhysicalSafety maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-environment-PhysicalSafety",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.environment.PhysicalSafety"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR PhysicalSafety Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.086Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.242Z",
   "description": "How often the subject feels physically safe in the subject's home environment.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR PhysicalSafety Profile",
         "definition": "How often the subject feels physically safe in the subject's home environment.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-environment-PhysicalSafety.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "168",
+          "id": "166",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -398,6 +435,7 @@
         "path": "Observation.extension",
         "sliceName": "details",
         "definition": "Particulars considered individually and in relation to a whole.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -429,16 +467,19 @@
         "id": "Observation:shr-environment-PhysicalSafety.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "169",
+          "id": "167",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -468,6 +509,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -498,8 +540,8 @@
       {
         "id": "Observation:shr-environment-PhysicalSafety.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -508,7 +550,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -523,6 +570,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-environment-PhysicalSafety.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-environment-PhysicalSafety.status",
         "extension": [
@@ -534,6 +638,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -545,6 +650,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -552,6 +663,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -571,8 +690,8 @@
         "path": "Observation.category",
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 0,
         "max": "*",
         "type": [
@@ -582,8 +701,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -605,6 +730,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -615,6 +743,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -622,6 +756,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -630,6 +772,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -641,7 +787,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -665,6 +811,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -680,20 +830,32 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-PhysicalSafety.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-environment-PhysicalSafety.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -713,8 +875,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -728,6 +893,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -747,7 +916,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -799,6 +968,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -817,17 +990,20 @@
         "id": "Observation:shr-environment-PhysicalSafety.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "167",
+          "id": "165",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 1,
         "max": "1",
         "type": [
@@ -841,6 +1017,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -848,6 +1032,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -869,7 +1057,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeFrequencyVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeFrequencyVS"
           }
         }
       },
@@ -878,7 +1066,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -891,6 +1079,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -898,6 +1092,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -925,6 +1123,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -932,6 +1136,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -939,6 +1147,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -956,6 +1168,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -971,8 +1187,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -981,6 +1196,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -988,6 +1209,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -995,6 +1220,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1003,7 +1232,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1014,6 +1243,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1036,7 +1271,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1046,6 +1281,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1053,6 +1292,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1061,7 +1304,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1075,6 +1318,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1082,6 +1329,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1090,7 +1341,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1159,7 +1410,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1188,7 +1439,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1270,30 +1521,82 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-PhysicalSafety.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-environment-PhysicalSafety.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-environment-PhysicalSafety.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1349,8 +1652,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1412,7 +1715,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1441,7 +1744,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1473,7 +1776,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1483,6 +1786,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1533,7 +1842,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1596,7 +1905,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1625,7 +1934,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1667,6 +1976,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1674,6 +1989,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1693,8 +2012,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1731,6 +2050,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1738,6 +2061,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1746,7 +2073,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1759,6 +2086,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1781,7 +2114,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1794,6 +2127,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1801,6 +2140,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1808,6 +2151,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1816,7 +2163,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1951,12 +2298,16 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-PhysicalSafety.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-environment-PhysicalSafety.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
@@ -2005,9 +2356,12 @@
         "id": "Observation:shr-environment-PhysicalSafety.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "167",
+          "id": "165",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -2033,7 +2387,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeFrequencyVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeFrequencyVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-SocialEnvironmentPanel.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-SocialEnvironmentPanel.json
old mode 100755
new mode 100644
index 662e1ea..c9127de
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-SocialEnvironmentPanel.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-SocialEnvironmentPanel.json
@@ -3,7 +3,7 @@
   "id": "shr-environment-SocialEnvironmentPanel",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR SocialEnvironmentPanel Profile</b></p>\n  <p>Factors affecting the health of the subject in their daily living environment.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.SocialEnvironmentPanel maps to DiagnosticReport:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  CodeableConcept maps to codedDiagnosis\n  Observation maps to result\n  TBD &quot;Specimen&quot; maps to specimen\n  Interpretation maps to conclusion\n  ObservationCategory maps to category\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR SocialEnvironmentPanel Profile</b></p>\n  <p>Factors affecting the health of the subject in their daily living environment.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.SocialEnvironmentPanel maps to DiagnosticReport:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  CodeableConcept maps to codedDiagnosis\n  Observation maps to result\n  &lt;TBD &quot;Specimen&quot;&gt; maps to specimen\n  Interpretation maps to conclusion\n  ObservationCategory maps to category\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-environment-SocialEnvironmentPanel",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.environment.SocialEnvironmentPanel"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR SocialEnvironmentPanel Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.997Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,15 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.221Z",
   "description": "Factors affecting the health of the subject in their daily living environment.",
   "purpose": "To support reporting for any diagnostic report into a clinical data repository.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -58,7 +64,7 @@
         "path": "DiagnosticReport",
         "short": "SHR SocialEnvironmentPanel Profile",
         "definition": "Factors affecting the health of the subject in their daily living environment.",
-        "comments": "This is intended to capture a single report, and is not suitable for use in displaying summary information that covers multiple reports.  For example, this resource has not been designed for laboratory cumulative reporting formats nor detailed structured reports for sequencing.",
+        "comment": "This is intended to capture a single report, and is not suitable for use in displaying summary information that covers multiple reports.  For example, this resource has not been designed for laboratory cumulative reporting formats nor detailed structured reports for sequencing.",
         "alias": [
           "Report",
           "Test",
@@ -108,6 +114,10 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
           {
             "identity": "v2",
             "map": "ORU -> OBR"
@@ -127,7 +137,7 @@
         "path": "DiagnosticReport.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -166,7 +176,7 @@
         "path": "DiagnosticReport.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -187,7 +197,7 @@
         "path": "DiagnosticReport.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -207,6 +217,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -221,7 +239,7 @@
         "path": "DiagnosticReport.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -255,7 +273,7 @@
         "path": "DiagnosticReport.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -284,16 +302,19 @@
         "id": "DiagnosticReport:shr-environment-SocialEnvironmentPanel.extension",
         "path": "DiagnosticReport.extension",
         "slicing": {
-          "id": "160",
+          "id": "158",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -322,6 +343,7 @@
         "path": "DiagnosticReport.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -354,6 +376,7 @@
         "path": "DiagnosticReport.extension",
         "sliceName": "transportationavailability",
         "definition": "Whether the subject has reliable transportation to bring him or her to medical appointments and to get medications.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -386,6 +409,7 @@
         "path": "DiagnosticReport.extension",
         "sliceName": "housingsecurity",
         "definition": "Whether the subject is at-risk of losing their housing or in a stable housing situation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -418,6 +442,7 @@
         "path": "DiagnosticReport.extension",
         "sliceName": "physicalsafety",
         "definition": "How often the subject feels physically safe in the subject's home environment.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -450,6 +475,7 @@
         "path": "DiagnosticReport.extension",
         "sliceName": "emotionalsafety",
         "definition": "Whether the subject feels physically safe in the subject's home environment.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -482,6 +508,7 @@
         "path": "DiagnosticReport.extension",
         "sliceName": "domesticviolence",
         "definition": "Whether the subject experiences domestic violence.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -514,6 +541,7 @@
         "path": "DiagnosticReport.extension",
         "sliceName": "homeenvironmentrisk",
         "definition": "A risk experienced in the home environment.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -546,7 +574,7 @@
         "path": "DiagnosticReport.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -574,11 +602,14 @@
       {
         "id": "DiagnosticReport:shr-environment-SocialEnvironmentPanel.identifier",
         "path": "DiagnosticReport.identifier",
-        "short": "Id for external references to this report",
-        "definition": "The local ID assigned to the report by the order filler, usually by the Information System of the diagnostic service provider.",
+        "short": "Business identifier for report",
+        "definition": "Identifiers assigned to this report by the performer or other systems.",
+        "comment": "Usually assigned by the Information System of the diagnostic service provider (filler id).",
         "requirements": "Need to know what identifier to use when making queries about this report from the source laboratory, and for linking to the report outside FHIR context.",
         "alias": [
-          "ReportID"
+          "ReportID",
+          "Filler ID",
+          "Placer ID"
         ],
         "min": 0,
         "max": "*",
@@ -589,6 +620,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBR-51"
@@ -603,12 +638,65 @@
           }
         ]
       },
+      {
+        "id": "DiagnosticReport:shr-environment-SocialEnvironmentPanel.basedOn",
+        "path": "DiagnosticReport.basedOn",
+        "short": "What was requested",
+        "definition": "Details concerning a test or procedure requested.",
+        "comment": "Note: Usually there is one test request for each result, however in some circumstances multiple test requests may be represented using a single test result resource. Note that there are also cases where one request leads to multiple reports.",
+        "requirements": "This allows tracing of authorization for the report and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Request"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC? OBR-2/3?"
+          },
+          {
+            "identity": "rim",
+            "map": "outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "DiagnosticReport:shr-environment-SocialEnvironmentPanel.status",
         "path": "DiagnosticReport.status",
-        "short": "registered | partial | final | corrected | appended | cancelled | entered-in-error",
+        "short": "registered | partial | preliminary | final +",
         "definition": "The status of the diagnostic report as a whole.",
-        "comments": "This is labeled as \"Is Modifier\" because applications need to take appropriate action if a report is withdrawn.",
+        "comment": "This is labeled as \"Is Modifier\" because applications need to take appropriate action if a report is withdrawn.",
         "requirements": "Diagnostic services routinely issue provisional/incomplete reports, and sometimes withdraw previously released reports.",
         "min": 1,
         "max": "1",
@@ -620,6 +708,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "DiagnosticReportStatus"
+            }
+          ],
           "strength": "required",
           "description": "The status of the diagnostic report as a whole.",
           "valueSetReference": {
@@ -627,6 +721,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
           {
             "identity": "v2",
             "map": "OBR-25 (not 1:1 mapping)"
@@ -646,12 +744,12 @@
         "path": "DiagnosticReport.category",
         "short": "Service category",
         "definition": "A code that classifies the clinical discipline, department or diagnostic service that created the report (e.g. cardiology, biochemistry, hematology, MRI). This is used for searching, sorting and display purposes.",
-        "comments": "The level of granularity is defined by the category concepts in the value set. More fine-grained filtering can be performed using the metadata and/or terminology hierarchy in DiagnosticReport.code.",
+        "comment": "The level of granularity is defined by the category concepts in the value set. More fine-grained filtering can be performed using the metadata and/or terminology hierarchy in DiagnosticReport.code.",
         "alias": [
           "Department",
           "Sub-department",
-          "service",
-          "discipline"
+          "Service",
+          "Discipline"
         ],
         "min": 0,
         "max": "1",
@@ -688,6 +786,9 @@
         "path": "DiagnosticReport.code",
         "short": "Name/Code for this diagnostic report",
         "definition": "A code or name that describes this diagnostic report.",
+        "alias": [
+          "Type"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -697,6 +798,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "DiagnosticReportCodes"
+            }
+          ],
           "strength": "preferred",
           "description": "Codes that describe Diagnostic Reports.",
           "valueSetReference": {
@@ -704,6 +811,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
           {
             "identity": "v2",
             "map": "OBR-4 (HL7 v2 doesn't provide an easy way to indicate both the ordered test and the performed panel)"
@@ -721,7 +832,7 @@
       {
         "id": "DiagnosticReport:shr-environment-SocialEnvironmentPanel.subject",
         "path": "DiagnosticReport.subject",
-        "short": "The subject of the report, usually, but not always, the patient",
+        "short": "The subject of the report - usually, but not always, the patient",
         "definition": "The subject of the report. Usually, but not always, this is a patient. However diagnostic services also perform analyses on specimens collected from a variety of other sources.",
         "requirements": "SHALL know the subject context.",
         "alias": [
@@ -749,6 +860,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3 (no HL7 v2 mapping for Group or Device)"
@@ -764,20 +879,33 @@
         ]
       },
       {
-        "id": "DiagnosticReport:shr-environment-SocialEnvironmentPanel.encounter",
-        "path": "DiagnosticReport.encounter",
+        "id": "DiagnosticReport:shr-environment-SocialEnvironmentPanel.context",
+        "path": "DiagnosticReport.context",
         "short": "Health care event when test ordered",
-        "definition": "The link to the health care event (encounter) when the order was made.",
+        "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) which this DiagnosticReport per is about.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
+        "requirements": "Links the request to the Encounter context.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1-19"
@@ -795,13 +923,14 @@
       {
         "id": "DiagnosticReport:shr-environment-SocialEnvironmentPanel.effective[x]",
         "path": "DiagnosticReport.effective[x]",
-        "short": "Clinically Relevant time/time-period for report",
+        "short": "Clinically relevant time/time-period for report",
         "definition": "The time or time-period the observed values are related to. When the subject of the report is a patient, this is usually either the time of the procedure or of specimen collection(s), but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "If the diagnostic procedure was performed on the patient, this is the time it was performed. If there are specimens, the diagnostically relevant time can be derived from the specimen collection times, but the specimen information is not always available, and the exact relationship between the specimens and the diagnostically relevant time is not always automatic.",
+        "comment": "If the diagnostic procedure was performed on the patient, this is the time it was performed. If there are specimens, the diagnostically relevant time can be derived from the specimen collection times, but the specimen information is not always available, and the exact relationship between the specimens and the diagnostically relevant time is not always automatic.",
         "requirements": "Need to know where in the patient history to file/present this report.",
         "alias": [
           "Observation time",
-          "Effective Time"
+          "Effective Time",
+          "Occurrence"
         ],
         "min": 0,
         "max": "1",
@@ -815,6 +944,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBR-7"
@@ -834,7 +967,7 @@
         "path": "DiagnosticReport.issued",
         "short": "DateTime this version was released",
         "definition": "The date and time that this version of the report was released from the source diagnostic service.",
-        "comments": "May be different from the update time of the resource itself, because that is the status of the record (potentially a secondary copy), not the actual release time of the report.",
+        "comment": "May be different from the update time of the resource itself, because that is the status of the record (potentially a secondary copy), not the actual release time of the report.",
         "requirements": "Clinicians need to be able to check the date that the report was released.",
         "alias": [
           "Date Created",
@@ -867,10 +1000,8 @@
       {
         "id": "DiagnosticReport:shr-environment-SocialEnvironmentPanel.performer",
         "path": "DiagnosticReport.performer",
-        "short": "Responsible Diagnostic Service",
-        "definition": "The diagnostic service that is responsible for issuing the report.",
-        "comments": "This is not necessarily the source of the atomic data items. It is the entity that takes responsibility for the clinical report.",
-        "requirements": "Need to know whom to contact if there are queries about the results. Also may need to track the source of reports for secondary data analysis.",
+        "short": "Participants in producing the report",
+        "definition": "Indicates who or what participated in producing the report.",
         "alias": [
           "Laboratory",
           "Service",
@@ -882,23 +1013,32 @@
         "max": "*",
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
-          },
+            "code": "BackboneElement"
+          }
+        ],
+        "constraint": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
+            "key": "ele-1",
+            "severity": "error",
+            "human": "All FHIR elements must have a @value or children",
+            "expression": "children().count() > id.count()",
+            "xpath": "@value|f:*|h:div",
+            "source": "Element"
           }
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "PRT-8 (where this PRT-4-Participation = \"PO\")"
           },
           {
             "identity": "rim",
-            "map": "participation[typeCode=AUT].role[classCode=ASSIGN].scoper"
+            "map": ".participation[typeCode=PRF]"
           },
           {
             "identity": "w5",
@@ -907,36 +1047,166 @@
         ]
       },
       {
-        "id": "DiagnosticReport:shr-environment-SocialEnvironmentPanel.request",
-        "path": "DiagnosticReport.request",
-        "short": "What was requested",
-        "definition": "Details concerning a test or procedure requested.",
-        "comments": "Note: Usually there is one test request for each result, however in some circumstances multiple test requests may be represented using a single test result resource. Note that there are also cases where one request leads to multiple reports.",
-        "requirements": "Need to be able to track completion of requests based on reports issued and also to report what diagnostic tests were requested (not always the same as what is delivered).",
+        "id": "DiagnosticReport:shr-environment-SocialEnvironmentPanel.performer.id",
+        "path": "DiagnosticReport.performer.id",
+        "representation": [
+          "xmlAttr"
+        ],
+        "short": "xml:id (or equivalent in JSON)",
+        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Element.id",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "DiagnosticReport:shr-environment-SocialEnvironmentPanel.performer.extension",
+        "path": "DiagnosticReport.performer.extension",
+        "short": "Additional Content defined by implementations",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content"
+        ],
         "min": 0,
         "max": "*",
+        "base": {
+          "path": "Element.extension",
+          "min": 0,
+          "max": "*"
+        },
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DiagnosticRequest"
+            "code": "Extension"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "DiagnosticReport:shr-environment-SocialEnvironmentPanel.performer.modifierExtension",
+        "path": "DiagnosticReport.performer.modifierExtension",
+        "short": "Extensions that cannot be ignored",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content",
+          "modifiers"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "BackboneElement.modifierExtension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "isModifier": true,
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "N/A"
+          }
+        ]
+      },
+      {
+        "id": "DiagnosticReport:shr-environment-SocialEnvironmentPanel.performer.role",
+        "path": "DiagnosticReport.performer.role",
+        "short": "Type of performer",
+        "definition": "Describes the type of participation (e.g.  a responsible party, author, or verifier).",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Role"
+            }
+          ],
+          "strength": "example",
+          "description": "Indicate a role of diagnostic report performer",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/performer-role"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer.role"
+          },
+          {
+            "identity": "v2",
+            "map": "PRT-8 (where this PRT-4-Participation = \"PO\")"
           },
+          {
+            "identity": "rim",
+            "map": ".functionCode"
+          }
+        ]
+      },
+      {
+        "id": "DiagnosticReport:shr-environment-SocialEnvironmentPanel.performer.actor",
+        "path": "DiagnosticReport.performer.actor",
+        "short": "Practitioner or Organization  participant",
+        "definition": "The reference to the  practitioner or organization involved in producing the report. For example, the diagnostic service that is responsible for issuing the report.",
+        "comment": "This is not necessarily the source of the atomic data items. It is the entity that takes responsibility for the clinical report.",
+        "requirements": "Need to know whom to contact if there are queries about the results. Also may need to track the source of reports for secondary data analysis.",
+        "min": 1,
+        "max": "1",
+        "type": [
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
           },
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer.actor"
+          },
           {
             "identity": "v2",
-            "map": "ORC? OBR-2/3?"
+            "map": "PRT-8 (where this PRT-4-Participation = \"PO\")"
           },
           {
             "identity": "rim",
-            "map": "outboundRelationship[typeCode=FLFS].target"
+            "map": ".role"
           }
         ]
       },
@@ -945,7 +1215,7 @@
         "path": "DiagnosticReport.specimen",
         "short": "Specimens this report is based on",
         "definition": "Details about the specimens on which this diagnostic report is based.",
-        "comments": "If the specimen is sufficiently specified with a code in the test result name, then this additional data may be redundant. If there are multiple specimens, these may be represented per Observation or group.",
+        "comment": "If the specimen is sufficiently specified with a code in the test result name, then this additional data may be redundant. If there are multiple specimens, these may be represented per observation or group.",
         "requirements": "Need to be able to report information about the collected specimens on which the report is based.",
         "min": 0,
         "max": "*",
@@ -1007,7 +1277,7 @@
         "path": "DiagnosticReport.imagingStudy",
         "short": "Reference to full details of imaging associated with the diagnostic report",
         "definition": "One or more links to full details of any imaging performed during the diagnostic investigation. Typically, this is imaging performed by DICOM enabled modalities, but this is not required. A fully enabled PACS viewer can use this information to provide views of the source images.",
-        "comments": "ImagingStudy and ImageManifest and the image element are somewhat overlapping - typically, the list of image references in the image element will also be found in one of the imaging study resources. However each caters to different types of displays for different types of purposes. Neither, either, or both may be provided.",
+        "comment": "ImagingStudy and ImageManifest and the image element are somewhat overlapping - typically, the list of image references in the image element will also be found in one of the imaging study resources. However each caters to different types of displays for different types of purposes. Neither, either, or both may be provided.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1099,7 +1369,7 @@
         "path": "DiagnosticReport.image.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1128,7 +1398,7 @@
         "path": "DiagnosticReport.image.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1160,7 +1430,7 @@
         "path": "DiagnosticReport.image.comment",
         "short": "Comment about the image (e.g. explanation)",
         "definition": "A comment about the image. Typically, this is used to provide an explanation for why the image is included, or to draw the viewer's attention to important features.",
-        "comments": "The comment should be displayed with the image. It would be common for the report to include additional discussion of the image contents in other sections such as the conclusion.",
+        "comment": "The comment should be displayed with the image. It would be common for the report to include additional discussion of the image contents in other sections such as the conclusion.",
         "requirements": "The provider of the report should make a comment about each image included in the report.",
         "min": 0,
         "max": "1",
@@ -1238,8 +1508,14 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AdjunctDiagnosis"
+            }
+          ],
           "strength": "example",
-          "description": "Diagnoses codes provided as adjuncts to the report.",
+          "description": "Diagnosis codes provided as adjuncts to the report.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/clinical-findings"
           }
@@ -1260,8 +1536,8 @@
         "path": "DiagnosticReport.presentedForm",
         "short": "Entire report as issued",
         "definition": "Rich text representation of the entire result as issued by the diagnostic service. Multiple formats are allowed but they SHALL be semantically equivalent.",
-        "comments": "\"application/pdf\" is recommended as the most reliable and interoperable in this context.",
-        "requirements": "Gives Laboratory the ability to provide its own fully formatted report for clinical fidelity.",
+        "comment": "\"application/pdf\" is recommended as the most reliable and interoperable in this context.",
+        "requirements": "Gives laboratory the ability to provide its own fully formatted report for clinical fidelity.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1443,12 +1719,16 @@
         ]
       },
       {
-        "id": "DiagnosticReport:shr-environment-SocialEnvironmentPanel.encounter",
-        "path": "DiagnosticReport.encounter",
+        "id": "DiagnosticReport:shr-environment-SocialEnvironmentPanel.context",
+        "path": "DiagnosticReport.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-TransportationAvailability-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-TransportationAvailability-extension.json
old mode 100755
new mode 100644
index 97998c8..283df6e
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-TransportationAvailability-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-TransportationAvailability-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.environment.TransportationAvailability"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR TransportationAvailability Extension",
   "title": "SHR TransportationAvailability Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.009Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.221Z",
   "description": "Whether the subject has reliable transportation to bring him or her to medical appointments and to get medications.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-environment-TransportationAvailability.json b/lib/resources/standard_health_record/StructureDefinition-shr-environment-TransportationAvailability.json
old mode 100755
new mode 100644
index 21bbc93..6e676b4
--- a/lib/resources/standard_health_record/StructureDefinition-shr-environment-TransportationAvailability.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-environment-TransportationAvailability.json
@@ -3,7 +3,7 @@
   "id": "shr-environment-TransportationAvailability",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR TransportationAvailability Profile</b></p>\n  <p>Whether the subject has reliable transportation to bring him or her to medical appointments and to get medications.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.TransportationAvailability maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR TransportationAvailability Profile</b></p>\n  <p>Whether the subject has reliable transportation to bring him or her to medical appointments and to get medications.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.environment.TransportationAvailability maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-environment-TransportationAvailability",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.environment.TransportationAvailability"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR TransportationAvailability Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.017Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.228Z",
   "description": "Whether the subject has reliable transportation to bring him or her to medical appointments and to get medications.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR TransportationAvailability Profile",
         "definition": "Whether the subject has reliable transportation to bring him or her to medical appointments and to get medications.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-environment-TransportationAvailability.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "162",
+          "id": "160",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -398,6 +435,7 @@
         "path": "Observation.extension",
         "sliceName": "details",
         "definition": "Particulars considered individually and in relation to a whole.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -429,16 +467,19 @@
         "id": "Observation:shr-environment-TransportationAvailability.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "163",
+          "id": "161",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -468,6 +509,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -498,8 +540,8 @@
       {
         "id": "Observation:shr-environment-TransportationAvailability.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -508,7 +550,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -523,6 +570,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-environment-TransportationAvailability.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-environment-TransportationAvailability.status",
         "extension": [
@@ -534,6 +638,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -545,6 +650,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -552,6 +663,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -571,8 +690,8 @@
         "path": "Observation.category",
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 0,
         "max": "*",
         "type": [
@@ -582,8 +701,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -605,6 +730,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -615,6 +743,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -622,6 +756,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -630,6 +772,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -641,7 +787,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -665,6 +811,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -680,20 +830,32 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-TransportationAvailability.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-environment-TransportationAvailability.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -713,8 +875,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -728,6 +893,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -747,7 +916,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -799,6 +968,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -817,17 +990,20 @@
         "id": "Observation:shr-environment-TransportationAvailability.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "161",
+          "id": "159",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 1,
         "max": "1",
         "type": [
@@ -841,6 +1017,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -848,6 +1032,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -869,7 +1057,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeFrequencyVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeFrequencyVS"
           }
         }
       },
@@ -878,7 +1066,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -891,6 +1079,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -898,6 +1092,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -925,6 +1123,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -932,6 +1136,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -939,6 +1147,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -956,6 +1168,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -971,8 +1187,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -981,6 +1196,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -988,6 +1209,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -995,6 +1220,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1003,7 +1232,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1014,6 +1243,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1036,7 +1271,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1046,6 +1281,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1053,6 +1292,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1061,7 +1304,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1075,6 +1318,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1082,6 +1329,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1090,7 +1341,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1159,7 +1410,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1188,7 +1439,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1270,30 +1521,82 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-TransportationAvailability.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-environment-TransportationAvailability.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-environment-TransportationAvailability.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1349,8 +1652,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1412,7 +1715,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1441,7 +1744,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1473,7 +1776,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1483,6 +1786,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1533,7 +1842,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1596,7 +1905,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1625,7 +1934,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1667,6 +1976,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1674,6 +1989,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1693,8 +2012,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1731,6 +2050,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1738,6 +2061,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1746,7 +2073,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1759,6 +2086,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1781,7 +2114,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1794,6 +2127,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1801,6 +2140,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1808,6 +2151,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1816,7 +2163,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1951,12 +2298,16 @@
         ]
       },
       {
-        "id": "Observation:shr-environment-TransportationAvailability.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-environment-TransportationAvailability.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
@@ -2005,9 +2356,12 @@
         "id": "Observation:shr-environment-TransportationAvailability.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "161",
+          "id": "159",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -2033,7 +2387,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeFrequencyVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeFrequencyVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-immunization-Immunization.json b/lib/resources/standard_health_record/StructureDefinition-shr-immunization-Immunization.json
old mode 100755
new mode 100644
index 15a6865..12abe17
--- a/lib/resources/standard_health_record/StructureDefinition-shr-immunization-Immunization.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-immunization-Immunization.json
@@ -3,7 +3,7 @@
   "id": "shr-immunization-Immunization",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR Immunization Profile</b></p>\n  <p>A statement relating to a vaccination that was or was not administered to the subject.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.immunization.Immunization maps to Immunization:\n  Vaccine.CodeableConcept maps to vaccineCode\n  Vaccine.VaccineManufacturer maps to manufacturer\n  ImmunizationNotGivenModifier maps to wasNotGiven\n  explanation is 0..1\n  ImmunizationNotGivenModifier.Reason maps to explanation.reasonNotGiven\n  BodySite maps to site\n  RouteIntoBody maps to route\n  AmountOfMedication maps to doseQuantity\n  TBD &quot;DoseSequenceNumber&quot; maps to vaccinationProtocol.doseSequence\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR Immunization Profile</b></p>\n  <p>A statement relating to a vaccination that was or was not administered to the subject.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.immunization.Immunization maps to Immunization:\n  Vaccine.CodeableConcept maps to vaccineCode\n  Vaccine.VaccineManufacturer maps to manufacturer\n  ImmunizationNotGivenModifier maps to notGiven\n  constrain explanation to 0..1\n  ImmunizationNotGivenModifier.Reason maps to explanation.reasonNotGiven\n  BodySite maps to site\n  RouteIntoBody maps to route\n  AmountOfMedication maps to doseQuantity\n  &lt;TBD &quot;DoseSequenceNumber&quot;&gt; maps to vaccinationProtocol.doseSequence\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-immunization-Immunization",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.immunization.Immunization"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Immunization Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.527Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.354Z",
   "description": "A statement relating to a vaccination that was or was not administered to the subject.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "v2",
@@ -44,6 +45,11 @@
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
     },
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
     {
       "identity": "cda",
       "uri": "http://hl7.org/v3/cda",
@@ -100,16 +106,16 @@
           {
             "key": "imm-2",
             "severity": "error",
-            "human": "If immunization was administered (wasNotGiven=false) then explanation.reasonNotGiven SHALL be absent.",
-            "expression": "(wasNotGiven = true) or explanation.reasonNotGiven.empty()",
-            "xpath": "not(f:wasNotGiven/@value=false() and exists(f:explanation/f:reasonNotGiven))"
+            "human": "If immunization was administered (notGiven=false) then explanation.reasonNotGiven SHALL be absent.",
+            "expression": "(notGiven = true) or explanation.reasonNotGiven.empty()",
+            "xpath": "not(f:notGiven/@value=false() and exists(f:explanation/f:reasonNotGiven))"
           },
           {
             "key": "imm-1",
             "severity": "error",
-            "human": "If immunization was not administered (wasNotGiven=true) then there SHALL be no reaction nor explanation.reason present",
-            "expression": "(wasNotGiven = true).not() or (reaction.empty() and explanation.reason.empty())",
-            "xpath": "not(f:wasNotGiven/@value=true() and (count(f:reaction) > 0 or exists(f:explanation/f:reason)))"
+            "human": "If immunization was not administered (notGiven=true) then there SHALL be no reaction nor explanation.reason present",
+            "expression": "(notGiven = true).not() or (reaction.empty() and explanation.reason.empty())",
+            "xpath": "not(f:notGiven/@value=true() and (count(f:reaction) > 0 or exists(f:explanation/f:reason)))"
           }
         ],
         "mapping": [
@@ -136,7 +142,7 @@
         "path": "Immunization.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -175,7 +181,7 @@
         "path": "Immunization.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -196,7 +202,7 @@
         "path": "Immunization.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -216,6 +222,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -230,7 +244,7 @@
         "path": "Immunization.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -264,7 +278,7 @@
         "path": "Immunization.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -294,7 +308,7 @@
         "path": "Immunization.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -323,7 +337,7 @@
         "path": "Immunization.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -361,6 +375,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "rim",
             "map": ".id"
@@ -380,7 +398,7 @@
         "path": "Immunization.status",
         "short": "completed | entered-in-error",
         "definition": "Indicates the current status of the vaccination event.",
-        "comments": "Will generally be set to show that the immunization has been completed.",
+        "comment": "Will generally be set to show that the immunization has been completed.\n\nThis element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "min": 1,
         "max": "1",
         "type": [
@@ -391,6 +409,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ImmunizationStatus"
+            }
+          ],
           "strength": "required",
           "description": "A set of codes indicating the current status of an Immunization",
           "valueSetReference": {
@@ -398,6 +422,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
           {
             "identity": "rim",
             "map": "statusCode"
@@ -409,34 +437,32 @@
         ]
       },
       {
-        "id": "Immunization:shr-immunization-Immunization.date",
-        "path": "Immunization.date",
-        "short": "Vaccination administration date",
-        "definition": "Date vaccine administered or was to be administered.",
-        "comments": "When immunizations are given a specific date and time should always be known.   When immunizations are patient reported, a specific date might not be known.  Although partial dates are allowed, an adult patient might not be able to recall the year a childhood immunization was given.",
-        "min": 0,
+        "id": "Immunization:shr-immunization-Immunization.notGiven",
+        "path": "Immunization.notGiven",
+        "short": "Flag for whether immunization was given",
+        "definition": "Indicates if the vaccination was or was not given.",
+        "comment": "This element is labeled as a modifier because it indicates that an immunization didn't happen.",
+        "min": 1,
         "max": "1",
         "type": [
           {
-            "code": "dateTime"
+            "code": "boolean"
           }
         ],
+        "isModifier": true,
+        "isSummary": true,
         "mapping": [
           {
-            "identity": "v2",
-            "map": "RXA-3"
+            "identity": "workflow",
+            "map": "Event.notDone"
           },
           {
             "identity": "rim",
-            "map": ".effectiveTime"
-          },
-          {
-            "identity": "cda",
-            "map": "ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/effectiveTime/value"
+            "map": "[actionNegationInd=true].reasonCode"
           },
           {
             "identity": "w5",
-            "map": "when.init"
+            "map": "status"
           }
         ]
       },
@@ -454,6 +480,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "VaccineCode"
+            }
+          ],
           "strength": "example",
           "description": "The code for vaccine product administered",
           "valueSetReference": {
@@ -461,6 +493,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
           {
             "identity": "v2",
             "map": "RXA-5"
@@ -493,6 +529,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -508,179 +548,167 @@
         ]
       },
       {
-        "id": "Immunization:shr-immunization-Immunization.wasNotGiven",
-        "path": "Immunization.wasNotGiven",
-        "short": "Flag for whether immunization was given",
-        "definition": "Indicates if the vaccination was or was not given.",
-        "min": 1,
+        "id": "Immunization:shr-immunization-Immunization.encounter",
+        "path": "Immunization.encounter",
+        "short": "Encounter administered as part of",
+        "definition": "The visit or admission or other contact between patient and health care provider the immunization was performed as part of.",
+        "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "boolean"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Encounter"
           }
         ],
-        "isModifier": true,
-        "isSummary": true,
         "mapping": [
           {
-            "identity": "rim",
-            "map": "[actionNegationInd=true].reasonCode"
+            "identity": "workflow",
+            "map": "Event.context"
           },
-          {
-            "identity": "w5",
-            "map": "status"
-          }
-        ]
-      },
-      {
-        "id": "Immunization:shr-immunization-Immunization.primarySource",
-        "path": "Immunization.primarySource",
-        "short": "Indicates context the data was recorded in",
-        "definition": "An indication that the content of the record is based on information from the person who administered the vaccine. This reflects the context under which the data was originally recorded.",
-        "comments": "Reflects the “reliability” of the content.",
-        "min": 1,
-        "max": "1",
-        "type": [
-          {
-            "code": "boolean"
-          }
-        ],
-        "mapping": [
           {
             "identity": "v2",
-            "map": "RXA-9"
+            "map": "PV1-19"
           },
           {
             "identity": "rim",
-            "map": "immunization.uncertaintycode (if primary source=false, uncertainty=U)"
+            "map": "component->EncounterEvent"
           },
           {
             "identity": "w5",
-            "map": "who.source"
+            "map": "context"
           }
         ]
       },
       {
-        "id": "Immunization:shr-immunization-Immunization.reportOrigin",
-        "path": "Immunization.reportOrigin",
-        "short": "Indicates the source of a secondarily reported record",
-        "definition": "The source of the data when the report of the immunization event is not based on information from the person who administered the vaccine.",
-        "comments": "Should not be populated if primarySource = True, will not be required even if primarySource = False.",
+        "id": "Immunization:shr-immunization-Immunization.date",
+        "path": "Immunization.date",
+        "short": "Vaccination administration date",
+        "definition": "Date vaccine administered or was to be administered.",
+        "comment": "When immunizations are given a specific date and time should always be known.   When immunizations are patient reported, a specific date might not be known.  Although partial dates are allowed, an adult patient might not be able to recall the year a childhood immunization was given.",
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "CodeableConcept"
+            "code": "dateTime"
           }
         ],
-        "binding": {
-          "strength": "example",
-          "description": "The source of the data for a record which is not from a primary source.",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/immunization-origin"
-          }
-        },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence.occurrenceDateTime"
+          },
           {
             "identity": "v2",
-            "map": "RXA-9"
+            "map": "RXA-3"
           },
           {
             "identity": "rim",
-            "map": ".participation[typeCode=INF].role[classCode=PAT] (this syntax for self-reported)\n.participation[typeCode=INF].role[classCode=LIC] (this syntax for health care professional)\n.participation[typeCode=INF].role[classCode=PRS] (this syntax for family member)"
+            "map": ".effectiveTime"
+          },
+          {
+            "identity": "cda",
+            "map": "ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/effectiveTime/value"
           },
           {
             "identity": "w5",
-            "map": "who.source"
+            "map": "when.init"
           }
         ]
       },
       {
-        "id": "Immunization:shr-immunization-Immunization.performer",
-        "path": "Immunization.performer",
-        "short": "Who administered vaccine",
-        "definition": "Clinician who administered the vaccine.",
-        "min": 0,
+        "id": "Immunization:shr-immunization-Immunization.primarySource",
+        "path": "Immunization.primarySource",
+        "short": "Indicates context the data was recorded in",
+        "definition": "An indication that the content of the record is based on information from the person who administered the vaccine. This reflects the context under which the data was originally recorded.",
+        "comment": "Reflects the “reliability” of the content.",
+        "min": 1,
         "max": "1",
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
+            "code": "boolean"
           }
         ],
         "mapping": [
           {
             "identity": "v2",
-            "map": "RXA-10"
+            "map": "RXA-9"
           },
           {
             "identity": "rim",
-            "map": ".participation[typeCode=PRF].COCT_MT090102UV"
-          },
-          {
-            "identity": "cda",
-            "map": "ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/performer/assignedEntity/assignedPerson/name"
+            "map": "immunization.uncertaintycode (if primary source=false, uncertainty=U)"
           },
           {
             "identity": "w5",
-            "map": "who.actor"
+            "map": "who.source"
           }
         ]
       },
       {
-        "id": "Immunization:shr-immunization-Immunization.requester",
-        "path": "Immunization.requester",
-        "short": "Who ordered vaccination",
-        "definition": "Clinician who ordered the vaccination.",
-        "comments": "Other participants - delegate to Provenance resource.",
+        "id": "Immunization:shr-immunization-Immunization.reportOrigin",
+        "path": "Immunization.reportOrigin",
+        "short": "Indicates the source of a secondarily reported record",
+        "definition": "The source of the data when the report of the immunization event is not based on information from the person who administered the vaccine.",
+        "comment": "Should not be populated if primarySource = True, will not be required even if primarySource = False.",
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
+            "code": "CodeableConcept"
           }
         ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ImmunizationReportOrigin"
+            }
+          ],
+          "strength": "example",
+          "description": "The source of the data for a record which is not from a primary source.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/immunization-origin"
+          }
+        },
         "mapping": [
           {
             "identity": "v2",
-            "map": "ORC-12"
+            "map": "RXA-9"
           },
           {
             "identity": "rim",
-            "map": "outboundRelationship.target[classCode=SBADM].participation[typeCode=AUT].COCT_MT090102UV"
+            "map": ".participation[typeCode=INF].role[classCode=PAT] (this syntax for self-reported)\n.participation[typeCode=INF].role[classCode=LIC] (this syntax for health care professional)\n.participation[typeCode=INF].role[classCode=PRS] (this syntax for family member)"
           },
           {
             "identity": "w5",
-            "map": "who.cause"
+            "map": "who.source"
           }
         ]
       },
       {
-        "id": "Immunization:shr-immunization-Immunization.encounter",
-        "path": "Immunization.encounter",
-        "short": "Encounter administered as part of",
-        "definition": "The visit or admission or other contact between patient and health care provider the immunization was performed as part of.",
+        "id": "Immunization:shr-immunization-Immunization.location",
+        "path": "Immunization.location",
+        "short": "Where vaccination occurred",
+        "definition": "The service delivery location where the vaccine administration occurred.",
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Encounter"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Location"
           }
         ],
         "mapping": [
           {
             "identity": "v2",
-            "map": "PV1-19"
+            "map": "RXA-27  (or RXA-11, deprecated as of v2.7)"
           },
           {
             "identity": "rim",
-            "map": "component->EncounterEvent"
+            "map": ".participation[typeCode=LOC].COCT_MT240000UV"
           },
           {
             "identity": "w5",
-            "map": "context"
+            "map": "where"
           }
         ]
       },
@@ -712,34 +740,6 @@
           }
         ]
       },
-      {
-        "id": "Immunization:shr-immunization-Immunization.location",
-        "path": "Immunization.location",
-        "short": "Where vaccination occurred",
-        "definition": "The service delivery location where the vaccine administration occurred.",
-        "min": 0,
-        "max": "1",
-        "type": [
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Location"
-          }
-        ],
-        "mapping": [
-          {
-            "identity": "v2",
-            "map": "RXA-27  (or RXA-11, deprecated as of v2.7)"
-          },
-          {
-            "identity": "rim",
-            "map": ".participation[typeCode=LOC].COCT_MT240000UV"
-          },
-          {
-            "identity": "w5",
-            "map": "where"
-          }
-        ]
-      },
       {
         "id": "Immunization:shr-immunization-Immunization.lotNumber",
         "path": "Immunization.lotNumber",
@@ -806,7 +806,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
           }
         },
         "mapping": [
@@ -882,6 +882,198 @@
           }
         ]
       },
+      {
+        "id": "Immunization:shr-immunization-Immunization.practitioner",
+        "path": "Immunization.practitioner",
+        "short": "Who performed event",
+        "definition": "Indicates who or what performed the event.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "BackboneElement"
+          }
+        ],
+        "constraint": [
+          {
+            "key": "ele-1",
+            "severity": "error",
+            "human": "All FHIR elements must have a @value or children",
+            "expression": "children().count() > id.count()",
+            "xpath": "@value|f:*|h:div",
+            "source": "Element"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC-12 / RXA-10"
+          },
+          {
+            "identity": "rim",
+            "map": ".participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]"
+          }
+        ]
+      },
+      {
+        "id": "Immunization:shr-immunization-Immunization.practitioner.id",
+        "path": "Immunization.practitioner.id",
+        "representation": [
+          "xmlAttr"
+        ],
+        "short": "xml:id (or equivalent in JSON)",
+        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Element.id",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "Immunization:shr-immunization-Immunization.practitioner.extension",
+        "path": "Immunization.practitioner.extension",
+        "short": "Additional Content defined by implementations",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "Element.extension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "Immunization:shr-immunization-Immunization.practitioner.modifierExtension",
+        "path": "Immunization.practitioner.modifierExtension",
+        "short": "Extensions that cannot be ignored",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content",
+          "modifiers"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "BackboneElement.modifierExtension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "isModifier": true,
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "N/A"
+          }
+        ]
+      },
+      {
+        "id": "Immunization:shr-immunization-Immunization.practitioner.role",
+        "path": "Immunization.practitioner.role",
+        "short": "What type of performance was done",
+        "definition": "Describes the type of performance (e.g. ordering provider, administering provider, etc.).",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ImmunizationRole"
+            }
+          ],
+          "strength": "extensible",
+          "description": "The role a practitioner plays in the immunization event",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/immunization-role"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer.role"
+          },
+          {
+            "identity": "rim",
+            "map": ".participation.functionCode"
+          }
+        ]
+      },
+      {
+        "id": "Immunization:shr-immunization-Immunization.practitioner.actor",
+        "path": "Immunization.practitioner.actor",
+        "short": "Individual who was performing",
+        "definition": "The device, practitioner, etc. who performed the action.",
+        "min": 1,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer.actor"
+          },
+          {
+            "identity": "rim",
+            "map": ".player"
+          },
+          {
+            "identity": "w5",
+            "map": "who.actor"
+          }
+        ]
+      },
       {
         "id": "Immunization:shr-immunization-Immunization.note",
         "path": "Immunization.note",
@@ -896,6 +1088,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "rim",
             "map": "note"
@@ -963,7 +1159,7 @@
         "path": "Immunization.explanation.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -992,7 +1188,7 @@
         "path": "Immunization.explanation.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1032,6 +1228,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ImmunizationReason"
+            }
+          ],
           "strength": "example",
           "description": "The reason why a vaccine was administered",
           "valueSetReference": {
@@ -1039,6 +1241,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.reasonCodeableConcept"
+          },
           {
             "identity": "rim",
             "map": "[actionNegationInd=false].reasonCode"
@@ -1059,6 +1265,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "NoImmunizationReason"
+            }
+          ],
           "strength": "example",
           "description": "The reason why a vaccine was not administered",
           "valueSetReference": {
@@ -1066,6 +1278,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDoneReason"
+          },
           {
             "identity": "v2",
             "map": "RXA-18"
@@ -1081,7 +1297,7 @@
         "path": "Immunization.reaction",
         "short": "Details of a reaction that follows immunization",
         "definition": "Categorical data indicating that an adverse event is associated in time to an immunization.",
-        "comments": "A reaction may be an indication of an allergy or intolerance and, if this is determined to be the case,  it should be recorded as a new [AllergyIntolerance](allergyintolerance.html) resource instance as most systems will not query against  past Immunization.reaction elements.",
+        "comment": "A reaction may be an indication of an allergy or intolerance and, if this is determined to be the case,  it should be recorded as a new [AllergyIntolerance](allergyintolerance.html) resource instance as most systems will not query against  past Immunization.reaction elements.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1142,7 +1358,7 @@
         "path": "Immunization.reaction.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1171,7 +1387,7 @@
         "path": "Immunization.reaction.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1333,7 +1549,7 @@
         "path": "Immunization.vaccinationProtocol.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1362,7 +1578,7 @@
         "path": "Immunization.vaccinationProtocol.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1498,6 +1714,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "VaccinationProtocoltargetDisease"
+            }
+          ],
           "strength": "example",
           "description": "The disease target of the vaccination protocol",
           "valueSetReference": {
@@ -1516,7 +1738,7 @@
         "path": "Immunization.vaccinationProtocol.doseStatus",
         "short": "Indicates if dose counts towards immunity",
         "definition": "Indicates if the immunization event should \"count\" against  the protocol.",
-        "comments": "May need to differentiate between status declarations by a provider vs. a CDS engine.",
+        "comment": "May need to differentiate between status declarations by a provider vs. a CDS engine.",
         "min": 1,
         "max": "1",
         "type": [
@@ -1525,6 +1747,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "VaccinationProtocolDoseStatus"
+            }
+          ],
           "strength": "example",
           "description": "The status of the vaccination protocol (i.e. should this count)",
           "valueSetReference": {
@@ -1551,6 +1779,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "VaccinationProtocolDoseStatusReason"
+            }
+          ],
           "strength": "example",
           "description": "The reason for the determining if a vaccination should count or why vaccination should not count.",
           "valueSetReference": {
@@ -1606,7 +1840,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-immunization-ImmunizationAdministered.json b/lib/resources/standard_health_record/StructureDefinition-shr-immunization-ImmunizationAdministered.json
old mode 100755
new mode 100644
index 3dce553..203c22b
--- a/lib/resources/standard_health_record/StructureDefinition-shr-immunization-ImmunizationAdministered.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-immunization-ImmunizationAdministered.json
@@ -3,7 +3,7 @@
   "id": "shr-immunization-ImmunizationAdministered",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR ImmunizationAdministered Profile</b></p>\n  <p>Represents an immunization that was administered to the subject.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.immunization.ImmunizationAdministered maps to Immunization:\n  Vaccine.CodeableConcept maps to vaccineCode\n  Vaccine.VaccineManufacturer maps to manufacturer\n  ImmunizationNotGivenModifier maps to wasNotGiven\n  explanation is 0..1\n  ImmunizationNotGivenModifier.Reason maps to explanation.reasonNotGiven\n  BodySite maps to site\n  RouteIntoBody maps to route\n  AmountOfMedication maps to doseQuantity\n  TBD &quot;DoseSequenceNumber&quot; maps to vaccinationProtocol.doseSequence\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR ImmunizationAdministered Profile</b></p>\n  <p>Represents an immunization that was administered to the subject.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.immunization.ImmunizationAdministered maps to Immunization:\n  Vaccine.CodeableConcept maps to vaccineCode\n  Vaccine.VaccineManufacturer maps to manufacturer\n  ImmunizationNotGivenModifier maps to notGiven\n  constrain explanation to 0..1\n  ImmunizationNotGivenModifier.Reason maps to explanation.reasonNotGiven\n  BodySite maps to site\n  RouteIntoBody maps to route\n  AmountOfMedication maps to doseQuantity\n  &lt;TBD &quot;DoseSequenceNumber&quot;&gt; maps to vaccinationProtocol.doseSequence\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-immunization-ImmunizationAdministered",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.immunization.ImmunizationAdministered"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ImmunizationAdministered Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.537Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.359Z",
   "description": "Represents an immunization that was administered to the subject.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "v2",
@@ -44,6 +45,11 @@
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
     },
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
     {
       "identity": "cda",
       "uri": "http://hl7.org/v3/cda",
@@ -100,16 +106,16 @@
           {
             "key": "imm-2",
             "severity": "error",
-            "human": "If immunization was administered (wasNotGiven=false) then explanation.reasonNotGiven SHALL be absent.",
-            "expression": "(wasNotGiven = true) or explanation.reasonNotGiven.empty()",
-            "xpath": "not(f:wasNotGiven/@value=false() and exists(f:explanation/f:reasonNotGiven))"
+            "human": "If immunization was administered (notGiven=false) then explanation.reasonNotGiven SHALL be absent.",
+            "expression": "(notGiven = true) or explanation.reasonNotGiven.empty()",
+            "xpath": "not(f:notGiven/@value=false() and exists(f:explanation/f:reasonNotGiven))"
           },
           {
             "key": "imm-1",
             "severity": "error",
-            "human": "If immunization was not administered (wasNotGiven=true) then there SHALL be no reaction nor explanation.reason present",
-            "expression": "(wasNotGiven = true).not() or (reaction.empty() and explanation.reason.empty())",
-            "xpath": "not(f:wasNotGiven/@value=true() and (count(f:reaction) > 0 or exists(f:explanation/f:reason)))"
+            "human": "If immunization was not administered (notGiven=true) then there SHALL be no reaction nor explanation.reason present",
+            "expression": "(notGiven = true).not() or (reaction.empty() and explanation.reason.empty())",
+            "xpath": "not(f:notGiven/@value=true() and (count(f:reaction) > 0 or exists(f:explanation/f:reason)))"
           }
         ],
         "mapping": [
@@ -136,7 +142,7 @@
         "path": "Immunization.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -175,7 +181,7 @@
         "path": "Immunization.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -196,7 +202,7 @@
         "path": "Immunization.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -216,6 +222,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -230,7 +244,7 @@
         "path": "Immunization.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -264,7 +278,7 @@
         "path": "Immunization.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -294,7 +308,7 @@
         "path": "Immunization.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -323,7 +337,7 @@
         "path": "Immunization.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -361,6 +375,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "rim",
             "map": ".id"
@@ -380,7 +398,7 @@
         "path": "Immunization.status",
         "short": "completed | entered-in-error",
         "definition": "Indicates the current status of the vaccination event.",
-        "comments": "Will generally be set to show that the immunization has been completed.",
+        "comment": "Will generally be set to show that the immunization has been completed.\n\nThis element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "min": 1,
         "max": "1",
         "type": [
@@ -391,6 +409,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ImmunizationStatus"
+            }
+          ],
           "strength": "required",
           "description": "A set of codes indicating the current status of an Immunization",
           "valueSetReference": {
@@ -398,6 +422,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
           {
             "identity": "rim",
             "map": "statusCode"
@@ -409,34 +437,32 @@
         ]
       },
       {
-        "id": "Immunization:shr-immunization-ImmunizationAdministered.date",
-        "path": "Immunization.date",
-        "short": "Vaccination administration date",
-        "definition": "Date vaccine administered or was to be administered.",
-        "comments": "When immunizations are given a specific date and time should always be known.   When immunizations are patient reported, a specific date might not be known.  Although partial dates are allowed, an adult patient might not be able to recall the year a childhood immunization was given.",
-        "min": 0,
+        "id": "Immunization:shr-immunization-ImmunizationAdministered.notGiven",
+        "path": "Immunization.notGiven",
+        "short": "Flag for whether immunization was given",
+        "definition": "Indicates if the vaccination was or was not given.",
+        "comment": "This element is labeled as a modifier because it indicates that an immunization didn't happen.",
+        "min": 1,
         "max": "1",
         "type": [
           {
-            "code": "dateTime"
+            "code": "boolean"
           }
         ],
+        "isModifier": true,
+        "isSummary": true,
         "mapping": [
           {
-            "identity": "v2",
-            "map": "RXA-3"
+            "identity": "workflow",
+            "map": "Event.notDone"
           },
           {
             "identity": "rim",
-            "map": ".effectiveTime"
-          },
-          {
-            "identity": "cda",
-            "map": "ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/effectiveTime/value"
+            "map": "[actionNegationInd=true].reasonCode"
           },
           {
             "identity": "w5",
-            "map": "when.init"
+            "map": "status"
           }
         ]
       },
@@ -454,6 +480,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "VaccineCode"
+            }
+          ],
           "strength": "example",
           "description": "The code for vaccine product administered",
           "valueSetReference": {
@@ -461,6 +493,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
           {
             "identity": "v2",
             "map": "RXA-5"
@@ -493,6 +529,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -508,179 +548,167 @@
         ]
       },
       {
-        "id": "Immunization:shr-immunization-ImmunizationAdministered.wasNotGiven",
-        "path": "Immunization.wasNotGiven",
-        "short": "Flag for whether immunization was given",
-        "definition": "Indicates if the vaccination was or was not given.",
-        "min": 1,
+        "id": "Immunization:shr-immunization-ImmunizationAdministered.encounter",
+        "path": "Immunization.encounter",
+        "short": "Encounter administered as part of",
+        "definition": "The visit or admission or other contact between patient and health care provider the immunization was performed as part of.",
+        "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "boolean"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Encounter"
           }
         ],
-        "isModifier": true,
-        "isSummary": true,
         "mapping": [
           {
-            "identity": "rim",
-            "map": "[actionNegationInd=true].reasonCode"
+            "identity": "workflow",
+            "map": "Event.context"
           },
-          {
-            "identity": "w5",
-            "map": "status"
-          }
-        ]
-      },
-      {
-        "id": "Immunization:shr-immunization-ImmunizationAdministered.primarySource",
-        "path": "Immunization.primarySource",
-        "short": "Indicates context the data was recorded in",
-        "definition": "An indication that the content of the record is based on information from the person who administered the vaccine. This reflects the context under which the data was originally recorded.",
-        "comments": "Reflects the “reliability” of the content.",
-        "min": 1,
-        "max": "1",
-        "type": [
-          {
-            "code": "boolean"
-          }
-        ],
-        "mapping": [
           {
             "identity": "v2",
-            "map": "RXA-9"
+            "map": "PV1-19"
           },
           {
             "identity": "rim",
-            "map": "immunization.uncertaintycode (if primary source=false, uncertainty=U)"
+            "map": "component->EncounterEvent"
           },
           {
             "identity": "w5",
-            "map": "who.source"
+            "map": "context"
           }
         ]
       },
       {
-        "id": "Immunization:shr-immunization-ImmunizationAdministered.reportOrigin",
-        "path": "Immunization.reportOrigin",
-        "short": "Indicates the source of a secondarily reported record",
-        "definition": "The source of the data when the report of the immunization event is not based on information from the person who administered the vaccine.",
-        "comments": "Should not be populated if primarySource = True, will not be required even if primarySource = False.",
+        "id": "Immunization:shr-immunization-ImmunizationAdministered.date",
+        "path": "Immunization.date",
+        "short": "Vaccination administration date",
+        "definition": "Date vaccine administered or was to be administered.",
+        "comment": "When immunizations are given a specific date and time should always be known.   When immunizations are patient reported, a specific date might not be known.  Although partial dates are allowed, an adult patient might not be able to recall the year a childhood immunization was given.",
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "CodeableConcept"
+            "code": "dateTime"
           }
         ],
-        "binding": {
-          "strength": "example",
-          "description": "The source of the data for a record which is not from a primary source.",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/immunization-origin"
-          }
-        },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence.occurrenceDateTime"
+          },
           {
             "identity": "v2",
-            "map": "RXA-9"
+            "map": "RXA-3"
           },
           {
             "identity": "rim",
-            "map": ".participation[typeCode=INF].role[classCode=PAT] (this syntax for self-reported)\n.participation[typeCode=INF].role[classCode=LIC] (this syntax for health care professional)\n.participation[typeCode=INF].role[classCode=PRS] (this syntax for family member)"
+            "map": ".effectiveTime"
+          },
+          {
+            "identity": "cda",
+            "map": "ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/effectiveTime/value"
           },
           {
             "identity": "w5",
-            "map": "who.source"
+            "map": "when.init"
           }
         ]
       },
       {
-        "id": "Immunization:shr-immunization-ImmunizationAdministered.performer",
-        "path": "Immunization.performer",
-        "short": "Who administered vaccine",
-        "definition": "Clinician who administered the vaccine.",
-        "min": 0,
+        "id": "Immunization:shr-immunization-ImmunizationAdministered.primarySource",
+        "path": "Immunization.primarySource",
+        "short": "Indicates context the data was recorded in",
+        "definition": "An indication that the content of the record is based on information from the person who administered the vaccine. This reflects the context under which the data was originally recorded.",
+        "comment": "Reflects the “reliability” of the content.",
+        "min": 1,
         "max": "1",
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
+            "code": "boolean"
           }
         ],
         "mapping": [
           {
             "identity": "v2",
-            "map": "RXA-10"
+            "map": "RXA-9"
           },
           {
             "identity": "rim",
-            "map": ".participation[typeCode=PRF].COCT_MT090102UV"
-          },
-          {
-            "identity": "cda",
-            "map": "ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/performer/assignedEntity/assignedPerson/name"
+            "map": "immunization.uncertaintycode (if primary source=false, uncertainty=U)"
           },
           {
             "identity": "w5",
-            "map": "who.actor"
+            "map": "who.source"
           }
         ]
       },
       {
-        "id": "Immunization:shr-immunization-ImmunizationAdministered.requester",
-        "path": "Immunization.requester",
-        "short": "Who ordered vaccination",
-        "definition": "Clinician who ordered the vaccination.",
-        "comments": "Other participants - delegate to Provenance resource.",
+        "id": "Immunization:shr-immunization-ImmunizationAdministered.reportOrigin",
+        "path": "Immunization.reportOrigin",
+        "short": "Indicates the source of a secondarily reported record",
+        "definition": "The source of the data when the report of the immunization event is not based on information from the person who administered the vaccine.",
+        "comment": "Should not be populated if primarySource = True, will not be required even if primarySource = False.",
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
+            "code": "CodeableConcept"
           }
         ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ImmunizationReportOrigin"
+            }
+          ],
+          "strength": "example",
+          "description": "The source of the data for a record which is not from a primary source.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/immunization-origin"
+          }
+        },
         "mapping": [
           {
             "identity": "v2",
-            "map": "ORC-12"
+            "map": "RXA-9"
           },
           {
             "identity": "rim",
-            "map": "outboundRelationship.target[classCode=SBADM].participation[typeCode=AUT].COCT_MT090102UV"
+            "map": ".participation[typeCode=INF].role[classCode=PAT] (this syntax for self-reported)\n.participation[typeCode=INF].role[classCode=LIC] (this syntax for health care professional)\n.participation[typeCode=INF].role[classCode=PRS] (this syntax for family member)"
           },
           {
             "identity": "w5",
-            "map": "who.cause"
+            "map": "who.source"
           }
         ]
       },
       {
-        "id": "Immunization:shr-immunization-ImmunizationAdministered.encounter",
-        "path": "Immunization.encounter",
-        "short": "Encounter administered as part of",
-        "definition": "The visit or admission or other contact between patient and health care provider the immunization was performed as part of.",
+        "id": "Immunization:shr-immunization-ImmunizationAdministered.location",
+        "path": "Immunization.location",
+        "short": "Where vaccination occurred",
+        "definition": "The service delivery location where the vaccine administration occurred.",
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Encounter"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Location"
           }
         ],
         "mapping": [
           {
             "identity": "v2",
-            "map": "PV1-19"
+            "map": "RXA-27  (or RXA-11, deprecated as of v2.7)"
           },
           {
             "identity": "rim",
-            "map": "component->EncounterEvent"
+            "map": ".participation[typeCode=LOC].COCT_MT240000UV"
           },
           {
             "identity": "w5",
-            "map": "context"
+            "map": "where"
           }
         ]
       },
@@ -712,34 +740,6 @@
           }
         ]
       },
-      {
-        "id": "Immunization:shr-immunization-ImmunizationAdministered.location",
-        "path": "Immunization.location",
-        "short": "Where vaccination occurred",
-        "definition": "The service delivery location where the vaccine administration occurred.",
-        "min": 0,
-        "max": "1",
-        "type": [
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Location"
-          }
-        ],
-        "mapping": [
-          {
-            "identity": "v2",
-            "map": "RXA-27  (or RXA-11, deprecated as of v2.7)"
-          },
-          {
-            "identity": "rim",
-            "map": ".participation[typeCode=LOC].COCT_MT240000UV"
-          },
-          {
-            "identity": "w5",
-            "map": "where"
-          }
-        ]
-      },
       {
         "id": "Immunization:shr-immunization-ImmunizationAdministered.lotNumber",
         "path": "Immunization.lotNumber",
@@ -806,7 +806,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
           }
         },
         "mapping": [
@@ -882,6 +882,198 @@
           }
         ]
       },
+      {
+        "id": "Immunization:shr-immunization-ImmunizationAdministered.practitioner",
+        "path": "Immunization.practitioner",
+        "short": "Who performed event",
+        "definition": "Indicates who or what performed the event.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "BackboneElement"
+          }
+        ],
+        "constraint": [
+          {
+            "key": "ele-1",
+            "severity": "error",
+            "human": "All FHIR elements must have a @value or children",
+            "expression": "children().count() > id.count()",
+            "xpath": "@value|f:*|h:div",
+            "source": "Element"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC-12 / RXA-10"
+          },
+          {
+            "identity": "rim",
+            "map": ".participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]"
+          }
+        ]
+      },
+      {
+        "id": "Immunization:shr-immunization-ImmunizationAdministered.practitioner.id",
+        "path": "Immunization.practitioner.id",
+        "representation": [
+          "xmlAttr"
+        ],
+        "short": "xml:id (or equivalent in JSON)",
+        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Element.id",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "Immunization:shr-immunization-ImmunizationAdministered.practitioner.extension",
+        "path": "Immunization.practitioner.extension",
+        "short": "Additional Content defined by implementations",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "Element.extension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "Immunization:shr-immunization-ImmunizationAdministered.practitioner.modifierExtension",
+        "path": "Immunization.practitioner.modifierExtension",
+        "short": "Extensions that cannot be ignored",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content",
+          "modifiers"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "BackboneElement.modifierExtension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "isModifier": true,
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "N/A"
+          }
+        ]
+      },
+      {
+        "id": "Immunization:shr-immunization-ImmunizationAdministered.practitioner.role",
+        "path": "Immunization.practitioner.role",
+        "short": "What type of performance was done",
+        "definition": "Describes the type of performance (e.g. ordering provider, administering provider, etc.).",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ImmunizationRole"
+            }
+          ],
+          "strength": "extensible",
+          "description": "The role a practitioner plays in the immunization event",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/immunization-role"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer.role"
+          },
+          {
+            "identity": "rim",
+            "map": ".participation.functionCode"
+          }
+        ]
+      },
+      {
+        "id": "Immunization:shr-immunization-ImmunizationAdministered.practitioner.actor",
+        "path": "Immunization.practitioner.actor",
+        "short": "Individual who was performing",
+        "definition": "The device, practitioner, etc. who performed the action.",
+        "min": 1,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer.actor"
+          },
+          {
+            "identity": "rim",
+            "map": ".player"
+          },
+          {
+            "identity": "w5",
+            "map": "who.actor"
+          }
+        ]
+      },
       {
         "id": "Immunization:shr-immunization-ImmunizationAdministered.note",
         "path": "Immunization.note",
@@ -896,6 +1088,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "rim",
             "map": "note"
@@ -963,7 +1159,7 @@
         "path": "Immunization.explanation.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -992,7 +1188,7 @@
         "path": "Immunization.explanation.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1032,6 +1228,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ImmunizationReason"
+            }
+          ],
           "strength": "example",
           "description": "The reason why a vaccine was administered",
           "valueSetReference": {
@@ -1039,6 +1241,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.reasonCodeableConcept"
+          },
           {
             "identity": "rim",
             "map": "[actionNegationInd=false].reasonCode"
@@ -1059,6 +1265,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "NoImmunizationReason"
+            }
+          ],
           "strength": "example",
           "description": "The reason why a vaccine was not administered",
           "valueSetReference": {
@@ -1066,6 +1278,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDoneReason"
+          },
           {
             "identity": "v2",
             "map": "RXA-18"
@@ -1081,7 +1297,7 @@
         "path": "Immunization.reaction",
         "short": "Details of a reaction that follows immunization",
         "definition": "Categorical data indicating that an adverse event is associated in time to an immunization.",
-        "comments": "A reaction may be an indication of an allergy or intolerance and, if this is determined to be the case,  it should be recorded as a new [AllergyIntolerance](allergyintolerance.html) resource instance as most systems will not query against  past Immunization.reaction elements.",
+        "comment": "A reaction may be an indication of an allergy or intolerance and, if this is determined to be the case,  it should be recorded as a new [AllergyIntolerance](allergyintolerance.html) resource instance as most systems will not query against  past Immunization.reaction elements.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1142,7 +1358,7 @@
         "path": "Immunization.reaction.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1171,7 +1387,7 @@
         "path": "Immunization.reaction.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1333,7 +1549,7 @@
         "path": "Immunization.vaccinationProtocol.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1362,7 +1578,7 @@
         "path": "Immunization.vaccinationProtocol.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1498,6 +1714,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "VaccinationProtocoltargetDisease"
+            }
+          ],
           "strength": "example",
           "description": "The disease target of the vaccination protocol",
           "valueSetReference": {
@@ -1516,7 +1738,7 @@
         "path": "Immunization.vaccinationProtocol.doseStatus",
         "short": "Indicates if dose counts towards immunity",
         "definition": "Indicates if the immunization event should \"count\" against  the protocol.",
-        "comments": "May need to differentiate between status declarations by a provider vs. a CDS engine.",
+        "comment": "May need to differentiate between status declarations by a provider vs. a CDS engine.",
         "min": 1,
         "max": "1",
         "type": [
@@ -1525,6 +1747,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "VaccinationProtocolDoseStatus"
+            }
+          ],
           "strength": "example",
           "description": "The status of the vaccination protocol (i.e. should this count)",
           "valueSetReference": {
@@ -1551,6 +1779,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "VaccinationProtocolDoseStatusReason"
+            }
+          ],
           "strength": "example",
           "description": "The reason for the determining if a vaccination should count or why vaccination should not count.",
           "valueSetReference": {
@@ -1608,7 +1842,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-immunization-ImmunizationNotGiven.json b/lib/resources/standard_health_record/StructureDefinition-shr-immunization-ImmunizationNotGiven.json
old mode 100755
new mode 100644
index d41f5d2..882b7df
--- a/lib/resources/standard_health_record/StructureDefinition-shr-immunization-ImmunizationNotGiven.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-immunization-ImmunizationNotGiven.json
@@ -3,7 +3,7 @@
   "id": "shr-immunization-ImmunizationNotGiven",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR ImmunizationNotGiven Profile</b></p>\n  <p>Represents an immunization that was not given.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.immunization.ImmunizationNotGiven maps to Immunization:\n  Vaccine.CodeableConcept maps to vaccineCode\n  Vaccine.VaccineManufacturer maps to manufacturer\n  ImmunizationNotGivenModifier maps to wasNotGiven\n  explanation is 0..1\n  ImmunizationNotGivenModifier.Reason maps to explanation.reasonNotGiven\n  BodySite maps to site\n  RouteIntoBody maps to route\n  AmountOfMedication maps to doseQuantity\n  TBD &quot;DoseSequenceNumber&quot; maps to vaccinationProtocol.doseSequence\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR ImmunizationNotGiven Profile</b></p>\n  <p>Represents an immunization that was not given.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.immunization.ImmunizationNotGiven maps to Immunization:\n  Vaccine.CodeableConcept maps to vaccineCode\n  Vaccine.VaccineManufacturer maps to manufacturer\n  ImmunizationNotGivenModifier maps to notGiven\n  constrain explanation to 0..1\n  ImmunizationNotGivenModifier.Reason maps to explanation.reasonNotGiven\n  BodySite maps to site\n  RouteIntoBody maps to route\n  AmountOfMedication maps to doseQuantity\n  &lt;TBD &quot;DoseSequenceNumber&quot;&gt; maps to vaccinationProtocol.doseSequence\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-immunization-ImmunizationNotGiven",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.immunization.ImmunizationNotGiven"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ImmunizationNotGiven Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.549Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.366Z",
   "description": "Represents an immunization that was not given.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "v2",
@@ -44,6 +45,11 @@
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
     },
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
     {
       "identity": "cda",
       "uri": "http://hl7.org/v3/cda",
@@ -100,16 +106,16 @@
           {
             "key": "imm-2",
             "severity": "error",
-            "human": "If immunization was administered (wasNotGiven=false) then explanation.reasonNotGiven SHALL be absent.",
-            "expression": "(wasNotGiven = true) or explanation.reasonNotGiven.empty()",
-            "xpath": "not(f:wasNotGiven/@value=false() and exists(f:explanation/f:reasonNotGiven))"
+            "human": "If immunization was administered (notGiven=false) then explanation.reasonNotGiven SHALL be absent.",
+            "expression": "(notGiven = true) or explanation.reasonNotGiven.empty()",
+            "xpath": "not(f:notGiven/@value=false() and exists(f:explanation/f:reasonNotGiven))"
           },
           {
             "key": "imm-1",
             "severity": "error",
-            "human": "If immunization was not administered (wasNotGiven=true) then there SHALL be no reaction nor explanation.reason present",
-            "expression": "(wasNotGiven = true).not() or (reaction.empty() and explanation.reason.empty())",
-            "xpath": "not(f:wasNotGiven/@value=true() and (count(f:reaction) > 0 or exists(f:explanation/f:reason)))"
+            "human": "If immunization was not administered (notGiven=true) then there SHALL be no reaction nor explanation.reason present",
+            "expression": "(notGiven = true).not() or (reaction.empty() and explanation.reason.empty())",
+            "xpath": "not(f:notGiven/@value=true() and (count(f:reaction) > 0 or exists(f:explanation/f:reason)))"
           }
         ],
         "mapping": [
@@ -136,7 +142,7 @@
         "path": "Immunization.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -175,7 +181,7 @@
         "path": "Immunization.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -196,7 +202,7 @@
         "path": "Immunization.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -216,6 +222,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -230,7 +244,7 @@
         "path": "Immunization.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -264,7 +278,7 @@
         "path": "Immunization.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -294,7 +308,7 @@
         "path": "Immunization.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -323,7 +337,7 @@
         "path": "Immunization.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -361,6 +375,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "rim",
             "map": ".id"
@@ -380,7 +398,7 @@
         "path": "Immunization.status",
         "short": "completed | entered-in-error",
         "definition": "Indicates the current status of the vaccination event.",
-        "comments": "Will generally be set to show that the immunization has been completed.",
+        "comment": "Will generally be set to show that the immunization has been completed.\n\nThis element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "min": 1,
         "max": "1",
         "type": [
@@ -391,6 +409,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ImmunizationStatus"
+            }
+          ],
           "strength": "required",
           "description": "A set of codes indicating the current status of an Immunization",
           "valueSetReference": {
@@ -398,6 +422,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
           {
             "identity": "rim",
             "map": "statusCode"
@@ -409,34 +437,33 @@
         ]
       },
       {
-        "id": "Immunization:shr-immunization-ImmunizationNotGiven.date",
-        "path": "Immunization.date",
-        "short": "Vaccination administration date",
-        "definition": "Date vaccine administered or was to be administered.",
-        "comments": "When immunizations are given a specific date and time should always be known.   When immunizations are patient reported, a specific date might not be known.  Although partial dates are allowed, an adult patient might not be able to recall the year a childhood immunization was given.",
-        "min": 0,
+        "id": "Immunization:shr-immunization-ImmunizationNotGiven.notGiven",
+        "path": "Immunization.notGiven",
+        "short": "Flag for whether immunization was given",
+        "definition": "Indicates if the vaccination was or was not given.",
+        "comment": "This element is labeled as a modifier because it indicates that an immunization didn't happen.",
+        "min": 1,
         "max": "1",
         "type": [
           {
-            "code": "dateTime"
+            "code": "boolean"
           }
         ],
+        "fixedBoolean": true,
+        "isModifier": true,
+        "isSummary": true,
         "mapping": [
           {
-            "identity": "v2",
-            "map": "RXA-3"
+            "identity": "workflow",
+            "map": "Event.notDone"
           },
           {
             "identity": "rim",
-            "map": ".effectiveTime"
-          },
-          {
-            "identity": "cda",
-            "map": "ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/effectiveTime/value"
+            "map": "[actionNegationInd=true].reasonCode"
           },
           {
             "identity": "w5",
-            "map": "when.init"
+            "map": "status"
           }
         ]
       },
@@ -454,6 +481,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "VaccineCode"
+            }
+          ],
           "strength": "example",
           "description": "The code for vaccine product administered",
           "valueSetReference": {
@@ -461,6 +494,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
           {
             "identity": "v2",
             "map": "RXA-5"
@@ -493,6 +530,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -508,180 +549,167 @@
         ]
       },
       {
-        "id": "Immunization:shr-immunization-ImmunizationNotGiven.wasNotGiven",
-        "path": "Immunization.wasNotGiven",
-        "short": "Flag for whether immunization was given",
-        "definition": "Indicates if the vaccination was or was not given.",
-        "min": 1,
+        "id": "Immunization:shr-immunization-ImmunizationNotGiven.encounter",
+        "path": "Immunization.encounter",
+        "short": "Encounter administered as part of",
+        "definition": "The visit or admission or other contact between patient and health care provider the immunization was performed as part of.",
+        "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "boolean"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Encounter"
           }
         ],
-        "fixedBoolean": true,
-        "isModifier": true,
-        "isSummary": true,
         "mapping": [
           {
-            "identity": "rim",
-            "map": "[actionNegationInd=true].reasonCode"
+            "identity": "workflow",
+            "map": "Event.context"
           },
-          {
-            "identity": "w5",
-            "map": "status"
-          }
-        ]
-      },
-      {
-        "id": "Immunization:shr-immunization-ImmunizationNotGiven.primarySource",
-        "path": "Immunization.primarySource",
-        "short": "Indicates context the data was recorded in",
-        "definition": "An indication that the content of the record is based on information from the person who administered the vaccine. This reflects the context under which the data was originally recorded.",
-        "comments": "Reflects the “reliability” of the content.",
-        "min": 1,
-        "max": "1",
-        "type": [
-          {
-            "code": "boolean"
-          }
-        ],
-        "mapping": [
           {
             "identity": "v2",
-            "map": "RXA-9"
+            "map": "PV1-19"
           },
           {
             "identity": "rim",
-            "map": "immunization.uncertaintycode (if primary source=false, uncertainty=U)"
+            "map": "component->EncounterEvent"
           },
           {
             "identity": "w5",
-            "map": "who.source"
+            "map": "context"
           }
         ]
       },
       {
-        "id": "Immunization:shr-immunization-ImmunizationNotGiven.reportOrigin",
-        "path": "Immunization.reportOrigin",
-        "short": "Indicates the source of a secondarily reported record",
-        "definition": "The source of the data when the report of the immunization event is not based on information from the person who administered the vaccine.",
-        "comments": "Should not be populated if primarySource = True, will not be required even if primarySource = False.",
+        "id": "Immunization:shr-immunization-ImmunizationNotGiven.date",
+        "path": "Immunization.date",
+        "short": "Vaccination administration date",
+        "definition": "Date vaccine administered or was to be administered.",
+        "comment": "When immunizations are given a specific date and time should always be known.   When immunizations are patient reported, a specific date might not be known.  Although partial dates are allowed, an adult patient might not be able to recall the year a childhood immunization was given.",
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "CodeableConcept"
+            "code": "dateTime"
           }
         ],
-        "binding": {
-          "strength": "example",
-          "description": "The source of the data for a record which is not from a primary source.",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/immunization-origin"
-          }
-        },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence.occurrenceDateTime"
+          },
           {
             "identity": "v2",
-            "map": "RXA-9"
+            "map": "RXA-3"
           },
           {
             "identity": "rim",
-            "map": ".participation[typeCode=INF].role[classCode=PAT] (this syntax for self-reported)\n.participation[typeCode=INF].role[classCode=LIC] (this syntax for health care professional)\n.participation[typeCode=INF].role[classCode=PRS] (this syntax for family member)"
+            "map": ".effectiveTime"
+          },
+          {
+            "identity": "cda",
+            "map": "ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/effectiveTime/value"
           },
           {
             "identity": "w5",
-            "map": "who.source"
+            "map": "when.init"
           }
         ]
       },
       {
-        "id": "Immunization:shr-immunization-ImmunizationNotGiven.performer",
-        "path": "Immunization.performer",
-        "short": "Who administered vaccine",
-        "definition": "Clinician who administered the vaccine.",
-        "min": 0,
+        "id": "Immunization:shr-immunization-ImmunizationNotGiven.primarySource",
+        "path": "Immunization.primarySource",
+        "short": "Indicates context the data was recorded in",
+        "definition": "An indication that the content of the record is based on information from the person who administered the vaccine. This reflects the context under which the data was originally recorded.",
+        "comment": "Reflects the “reliability” of the content.",
+        "min": 1,
         "max": "1",
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
+            "code": "boolean"
           }
         ],
         "mapping": [
           {
             "identity": "v2",
-            "map": "RXA-10"
+            "map": "RXA-9"
           },
           {
             "identity": "rim",
-            "map": ".participation[typeCode=PRF].COCT_MT090102UV"
-          },
-          {
-            "identity": "cda",
-            "map": "ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/performer/assignedEntity/assignedPerson/name"
+            "map": "immunization.uncertaintycode (if primary source=false, uncertainty=U)"
           },
           {
             "identity": "w5",
-            "map": "who.actor"
+            "map": "who.source"
           }
         ]
       },
       {
-        "id": "Immunization:shr-immunization-ImmunizationNotGiven.requester",
-        "path": "Immunization.requester",
-        "short": "Who ordered vaccination",
-        "definition": "Clinician who ordered the vaccination.",
-        "comments": "Other participants - delegate to Provenance resource.",
+        "id": "Immunization:shr-immunization-ImmunizationNotGiven.reportOrigin",
+        "path": "Immunization.reportOrigin",
+        "short": "Indicates the source of a secondarily reported record",
+        "definition": "The source of the data when the report of the immunization event is not based on information from the person who administered the vaccine.",
+        "comment": "Should not be populated if primarySource = True, will not be required even if primarySource = False.",
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
+            "code": "CodeableConcept"
           }
         ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ImmunizationReportOrigin"
+            }
+          ],
+          "strength": "example",
+          "description": "The source of the data for a record which is not from a primary source.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/immunization-origin"
+          }
+        },
         "mapping": [
           {
             "identity": "v2",
-            "map": "ORC-12"
+            "map": "RXA-9"
           },
           {
             "identity": "rim",
-            "map": "outboundRelationship.target[classCode=SBADM].participation[typeCode=AUT].COCT_MT090102UV"
+            "map": ".participation[typeCode=INF].role[classCode=PAT] (this syntax for self-reported)\n.participation[typeCode=INF].role[classCode=LIC] (this syntax for health care professional)\n.participation[typeCode=INF].role[classCode=PRS] (this syntax for family member)"
           },
           {
             "identity": "w5",
-            "map": "who.cause"
+            "map": "who.source"
           }
         ]
       },
       {
-        "id": "Immunization:shr-immunization-ImmunizationNotGiven.encounter",
-        "path": "Immunization.encounter",
-        "short": "Encounter administered as part of",
-        "definition": "The visit or admission or other contact between patient and health care provider the immunization was performed as part of.",
+        "id": "Immunization:shr-immunization-ImmunizationNotGiven.location",
+        "path": "Immunization.location",
+        "short": "Where vaccination occurred",
+        "definition": "The service delivery location where the vaccine administration occurred.",
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Encounter"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Location"
           }
         ],
         "mapping": [
           {
             "identity": "v2",
-            "map": "PV1-19"
+            "map": "RXA-27  (or RXA-11, deprecated as of v2.7)"
           },
           {
             "identity": "rim",
-            "map": "component->EncounterEvent"
+            "map": ".participation[typeCode=LOC].COCT_MT240000UV"
           },
           {
             "identity": "w5",
-            "map": "context"
+            "map": "where"
           }
         ]
       },
@@ -713,34 +741,6 @@
           }
         ]
       },
-      {
-        "id": "Immunization:shr-immunization-ImmunizationNotGiven.location",
-        "path": "Immunization.location",
-        "short": "Where vaccination occurred",
-        "definition": "The service delivery location where the vaccine administration occurred.",
-        "min": 0,
-        "max": "1",
-        "type": [
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Location"
-          }
-        ],
-        "mapping": [
-          {
-            "identity": "v2",
-            "map": "RXA-27  (or RXA-11, deprecated as of v2.7)"
-          },
-          {
-            "identity": "rim",
-            "map": ".participation[typeCode=LOC].COCT_MT240000UV"
-          },
-          {
-            "identity": "w5",
-            "map": "where"
-          }
-        ]
-      },
       {
         "id": "Immunization:shr-immunization-ImmunizationNotGiven.lotNumber",
         "path": "Immunization.lotNumber",
@@ -807,7 +807,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
           }
         },
         "mapping": [
@@ -883,6 +883,198 @@
           }
         ]
       },
+      {
+        "id": "Immunization:shr-immunization-ImmunizationNotGiven.practitioner",
+        "path": "Immunization.practitioner",
+        "short": "Who performed event",
+        "definition": "Indicates who or what performed the event.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "BackboneElement"
+          }
+        ],
+        "constraint": [
+          {
+            "key": "ele-1",
+            "severity": "error",
+            "human": "All FHIR elements must have a @value or children",
+            "expression": "children().count() > id.count()",
+            "xpath": "@value|f:*|h:div",
+            "source": "Element"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC-12 / RXA-10"
+          },
+          {
+            "identity": "rim",
+            "map": ".participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]"
+          }
+        ]
+      },
+      {
+        "id": "Immunization:shr-immunization-ImmunizationNotGiven.practitioner.id",
+        "path": "Immunization.practitioner.id",
+        "representation": [
+          "xmlAttr"
+        ],
+        "short": "xml:id (or equivalent in JSON)",
+        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Element.id",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "Immunization:shr-immunization-ImmunizationNotGiven.practitioner.extension",
+        "path": "Immunization.practitioner.extension",
+        "short": "Additional Content defined by implementations",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "Element.extension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "Immunization:shr-immunization-ImmunizationNotGiven.practitioner.modifierExtension",
+        "path": "Immunization.practitioner.modifierExtension",
+        "short": "Extensions that cannot be ignored",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content",
+          "modifiers"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "BackboneElement.modifierExtension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "isModifier": true,
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "N/A"
+          }
+        ]
+      },
+      {
+        "id": "Immunization:shr-immunization-ImmunizationNotGiven.practitioner.role",
+        "path": "Immunization.practitioner.role",
+        "short": "What type of performance was done",
+        "definition": "Describes the type of performance (e.g. ordering provider, administering provider, etc.).",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ImmunizationRole"
+            }
+          ],
+          "strength": "extensible",
+          "description": "The role a practitioner plays in the immunization event",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/immunization-role"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer.role"
+          },
+          {
+            "identity": "rim",
+            "map": ".participation.functionCode"
+          }
+        ]
+      },
+      {
+        "id": "Immunization:shr-immunization-ImmunizationNotGiven.practitioner.actor",
+        "path": "Immunization.practitioner.actor",
+        "short": "Individual who was performing",
+        "definition": "The device, practitioner, etc. who performed the action.",
+        "min": 1,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer.actor"
+          },
+          {
+            "identity": "rim",
+            "map": ".player"
+          },
+          {
+            "identity": "w5",
+            "map": "who.actor"
+          }
+        ]
+      },
       {
         "id": "Immunization:shr-immunization-ImmunizationNotGiven.note",
         "path": "Immunization.note",
@@ -897,6 +1089,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "rim",
             "map": "note"
@@ -964,7 +1160,7 @@
         "path": "Immunization.explanation.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -993,7 +1189,7 @@
         "path": "Immunization.explanation.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1033,6 +1229,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ImmunizationReason"
+            }
+          ],
           "strength": "example",
           "description": "The reason why a vaccine was administered",
           "valueSetReference": {
@@ -1040,6 +1242,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.reasonCodeableConcept"
+          },
           {
             "identity": "rim",
             "map": "[actionNegationInd=false].reasonCode"
@@ -1060,6 +1266,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "NoImmunizationReason"
+            }
+          ],
           "strength": "example",
           "description": "The reason why a vaccine was not administered",
           "valueSetReference": {
@@ -1067,6 +1279,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDoneReason"
+          },
           {
             "identity": "v2",
             "map": "RXA-18"
@@ -1082,7 +1298,7 @@
         "path": "Immunization.reaction",
         "short": "Details of a reaction that follows immunization",
         "definition": "Categorical data indicating that an adverse event is associated in time to an immunization.",
-        "comments": "A reaction may be an indication of an allergy or intolerance and, if this is determined to be the case,  it should be recorded as a new [AllergyIntolerance](allergyintolerance.html) resource instance as most systems will not query against  past Immunization.reaction elements.",
+        "comment": "A reaction may be an indication of an allergy or intolerance and, if this is determined to be the case,  it should be recorded as a new [AllergyIntolerance](allergyintolerance.html) resource instance as most systems will not query against  past Immunization.reaction elements.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1143,7 +1359,7 @@
         "path": "Immunization.reaction.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1172,7 +1388,7 @@
         "path": "Immunization.reaction.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1334,7 +1550,7 @@
         "path": "Immunization.vaccinationProtocol.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1363,7 +1579,7 @@
         "path": "Immunization.vaccinationProtocol.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1499,6 +1715,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "VaccinationProtocoltargetDisease"
+            }
+          ],
           "strength": "example",
           "description": "The disease target of the vaccination protocol",
           "valueSetReference": {
@@ -1517,7 +1739,7 @@
         "path": "Immunization.vaccinationProtocol.doseStatus",
         "short": "Indicates if dose counts towards immunity",
         "definition": "Indicates if the immunization event should \"count\" against  the protocol.",
-        "comments": "May need to differentiate between status declarations by a provider vs. a CDS engine.",
+        "comment": "May need to differentiate between status declarations by a provider vs. a CDS engine.",
         "min": 1,
         "max": "1",
         "type": [
@@ -1526,6 +1748,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "VaccinationProtocolDoseStatus"
+            }
+          ],
           "strength": "example",
           "description": "The status of the vaccination protocol (i.e. should this count)",
           "valueSetReference": {
@@ -1552,6 +1780,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "VaccinationProtocolDoseStatusReason"
+            }
+          ],
           "strength": "example",
           "description": "The reason for the determining if a vaccination should count or why vaccination should not count.",
           "valueSetReference": {
@@ -1575,6 +1809,11 @@
         "short": "SHR ImmunizationNotGiven Profile",
         "definition": "Represents an immunization that was not given."
       },
+      {
+        "id": "Immunization:shr-immunization-ImmunizationNotGiven.notGiven",
+        "path": "Immunization.notGiven",
+        "fixedBoolean": true
+      },
       {
         "id": "Immunization:shr-immunization-ImmunizationNotGiven.vaccineCode",
         "path": "Immunization.vaccineCode",
@@ -1585,11 +1824,6 @@
           }
         ]
       },
-      {
-        "id": "Immunization:shr-immunization-ImmunizationNotGiven.wasNotGiven",
-        "path": "Immunization.wasNotGiven",
-        "fixedBoolean": true
-      },
       {
         "id": "Immunization:shr-immunization-ImmunizationNotGiven.manufacturer",
         "path": "Immunization.manufacturer",
@@ -1614,7 +1848,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-lab-ChangeFlag-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-lab-ChangeFlag-extension.json
old mode 100755
new mode 100644
index 0172f80..4342532
--- a/lib/resources/standard_health_record/StructureDefinition-shr-lab-ChangeFlag-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-lab-ChangeFlag-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.lab.ChangeFlag"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ChangeFlag Extension",
   "title": "SHR ChangeFlag Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.121Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.521Z",
   "description": "Indicator of significant change (delta) from the last or previous measurement.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -170,7 +170,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-ChangeFlagVS"
+            "reference": "http://standardhealthrecord.org/shr/lab/vs/ChangeFlagVS"
           }
         },
         "mapping": [
@@ -221,7 +221,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-ChangeFlagVS"
+            "reference": "http://standardhealthrecord.org/shr/lab/vs/ChangeFlagVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-lab-HIVScreeningTest.json b/lib/resources/standard_health_record/StructureDefinition-shr-lab-HIVScreeningTest.json
old mode 100755
new mode 100644
index f97ab12..78d354d
--- a/lib/resources/standard_health_record/StructureDefinition-shr-lab-HIVScreeningTest.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-lab-HIVScreeningTest.json
@@ -3,7 +3,7 @@
   "id": "shr-lab-HIVScreeningTest",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR HIVScreeningTest Profile</b></p>\n  <p>The result of an HIV Screening Test.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.lab.HIVScreeningTest maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  BodySite maps to bodySite\n  BodyPosition maps to http://hl7.org/fhir/StructureDefinition/observation-bodyPosition\n  Device maps to device\n  TBD &quot;Specimen&quot; maps to specimen\n  Interpretation maps to interpretation\n  ReferenceRange maps to referenceRange\n  ChangeFlag maps to http://hl7.org/fhir/StructureDefinition/observation-delta\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR HIVScreeningTest Profile</b></p>\n  <p>The result of an HIV Screening Test.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.lab.HIVScreeningTest maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  BodySite maps to bodySite\n  BodyPosition maps to http://hl7.org/fhir/StructureDefinition/observation-bodyPosition\n  Device maps to device\n  &lt;TBD &quot;Specimen&quot;&gt; maps to specimen\n  Interpretation maps to interpretation\n  ReferenceRange maps to referenceRange\n  ChangeFlag maps to http://hl7.org/fhir/StructureDefinition/observation-delta\n  TestRequest maps to basedOn\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-HIVScreeningTest",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.lab.HIVScreeningTest"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR HIVScreeningTest Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.618Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.383Z",
   "description": "The result of an HIV Screening Test.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR HIVScreeningTest Profile",
         "definition": "The result of an HIV Screening Test.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-lab-HIVScreeningTest.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "218",
+          "id": "208",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "bodyposition",
         "definition": "The position or physical attitude of the body.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "changeflag",
         "definition": "Indicator of significant change (delta) from the last or previous measurement.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -398,6 +435,7 @@
         "path": "Observation.extension",
         "sliceName": "codeableconcept",
         "definition": "A set of codes drawn from different coding systems, representing the same concept.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -421,7 +459,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-HIVScreeningTestResultVS"
+            "reference": "http://standardhealthrecord.org/shr/lab/vs/HIVScreeningTestResultVS"
           }
         },
         "mapping": [
@@ -436,6 +474,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -468,6 +507,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -495,52 +535,23 @@
           }
         ]
       },
-      {
-        "id": "Observation:shr-lab-HIVScreeningTest.extension:testrequest",
-        "path": "Observation.extension",
-        "sliceName": "testrequest",
-        "definition": "A record of a request (order) for a test to be performed.",
-        "alias": [
-          "extensions",
-          "user content"
-        ],
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "DomainResource.extension",
-          "min": 0,
-          "max": "*"
-        },
-        "type": [
-          {
-            "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest-extension"
-          }
-        ],
-        "mustSupport": false,
-        "isModifier": false,
-        "isSummary": false,
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "N/A"
-          }
-        ]
-      },
       {
         "id": "Observation:shr-lab-HIVScreeningTest.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "219",
+          "id": "209",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -570,6 +581,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -600,8 +612,8 @@
       {
         "id": "Observation:shr-lab-HIVScreeningTest.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -610,7 +622,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -625,6 +642,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-lab-HIVScreeningTest.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-lab-HIVScreeningTest.status",
         "extension": [
@@ -636,6 +710,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -647,6 +722,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -654,6 +735,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -673,8 +762,8 @@
         "path": "Observation.category",
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 0,
         "max": "*",
         "type": [
@@ -684,8 +773,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -707,6 +802,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -719,10 +817,18 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-HIVScreeningTestCodeVS"
+            "reference": "http://standardhealthrecord.org/shr/lab/vs/HIVScreeningTestCodeVS"
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -731,6 +837,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -742,7 +852,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -766,6 +876,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -781,20 +895,32 @@
         ]
       },
       {
-        "id": "Observation:shr-lab-HIVScreeningTest.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-lab-HIVScreeningTest.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -814,8 +940,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -829,6 +958,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -848,7 +981,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -900,6 +1033,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -919,8 +1056,8 @@
         "path": "Observation.value[x]",
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -933,6 +1070,9 @@
           {
             "code": "string"
           },
+          {
+            "code": "boolean"
+          },
           {
             "code": "Range"
           },
@@ -960,6 +1100,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -967,6 +1115,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -975,7 +1127,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -988,6 +1140,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -995,6 +1153,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -1025,10 +1187,14 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-TestInterpretationVS"
+            "reference": "http://standardhealthrecord.org/shr/lab/vs/TestInterpretationVS"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1036,6 +1202,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1053,6 +1223,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -1068,8 +1242,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1081,10 +1254,14 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -1092,6 +1269,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1100,7 +1281,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1111,6 +1292,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1133,7 +1320,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1143,6 +1330,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1150,6 +1341,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1158,7 +1353,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1172,6 +1367,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1179,6 +1378,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1187,7 +1390,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "1",
@@ -1256,7 +1459,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1285,7 +1488,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1367,30 +1570,82 @@
         ]
       },
       {
-        "id": "Observation:shr-lab-HIVScreeningTest.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-lab-HIVScreeningTest.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-lab-HIVScreeningTest.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1446,8 +1701,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1509,7 +1764,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1538,7 +1793,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1570,7 +1825,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1580,6 +1835,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1630,7 +1891,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1693,7 +1954,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1722,7 +1983,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1764,6 +2025,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1771,6 +2038,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1790,8 +2061,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1828,6 +2099,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1835,6 +2110,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1843,7 +2122,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1856,6 +2135,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1878,7 +2163,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1891,6 +2176,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1898,6 +2189,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1905,6 +2200,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1913,7 +2212,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1989,7 +2288,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-HIVScreeningTestResultVS"
+            "reference": "http://standardhealthrecord.org/shr/lab/vs/HIVScreeningTestResultVS"
           }
         }
       },
@@ -2026,36 +2325,56 @@
         "isSummary": false
       },
       {
-        "id": "Observation:shr-lab-HIVScreeningTest.extension:testrequest",
-        "path": "Observation.extension",
-        "sliceName": "testrequest",
+        "id": "Observation:shr-lab-HIVScreeningTest.modifierExtension:observationnonoccurrencemodifier",
+        "path": "Observation.modifierExtension",
+        "sliceName": "observationnonoccurrencemodifier",
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest-extension"
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-observation-ObservationNonOccurrenceModifier-extension"
           }
         ],
-        "mustSupport": false,
-        "isModifier": false,
+        "mustSupport": true,
+        "isModifier": true,
         "isSummary": false
       },
       {
-        "id": "Observation:shr-lab-HIVScreeningTest.modifierExtension:observationnonoccurrencemodifier",
-        "path": "Observation.modifierExtension",
-        "sliceName": "observationnonoccurrencemodifier",
+        "id": "Observation:shr-lab-HIVScreeningTest.basedOn",
+        "path": "Observation.basedOn",
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-observation-ObservationNonOccurrenceModifier-extension"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
           }
-        ],
-        "mustSupport": true,
-        "isModifier": true,
-        "isSummary": false
+        ]
       },
       {
         "id": "Observation:shr-lab-HIVScreeningTest.category",
@@ -2079,7 +2398,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-HIVScreeningTestCodeVS"
+            "reference": "http://standardhealthrecord.org/shr/lab/vs/HIVScreeningTestCodeVS"
           }
         }
       },
@@ -2108,12 +2427,16 @@
         ]
       },
       {
-        "id": "Observation:shr-lab-HIVScreeningTest.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-lab-HIVScreeningTest.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
@@ -2170,7 +2493,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-TestInterpretationVS"
+            "reference": "http://standardhealthrecord.org/shr/lab/vs/TestInterpretationVS"
           }
         }
       },
@@ -2186,7 +2509,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-lab-HIVScreeningTestRequest.json b/lib/resources/standard_health_record/StructureDefinition-shr-lab-HIVScreeningTestRequest.json
old mode 100755
new mode 100644
index 72c94cd..eedafea
--- a/lib/resources/standard_health_record/StructureDefinition-shr-lab-HIVScreeningTestRequest.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-lab-HIVScreeningTestRequest.json
@@ -3,7 +3,7 @@
   "id": "shr-lab-HIVScreeningTestRequest",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR HIVScreeningTestRequest Profile</b></p>\n  <p>A request for a rapid HIV screening test.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.lab.HIVScreeningTestRequest maps to ProcedureRequest:\n  Entry.Author maps to orderer\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Reason maps to reason[x].CodeableConcept\n  OccurrenceTime maps to orderedOn   // could potentially map Entry.DateEntered to authoredOn\n  ActionCode maps to code\n  RequestStatus maps to status\n  RequestedPerformanceTime maps to scheduled[x]\n  PriorityOfRequest maps to priority\n  RequestedPerformer maps to performer\n  BodySite maps to bodySite\n  TBD &quot;Specimen&quot; maps to specimen\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR HIVScreeningTestRequest Profile</b></p>\n  <p>A request for a rapid HIV screening test.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.lab.HIVScreeningTestRequest maps to ProcedureRequest:\n  Entry.Author maps to requester.agent\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Reason maps to reasonCode\n  OccurrenceTime maps to authoredOn   // or could potentially map Entry.DateEntered to authoredOn\n  ActionCode maps to code\n  RequestNotToPerformActionModifier maps to doNotPerform\n  RequestStatus maps to status\n  RequestedPerformanceTime maps to occurrence[x]\n  PriorityOfRequest maps to priority\n  RequestedPerformerType maps to performerType\n  RequestedPerformer maps to performer\n  BodySite maps to bodySite\n  &lt;TBD &quot;Specimen&quot;&gt; maps to specimen\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-HIVScreeningTestRequest",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.lab.HIVScreeningTestRequest"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR HIVScreeningTestRequest Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.681Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,10 +27,24 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.394Z",
   "description": "A request for a rapid HIV screening test.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "v2",
+      "uri": "http://hl7.org/v2",
+      "name": "HL7 v2 Mapping"
+    },
+    {
+      "identity": "rim",
+      "uri": "http://hl7.org/v3",
+      "name": "RIM Mapping"
+    },
     {
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
@@ -38,11 +54,6 @@
       "identity": "quick",
       "uri": "http://wiki.siframework.org/CQF",
       "name": "Quality Improvement and Clinical Knowledge (QUICK)"
-    },
-    {
-      "identity": "rim",
-      "uri": "http://hl7.org/v3",
-      "name": "RIM Mapping"
     }
   ],
   "kind": "resource",
@@ -57,6 +68,9 @@
         "path": "ProcedureRequest",
         "short": "SHR HIVScreeningTestRequest Profile",
         "definition": "A request for a rapid HIV screening test.",
+        "alias": [
+          "diagnostic request"
+        ],
         "min": 0,
         "max": "*",
         "constraint": [
@@ -98,6 +112,18 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Request"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": "Act[moodCode<=INT]"
+          },
           {
             "identity": "w5",
             "map": "clinical.general"
@@ -109,7 +135,7 @@
         "path": "ProcedureRequest.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -148,7 +174,7 @@
         "path": "ProcedureRequest.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -169,7 +195,7 @@
         "path": "ProcedureRequest.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -189,6 +215,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -203,7 +237,7 @@
         "path": "ProcedureRequest.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -237,7 +271,7 @@
         "path": "ProcedureRequest.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -266,16 +300,19 @@
         "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.extension",
         "path": "ProcedureRequest.extension",
         "slicing": {
-          "id": "222",
+          "id": "212",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -304,6 +341,7 @@
         "path": "ProcedureRequest.extension",
         "sliceName": "participant",
         "definition": "A statement about an actor who did (or did not) participate in a certain task or activity. Unlike a HealthcareInvolvement which continues over period of time, the participant is associated with doing or not doing a specific task, such admitting a patient, performing a procedure, or taking a measurement.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -336,6 +374,7 @@
         "path": "ProcedureRequest.extension",
         "sliceName": "performerinstructions",
         "definition": "Information for the performer of the test, if needed.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -368,6 +407,7 @@
         "path": "ProcedureRequest.extension",
         "sliceName": "patientinstructions",
         "definition": "Information for the patient, such as, where to get the test, how to prepare for the test, etc.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -399,16 +439,19 @@
         "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.modifierExtension",
         "path": "ProcedureRequest.modifierExtension",
         "slicing": {
-          "id": "223",
+          "id": "213",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -438,6 +481,7 @@
         "path": "ProcedureRequest.modifierExtension",
         "sliceName": "nonoccurrencemodifier",
         "definition": "When true, indicates either that the event or action documented in the entry did not occur, or the the thing documented is absent or does not exist.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -465,43 +509,12 @@
           }
         ]
       },
-      {
-        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.modifierExtension:requestnottoperformactionmodifier",
-        "path": "ProcedureRequest.modifierExtension",
-        "sliceName": "requestnottoperformactionmodifier",
-        "definition": "If true, the thing requested should not take place. For example, a request to NOT elevate the head of a bed using the code for elevating the bed, and setting RequestNotToPerformActionModifier to true. Other examples include do not ambulate, do not flush NG tube, do not take blood pressure on a certain arm, etc. If the Request.code and RequestAgainstModifier both contain negation, that will reinforce the prohibition, and should not be interpreted as a double negative that equals a positive.",
-        "alias": [
-          "extensions",
-          "user content"
-        ],
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "DomainResource.modifierExtension",
-          "min": 0,
-          "max": "*"
-        },
-        "type": [
-          {
-            "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-RequestNotToPerformActionModifier-extension"
-          }
-        ],
-        "mustSupport": true,
-        "isModifier": true,
-        "isSummary": false,
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "N/A"
-          }
-        ]
-      },
       {
         "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.identifier",
         "path": "ProcedureRequest.identifier",
-        "short": "Unique identifier for the request",
-        "definition": "Identifiers assigned to this order by the order or by the receiver.",
+        "short": "Identifiers assigned to this order",
+        "definition": "Identifiers assigned to this order instance by the orderer and/or the receiver and/or order fulfiller.",
+        "comment": "The identifier.type element is used to distinguish between the identifiers assigned by the orderer (known as the 'Placer' in HL7 v2) and the producer of the observations in response to the order (known as the 'Filler' in HL7 v2).  For further discussion and examples see the resource notes section below.",
         "min": 0,
         "max": "*",
         "type": [
@@ -511,6 +524,18 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.identifier"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC.2, ORC.3"
+          },
+          {
+            "identity": "rim",
+            "map": ".identifier"
+          },
           {
             "identity": "quick",
             "map": "ClinicalStatement.identifier"
@@ -522,397 +547,1150 @@
         ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.subject",
-        "path": "ProcedureRequest.subject",
-        "short": "Who the procedure should be done to",
-        "definition": "The person, animal or group that should receive the procedure.",
-        "min": 1,
-        "max": "1",
+        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.definition",
+        "path": "ProcedureRequest.definition",
+        "short": "Protocol or definition",
+        "definition": "Protocol or definition followed by this request.",
+        "alias": [
+          "protocol"
+        ],
+        "min": 0,
+        "max": "*",
         "type": [
           {
             "code": "Reference",
-            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-demographics-PersonOfRecord"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ActivityDefinition"
           },
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Group"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/PlanDefinition"
           }
         ],
         "isSummary": true,
         "mapping": [
           {
-            "identity": "quick",
-            "map": "ClinicalStatement.subject"
+            "identity": "workflow",
+            "map": "Request.definition"
           },
           {
-            "identity": "w5",
-            "map": "who.focus"
+            "identity": "v2",
+            "map": "Varies by domain"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=DEFN].target"
           }
         ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.code",
-        "path": "ProcedureRequest.code",
-        "short": "What procedure to perform",
-        "definition": "The specific procedure that is ordered. Use text if the exact nature of the procedure cannot be coded.",
-        "min": 1,
-        "max": "1",
+        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.basedOn",
+        "path": "ProcedureRequest.basedOn",
+        "short": "What request fulfills",
+        "definition": "Plan/proposal/order fulfilled by this request.",
+        "alias": [
+          "fulfills"
+        ],
+        "min": 0,
+        "max": "*",
         "type": [
           {
-            "code": "CodeableConcept",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Resource"
           }
         ],
         "isSummary": true,
-        "binding": {
-          "strength": "required",
-          "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-HIVScreeningTestCodeVS"
-          }
-        },
         "mapping": [
           {
-            "identity": "quick",
-            "map": "Procedure.procedureCode"
+            "identity": "workflow",
+            "map": "Request.basedOn"
           },
           {
-            "identity": "w5",
-            "map": "class"
+            "identity": "v2",
+            "map": "ORC.8 (plus others)"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
           }
         ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.bodySite",
-        "path": "ProcedureRequest.bodySite",
-        "short": "What part of body to perform on",
-        "definition": "Indicates the sites on the subject's body where the procedure should be performed (I.e. the target sites).",
-        "comments": "Only used if not implicit in the code found in ProcedureRequest.type.",
-        "requirements": "Knowing where the procedure is made is important for tracking if multiple sites are possible.",
+        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.replaces",
+        "path": "ProcedureRequest.replaces",
+        "short": "What request replaces",
+        "definition": "The request takes the place of the referenced completed or terminated request(s).",
         "min": 0,
-        "max": "1",
+        "max": "*",
         "type": [
           {
-            "code": "CodeableConcept",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Resource"
           }
         ],
         "isSummary": true,
-        "binding": {
-          "strength": "required",
-          "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
-          }
-        },
         "mapping": [
           {
-            "identity": "rim",
-            "map": "targetSiteCode"
+            "identity": "workflow",
+            "map": "Request.replaces"
           },
           {
-            "identity": "quick",
-            "map": "Procedure.targetBodySite"
+            "identity": "v2",
+            "map": "Handled by message location of ORC (ORC.1=RO or RU)"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=RPLC].target"
           }
         ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.reason[x]",
-        "path": "ProcedureRequest.reason[x]",
-        "short": "Why procedure should occur",
-        "definition": "The reason why the procedure is being proposed or ordered. This procedure request may be motivated by a Condition for instance.",
+        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.requisition",
+        "path": "ProcedureRequest.requisition",
+        "short": "Composite Request ID",
+        "definition": "A shared identifier common to all procedure or diagnostic requests that were authorized more or less simultaneously by a single author, representing the composite or group identifier.",
+        "comment": "Requests are linked either by a \"basedOn\" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation.",
+        "requirements": "Some business processes need to know if multiple items were ordered as part of the same \"requisition\" for billing or other purposes.",
+        "alias": [
+          "grouperId",
+          "groupIdentifier"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "CodeableConcept",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+            "code": "Identifier"
           }
         ],
         "isSummary": true,
-        "binding": {
-          "strength": "example",
-          "description": "A code that explains the reason why a procedure is  required.",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/procedure-reason"
-          }
-        },
         "mapping": [
           {
-            "identity": "quick",
-            "map": "Action.indication.reason"
+            "identity": "v2",
+            "map": "ORC.4"
+          },
+          {
+            "identity": "rim",
+            "map": ".inboundRelationship(typeCode=COMP].source[moodCode=INT].identifier"
           }
         ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.scheduled[x]",
-        "path": "ProcedureRequest.scheduled[x]",
-        "short": "When procedure should occur",
-        "definition": "The timing schedule for the proposed or ordered procedure. The Schedule data type allows many different expressions.  E.g. \"Every 8 hours\"; \"Three times a day\"; \"1/2 an hour before breakfast for 10 days from 23-Dec 2011:\"; \"15 Oct 2013, 17 Oct 2013 and 1 Nov 2013\".",
-        "min": 0,
+        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.status",
+        "path": "ProcedureRequest.status",
+        "short": "draft | active | suspended | completed | entered-in-error | cancelled",
+        "definition": "The status of the order.",
+        "comment": "The status is generally fully in the control of the requester - they determine whether the order is draft or active and, after it has been activated, competed, cancelled or suspended. States relating to the activities of the performer are reflected on either the corresponding event (see [Event Pattern](event.html) for general discussion) or using the [Task](task.html) resource.\n\nThis element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
+        "min": 1,
         "max": "1",
         "type": [
           {
-            "code": "dateTime"
-          },
-          {
-            "code": "Period"
-          },
-          {
-            "code": "Timing"
+            "code": "code"
           }
         ],
+        "isModifier": true,
         "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ProcedureRequestStatus"
+            }
+          ],
+          "strength": "required",
+          "description": "The status of a procedure or diagnostic order.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/request-status"
+          }
+        },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.status"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC.5"
+          },
+          {
+            "identity": "rim",
+            "map": ".status"
+          },
           {
             "identity": "quick",
-            "map": "Procedure.procedureSchedule"
+            "map": "Action.currentStatus"
           },
           {
             "identity": "w5",
-            "map": "when.planned"
+            "map": "status"
           }
         ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.encounter",
-        "path": "ProcedureRequest.encounter",
-        "short": "Encounter request created during",
-        "definition": "The encounter within which the procedure proposal or request was created.",
-        "min": 0,
+        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.intent",
+        "path": "ProcedureRequest.intent",
+        "short": "proposal | plan | order +",
+        "definition": "Whether the request is a proposal, plan, an original order or a reflex order.",
+        "comment": "This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.",
+        "min": 1,
         "max": "1",
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+            "code": "code"
           }
         ],
+        "isModifier": true,
         "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ProcedureRequestIntent"
+            }
+          ],
+          "strength": "required",
+          "description": "The kind of procedure or diagnostic request",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/request-intent"
+          }
+        },
         "mapping": [
           {
-            "identity": "quick",
-            "map": "ClinicalStatement.encounter"
+            "identity": "workflow",
+            "map": "Request.intent"
+          },
+          {
+            "identity": "v2",
+            "map": "N/A"
+          },
+          {
+            "identity": "rim",
+            "map": ".moodCode (nuances beyond PRP/PLAN/RQO would need to be elsewhere)"
           },
           {
             "identity": "w5",
-            "map": "context"
+            "map": "class"
           }
         ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.performer",
-        "path": "ProcedureRequest.performer",
-        "short": "Who should perform the procedure",
-        "definition": "For example, the surgeon, anaethetist, endoscopist, etc.",
+        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.priority",
+        "path": "ProcedureRequest.priority",
+        "short": "routine | urgent | asap | stat",
+        "definition": "Indicates how quickly the ProcedureRequest should be addressed with respect to other requests.",
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
-          },
+            "code": "code"
+          }
+        ],
+        "meaningWhenMissing": "If missing, this task should be performed with normal priority",
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ProcedureRequestPriority"
+            }
+          ],
+          "strength": "required",
+          "description": "Identifies the level of importance to be assigned to actioning the request",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/request-priority"
+          }
+        },
+        "mapping": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
+            "identity": "workflow",
+            "map": "Request.priority"
           },
           {
-            "code": "Reference",
-            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-demographics-PersonOfRecord"
+            "identity": "v2",
+            "map": "TQ1.9"
           },
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
-          }
-        ],
-        "isSummary": true,
-        "mapping": [
+            "identity": "rim",
+            "map": ".priorityCode"
+          },
           {
             "identity": "w5",
-            "map": "who.actor"
+            "map": "class"
           }
         ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.status",
-        "path": "ProcedureRequest.status",
-        "short": "proposed | draft | requested | received | accepted | in-progress | completed | suspended | rejected | aborted",
-        "definition": "The status of the order.",
-        "min": 1,
+        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.doNotPerform",
+        "path": "ProcedureRequest.doNotPerform",
+        "short": "True if procedure should not be performed",
+        "definition": "Set this to true if the record is saying that the procedure should NOT be performed.",
+        "comment": "This element is labeled as a [modifier](conformance-rules.html#isModifier.html) because it indicates that a procedure shouldn't happen, instead of a request for it to happen.  In general, only the code and timeframe will be present, though occasional additional qualifiers such as body site or even performer could be included to narrow the scope of the prohibition.  If the ProcedureRequest.code and ProcedureRequest.doNotPerform both contain negation, that will reinforce prohibition and should not have a double negative interpretation.",
+        "requirements": "Used for do not ambulate, do not elevate head of bed, do not flush NG tube, do not take blood pressure on a certain arm, etc.",
+        "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "code"
+            "code": "boolean"
           }
         ],
+        "defaultValueBoolean": false,
         "isModifier": true,
         "isSummary": true,
-        "binding": {
-          "strength": "required",
-          "description": "The status of the request.",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/procedure-request-status"
-          }
-        },
         "mapping": [
           {
-            "identity": "quick",
-            "map": "Action.currentStatus"
-          },
-          {
-            "identity": "w5",
-            "map": "status"
+            "identity": "rim",
+            "map": ".actionNegationInd"
           }
         ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.supportingInfo",
-        "path": "ProcedureRequest.supportingInfo",
-        "short": "Extra information to use in performing request",
-        "definition": "Information that may be needed by/relevant to the performer in their execution of this request.",
+        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.category",
+        "path": "ProcedureRequest.category",
+        "short": "Classification of procedure",
+        "definition": "A code that classifies the procedure for searching, sorting and display purposes (e.g. \"Surgical Procedure\").",
+        "comment": "There may be multiple axis of categorization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what procedure request are retrieved and displayed.",
         "min": 0,
         "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ProcedureRequestCategory"
+            }
+          ],
+          "strength": "example",
+          "description": "Classification of the procedure",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/procedure-category"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=\"COMP].target[classCode=\"LIST\", moodCode=\"INT\"].code"
+          },
+          {
+            "identity": "w5",
+            "map": "class"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.code",
+        "path": "ProcedureRequest.code",
+        "short": "What is being requested/ordered",
+        "definition": "A code that identifies a particular procedure, diagnostic investigation, or panel of investigations, that have been requested.",
+        "comment": "Many laboratory and radiology procedure codes embed the specimen/organ system in the test ordeer name, for example,  serum or serum/plasma glucose, or a chest xray. The specimen may not be recorded separately from the test code.",
+        "min": 1,
+        "max": "1",
+        "type": [
+          {
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "strength": "required",
+          "valueSetReference": {
+            "reference": "http://standardhealthrecord.org/shr/lab/vs/HIVScreeningTestCodeVS"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.code"
+          },
+          {
+            "identity": "v2",
+            "map": "Varies by domain"
+          },
+          {
+            "identity": "rim",
+            "map": ".code"
+          },
+          {
+            "identity": "quick",
+            "map": "Procedure.procedureCode"
+          },
+          {
+            "identity": "w5",
+            "map": "what"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.subject",
+        "path": "ProcedureRequest.subject",
+        "short": "Individual the service is ordered for",
+        "definition": "On whom or what the procedure or diagnostic is to be performed. This is usually a human patient, but can also be requested on animals, groups of humans or animals, devices such as dialysis machines, or even locations (typically for environmental scans).",
+        "min": 1,
+        "max": "1",
         "type": [
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Resource"
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-demographics-PersonOfRecord"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Group"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Location"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Device"
           }
         ],
-        "isSummary": true
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.subject"
+          },
+          {
+            "identity": "v2",
+            "map": "Accompanying PID segment"
+          },
+          {
+            "identity": "rim",
+            "map": ".participation[typeCode=SBJ].role"
+          },
+          {
+            "identity": "quick",
+            "map": "ClinicalStatement.subject"
+          },
+          {
+            "identity": "w5",
+            "map": "who.focus"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.context",
+        "path": "ProcedureRequest.context",
+        "short": "Encounter or Episode during which request was created",
+        "definition": "An encounter or episode of care that provides additional information about the healthcare context in which this request is made.",
+        "alias": [
+          "encounter"
+        ],
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.context"
+          },
+          {
+            "identity": "v2",
+            "map": "Accompanying PV1"
+          },
+          {
+            "identity": "rim",
+            "map": ".inboundRelationship(typeCode=COMP].source[classCode<=PCPR, moodCode=EVN]"
+          },
+          {
+            "identity": "quick",
+            "map": "ClinicalStatement.encounter"
+          },
+          {
+            "identity": "w5",
+            "map": "context"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.occurrence[x]",
+        "path": "ProcedureRequest.occurrence[x]",
+        "short": "When procedure should occur",
+        "definition": "The date/time at which the diagnostic testing should occur.",
+        "alias": [
+          "schedule"
+        ],
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "dateTime"
+          },
+          {
+            "code": "Period"
+          },
+          {
+            "code": "Timing"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.occurrence[x]"
+          },
+          {
+            "identity": "v2",
+            "map": "Accompanying TQ1/TQ2 segments"
+          },
+          {
+            "identity": "rim",
+            "map": ".effectiveTime"
+          },
+          {
+            "identity": "quick",
+            "map": "Procedure.procedureSchedule"
+          },
+          {
+            "identity": "w5",
+            "map": "when.planned"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.asNeeded[x]",
+        "path": "ProcedureRequest.asNeeded[x]",
+        "short": "Preconditions for procedure or diagnostic",
+        "definition": "If a CodeableConcept is present, it indicates the pre-condition for performing the procedure.  For example \"pain\", \"on flare-up\", etc.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "boolean"
+          },
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ProcedureAsNeededReason"
+            }
+          ],
+          "strength": "example",
+          "description": "A coded concept identifying the pre-condition that should hold prior to performing a procedure.  For example \"pain\", \"on flare-up\", etc.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/medication-as-needed-reason"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "boolean: precondition.negationInd (inversed - so negationInd = true means asNeeded=false CodeableConcept: precondition.observationEventCriterion[code=\"Assertion\"].value"
+          },
+          {
+            "identity": "quick",
+            "map": "Proposal.prnReason.reason"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.authoredOn",
+        "path": "ProcedureRequest.authoredOn",
+        "short": "Date request signed",
+        "definition": "When the request transitioned to being actionable.",
+        "alias": [
+          "orderedOn"
+        ],
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "dateTime"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.authoredOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC.9"
+          },
+          {
+            "identity": "rim",
+            "map": ".participation[typeCode=AUT].time"
+          },
+          {
+            "identity": "quick",
+            "map": "Proposal.proposedAtTime"
+          },
+          {
+            "identity": "w5",
+            "map": "when.recorded"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.requester",
+        "path": "ProcedureRequest.requester",
+        "short": "Who/what is requesting procedure or diagnostic",
+        "definition": "The individual who initiated the request and has responsibility for its activation.",
+        "comment": "This not the dispatcher, but rather who is the authorizer.",
+        "alias": [
+          "author",
+          "orderer"
+        ],
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "BackboneElement"
+          }
+        ],
+        "constraint": [
+          {
+            "key": "ele-1",
+            "severity": "error",
+            "human": "All FHIR elements must have a @value or children",
+            "expression": "children().count() > id.count()",
+            "xpath": "@value|f:*|h:div",
+            "source": "Element"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.requester"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC.12"
+          },
+          {
+            "identity": "rim",
+            "map": ".participation[typeCode=AUT].role"
+          },
+          {
+            "identity": "quick",
+            "map": "ClinicalStatement.statementAuthor"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.requester.id",
+        "path": "ProcedureRequest.requester.id",
+        "representation": [
+          "xmlAttr"
+        ],
+        "short": "xml:id (or equivalent in JSON)",
+        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Element.id",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.requester.extension",
+        "path": "ProcedureRequest.requester.extension",
+        "short": "Additional Content defined by implementations",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "Element.extension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.notes",
-        "path": "ProcedureRequest.notes",
-        "short": "Additional information about desired procedure",
-        "definition": "Any other notes associated with this proposal or order - e.g. provider instructions.",
+        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.requester.modifierExtension",
+        "path": "ProcedureRequest.requester.modifierExtension",
+        "short": "Extensions that cannot be ignored",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content",
+          "modifiers"
+        ],
         "min": 0,
         "max": "*",
+        "base": {
+          "path": "BackboneElement.modifierExtension",
+          "min": 0,
+          "max": "*"
+        },
         "type": [
           {
-            "code": "Annotation"
+            "code": "Extension"
+          }
+        ],
+        "isModifier": true,
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "N/A"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.requester.agent",
+        "path": "ProcedureRequest.requester.agent",
+        "short": "Individual making the request",
+        "definition": "The device, practitioner or organization who initiated the request.",
+        "min": 1,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Device"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-actor-Practitioner"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.requester.agent"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC.12"
+          },
+          {
+            "identity": "rim",
+            "map": ".player"
+          },
+          {
+            "identity": "quick",
+            "map": "ClinicalStatement.statementAuthor"
+          },
+          {
+            "identity": "w5",
+            "map": "who.author"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.requester.onBehalfOf",
+        "path": "ProcedureRequest.requester.onBehalfOf",
+        "short": "Organization agent is acting for",
+        "definition": "The organization the device or practitioner was acting on behalf of.",
+        "requirements": "Practitioners and Devices can be associated with multiple organizations.  This element indicates which organization they were acting on behalf of when authoring the request.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.requester.onBehalfOf"
+          },
+          {
+            "identity": "v2",
+            "map": "N/A"
+          },
+          {
+            "identity": "rim",
+            "map": ".scoper"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.performerType",
+        "path": "ProcedureRequest.performerType",
+        "short": "Performer role",
+        "definition": "Desired type of performer for doing the diagnostic testing.",
+        "comment": "this is a  role, not  a participation type.  I.e. does not describe the task, but describes the capacity.  For example, “compounding pharmacy” or “psychiatrist” or “internal referral”.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ProcedureRequestParticipantRole"
+            }
+          ],
+          "strength": "example",
+          "description": "Indicates specific responsibility of an individual within the care team, such as \"Primary physician\", \"Team coordinator\", \"Caregiver\", etc.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/participant-role"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.performerType"
+          },
+          {
+            "identity": "v2",
+            "map": "PRT"
+          },
+          {
+            "identity": "rim",
+            "map": ".participation[typeCode=PRF].role[scoper.determinerCode=KIND].code"
+          },
+          {
+            "identity": "w5",
+            "map": "who.actor"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.performer",
+        "path": "ProcedureRequest.performer",
+        "short": "Requested perfomer",
+        "definition": "The desired perfomer for doing the diagnostic testing.  For example, the surgeon, dermatopathologist, endoscopist, etc.",
+        "comment": "If needed, use an [extension](extensibility.html) for listing alternative performers and/or roles and/or preference.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-demographics-PersonOfRecord"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Device"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/HealthcareService"
           }
         ],
         "isSummary": true,
         "mapping": [
           {
-            "identity": "quick",
-            "map": "ClinicalStatement.additionalText"
+            "identity": "workflow",
+            "map": "Request.Performer"
+          },
+          {
+            "identity": "v2",
+            "map": "PRT"
+          },
+          {
+            "identity": "rim",
+            "map": ".participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]"
+          },
+          {
+            "identity": "w5",
+            "map": "who.actor"
           }
         ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.asNeeded[x]",
-        "path": "ProcedureRequest.asNeeded[x]",
-        "short": "Preconditions for procedure",
-        "definition": "If a CodeableConcept is present, it indicates the pre-condition for performing the procedure.",
+        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.reasonCode",
+        "path": "ProcedureRequest.reasonCode",
+        "short": "Explanation/Justification for test",
+        "definition": "An explanation or justification for why this diagnostic investigation is being requested in coded or textual form.   This is often for billing purposes.  May relate to the resources referred to in supportingInformation.",
+        "comment": "This may be used to decide how the diagnostic investigation will be performed, or even if it will be performed at all.   Use CodeableConcept text element if the data is free (uncoded) text as shown in the [CT Scan example](procedurerequest-example-di.html).",
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "boolean"
-          },
-          {
-            "code": "CodeableConcept"
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
           }
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ProcedureRequestReason"
+            }
+          ],
           "strength": "example",
-          "description": "A coded concept identifying the pre-condition that should hold prior to performing a procedure.  For example \"pain\", \"on flare-up\", etc."
+          "description": "Diagnosis or problem codes justifying the reason for requesting the procedure or diagnostic investigation.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/procedure-reason"
+          }
         },
         "mapping": [
           {
-            "identity": "quick",
-            "map": "Proposal.prnReason.reason"
+            "identity": "workflow",
+            "map": "Request.reasonCod"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC.16"
+          },
+          {
+            "identity": "rim",
+            "map": ".reasonCode"
+          },
+          {
+            "identity": "w5",
+            "map": "why"
           }
         ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.orderedOn",
-        "path": "ProcedureRequest.orderedOn",
-        "short": "When request was created",
-        "definition": "The time when the request was made.",
+        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.reasonReference",
+        "path": "ProcedureRequest.reasonReference",
+        "short": "Explanation/Justification for test",
+        "definition": "Indicates another resource that provides a justification for why this diagnostic investigation is being requested.   May relate to the resources referred to in supportingInformation.",
+        "comment": "This may be used to decide how the diagnostic investigation will be performed, or even if it will be performed at all.   Use CodeableConcept text element if the data is free (uncoded) text as shown in the [CT Scan example](procedurerequest-example-di.html).",
         "min": 0,
-        "max": "1",
+        "max": "*",
         "type": [
           {
-            "code": "dateTime"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Condition"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Observation"
           }
         ],
         "isSummary": true,
         "mapping": [
           {
-            "identity": "quick",
-            "map": "Proposal.proposedAtTime"
+            "identity": "workflow",
+            "map": "Request.reasonReference"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC.16"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=RSON].target"
           },
           {
             "identity": "w5",
-            "map": "when.recorded"
+            "map": "why"
           }
         ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.orderer",
-        "path": "ProcedureRequest.orderer",
-        "short": "Who made request",
-        "definition": "The healthcare professional responsible for proposing or ordering the procedure.",
+        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.supportingInfo",
+        "path": "ProcedureRequest.supportingInfo",
+        "short": "Additional clinical information",
+        "definition": "Additional clinical information about the patient or specimen that may influence the procedure or diagnostics or their interpretations.     This information includes diagnosis, clinical findings and other observations.  In laboratory ordering these are typically referred to as \"ask at order entry questions (AOEs)\".  This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example,  reporting the amount of inspired oxygen for blood gas measurements.",
+        "alias": [
+          "Ask at order entry question",
+          "AOE"
+        ],
         "min": 0,
-        "max": "1",
+        "max": "*",
         "type": [
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
-          },
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Resource"
+          }
+        ],
+        "mapping": [
           {
-            "code": "Reference",
-            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-demographics-PersonOfRecord"
+            "identity": "workflow",
+            "map": "Request.supportingInformation"
           },
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
+            "identity": "v2",
+            "map": "Accompanying segments"
           },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=PERT].target"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.specimen",
+        "path": "ProcedureRequest.specimen",
+        "short": "Procedure Samples",
+        "definition": "One or more specimens that the laboratory procedure will use.",
+        "comment": "Many diagnostic procedures need a specimen, but the request itself is not actually about the specimen. This element is for when the diagnostic is requested on already existing specimens and the request points to the specimen it applies to.    Conversely, If the request is entered first with an unknown specimen, The [Specimen](specimen.html) resource references to the ProcedureRequest.",
+        "min": 0,
+        "max": "*",
+        "type": [
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Device"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Specimen"
           }
         ],
         "isSummary": true,
         "mapping": [
           {
-            "identity": "quick",
-            "map": "ClinicalStatement.statementAuthor"
+            "identity": "v2",
+            "map": "SPM"
           },
           {
-            "identity": "w5",
-            "map": "who.author"
+            "identity": "rim",
+            "map": ".participation[typeCode=SPC].role"
           }
         ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.priority",
-        "path": "ProcedureRequest.priority",
-        "short": "routine | urgent | stat | asap",
-        "definition": "The clinical priority associated with this order.",
+        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.bodySite",
+        "path": "ProcedureRequest.bodySite",
+        "short": "Location on Body",
+        "definition": "Anatomic location where the procedure should be performed. This is the target site.",
+        "comment": "Only used if not implicit in the code found in ProcedureRequest.type.  If the use case requires BodySite to be handled as a separate resource instead of an inline coded element (e.g. to identify and track separately)  then use the standard extension [procedurerequest-targetBodySite](extension-procedurerequest-targetbodysite.html).",
+        "requirements": "Knowing where the procedure is performed is important for tracking if multiple sites are possible.",
+        "alias": [
+          "location"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "code"
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
           }
         ],
         "isSummary": true,
         "binding": {
           "strength": "required",
-          "description": "The priority of the request.",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/procedure-request-priority"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
           }
         },
         "mapping": [
+          {
+            "identity": "v2",
+            "map": "SPM"
+          },
+          {
+            "identity": "rim",
+            "map": "targetSiteCode"
+          },
           {
             "identity": "quick",
-            "map": "Proposal.urgency"
+            "map": "Procedure.targetBodySite"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.note",
+        "path": "ProcedureRequest.note",
+        "short": "Comments",
+        "definition": "Any other notes and comments made about the service request. For example, letting provider know that \"patient hates needles\" or other provider instructions.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Annotation"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.note"
           },
           {
-            "identity": "w5",
-            "map": "grade"
+            "identity": "v2",
+            "map": "NTE"
+          },
+          {
+            "identity": "rim",
+            "map": ".inboundRelationship(typeCode=SUBJ].source[classCode=ANNGEN, moodCode=EVN].value[xsi:type=ST]"
+          },
+          {
+            "identity": "quick",
+            "map": "ClinicalStatement.additionalText"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.relevantHistory",
+        "path": "ProcedureRequest.relevantHistory",
+        "short": "Request provenance",
+        "definition": "Key events in the history of the request.",
+        "comment": "This may not include provenances for all versions of the request – only those deemed “relevant” or important.\rThis SHALL NOT include the Provenance associated with this current version of the resource.  (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update.  Until then, it can be queried directly as the Provenance that points to this version using _revinclude\rAll Provenances should have some historical version of this Request as their subject.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Provenance"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.relevantHistory"
+          },
+          {
+            "identity": "v2",
+            "map": "N/A"
+          },
+          {
+            "identity": "rim",
+            "map": ".inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]"
           }
         ]
       }
@@ -991,20 +1769,20 @@
         "isSummary": false
       },
       {
-        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.modifierExtension:requestnottoperformactionmodifier",
-        "path": "ProcedureRequest.modifierExtension",
-        "sliceName": "requestnottoperformactionmodifier",
-        "min": 0,
-        "max": "1",
+        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.code",
+        "path": "ProcedureRequest.code",
         "type": [
           {
-            "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-RequestNotToPerformActionModifier-extension"
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
           }
         ],
-        "mustSupport": true,
-        "isModifier": true,
-        "isSummary": false
+        "binding": {
+          "strength": "required",
+          "valueSetReference": {
+            "reference": "http://standardhealthrecord.org/shr/lab/vs/HIVScreeningTestCodeVS"
+          }
+        }
       },
       {
         "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.subject",
@@ -1017,60 +1795,50 @@
           {
             "code": "Reference",
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/Group"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Location"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Device"
           }
         ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.code",
-        "path": "ProcedureRequest.code",
+        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.context",
+        "path": "ProcedureRequest.context",
         "type": [
           {
-            "code": "CodeableConcept",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
-          }
-        ],
-        "binding": {
-          "strength": "required",
-          "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-HIVScreeningTestCodeVS"
-          }
-        }
-      },
-      {
-        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.bodySite",
-        "path": "ProcedureRequest.bodySite",
-        "min": 0,
-        "max": "1",
-        "type": [
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
           {
-            "code": "CodeableConcept",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
-          }
-        ],
-        "binding": {
-          "strength": "required",
-          "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
-        }
+        ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.reason[x]",
-        "path": "ProcedureRequest.reason[x]",
-        "type": [
-          {
-            "code": "CodeableConcept",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
-          }
-        ]
+        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.requester",
+        "path": "ProcedureRequest.requester"
       },
       {
-        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.encounter",
-        "path": "ProcedureRequest.encounter",
+        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.requester.agent",
+        "path": "ProcedureRequest.requester.agent",
         "type": [
           {
             "code": "Reference",
-            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Device"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-actor-Practitioner"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
           }
         ]
       },
@@ -1090,39 +1858,49 @@
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-demographics-PersonOfRecord"
           },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Device"
+          },
           {
             "code": "Reference",
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/HealthcareService"
           }
         ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.status",
-        "path": "ProcedureRequest.status",
-        "min": 1,
-        "max": "1"
+        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.reasonCode",
+        "path": "ProcedureRequest.reasonCode",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+          }
+        ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.orderer",
-        "path": "ProcedureRequest.orderer",
+        "id": "ProcedureRequest:shr-lab-HIVScreeningTestRequest.bodySite",
+        "path": "ProcedureRequest.bodySite",
+        "min": 0,
+        "max": "1",
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
-          },
-          {
-            "code": "Reference",
-            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-demographics-PersonOfRecord"
-          },
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
-          },
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Device"
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
           }
-        ]
+        ],
+        "binding": {
+          "strength": "required",
+          "valueSetReference": {
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
+          }
+        }
       }
     ]
   }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-lab-HIVSupplementalTest.json b/lib/resources/standard_health_record/StructureDefinition-shr-lab-HIVSupplementalTest.json
old mode 100755
new mode 100644
index 063f8db..5802373
--- a/lib/resources/standard_health_record/StructureDefinition-shr-lab-HIVSupplementalTest.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-lab-HIVSupplementalTest.json
@@ -3,7 +3,7 @@
   "id": "shr-lab-HIVSupplementalTest",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR HIVSupplementalTest Profile</b></p>\n  <p>The result of a supplement HIV test, following up an initial screening.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.lab.HIVSupplementalTest maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  BodySite maps to bodySite\n  BodyPosition maps to http://hl7.org/fhir/StructureDefinition/observation-bodyPosition\n  Device maps to device\n  TBD &quot;Specimen&quot; maps to specimen\n  Interpretation maps to interpretation\n  ReferenceRange maps to referenceRange\n  ChangeFlag maps to http://hl7.org/fhir/StructureDefinition/observation-delta\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR HIVSupplementalTest Profile</b></p>\n  <p>The result of a supplement HIV test, following up an initial screening.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.lab.HIVSupplementalTest maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  BodySite maps to bodySite\n  BodyPosition maps to http://hl7.org/fhir/StructureDefinition/observation-bodyPosition\n  Device maps to device\n  &lt;TBD &quot;Specimen&quot;&gt; maps to specimen\n  Interpretation maps to interpretation\n  ReferenceRange maps to referenceRange\n  ChangeFlag maps to http://hl7.org/fhir/StructureDefinition/observation-delta\n  TestRequest maps to basedOn\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-HIVSupplementalTest",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.lab.HIVSupplementalTest"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR HIVSupplementalTest Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.651Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.391Z",
   "description": "The result of a supplement HIV test, following up an initial screening.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR HIVSupplementalTest Profile",
         "definition": "The result of a supplement HIV test, following up an initial screening.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-lab-HIVSupplementalTest.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "220",
+          "id": "210",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "bodyposition",
         "definition": "The position or physical attitude of the body.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "changeflag",
         "definition": "Indicator of significant change (delta) from the last or previous measurement.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -398,6 +435,7 @@
         "path": "Observation.extension",
         "sliceName": "codeableconcept",
         "definition": "A set of codes drawn from different coding systems, representing the same concept.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -421,7 +459,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-HIVSupplementalTestResultVS"
+            "reference": "http://standardhealthrecord.org/shr/lab/vs/HIVSupplementalTestResultVS"
           }
         },
         "mapping": [
@@ -436,6 +474,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -468,6 +507,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -495,52 +535,23 @@
           }
         ]
       },
-      {
-        "id": "Observation:shr-lab-HIVSupplementalTest.extension:testrequest",
-        "path": "Observation.extension",
-        "sliceName": "testrequest",
-        "definition": "A record of a request (order) for a test to be performed.",
-        "alias": [
-          "extensions",
-          "user content"
-        ],
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "DomainResource.extension",
-          "min": 0,
-          "max": "*"
-        },
-        "type": [
-          {
-            "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest-extension"
-          }
-        ],
-        "mustSupport": false,
-        "isModifier": false,
-        "isSummary": false,
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "N/A"
-          }
-        ]
-      },
       {
         "id": "Observation:shr-lab-HIVSupplementalTest.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "221",
+          "id": "211",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -570,6 +581,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -600,8 +612,8 @@
       {
         "id": "Observation:shr-lab-HIVSupplementalTest.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -610,7 +622,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -625,6 +642,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-lab-HIVSupplementalTest.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-lab-HIVSupplementalTest.status",
         "extension": [
@@ -636,6 +710,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -647,6 +722,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -654,6 +735,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -673,8 +762,8 @@
         "path": "Observation.category",
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 0,
         "max": "*",
         "type": [
@@ -684,8 +773,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -707,6 +802,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -719,10 +817,18 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-HIVSupplementalTestCodeVS"
+            "reference": "http://standardhealthrecord.org/shr/lab/vs/HIVSupplementalTestCodeVS"
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -731,6 +837,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -742,7 +852,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -766,6 +876,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -781,20 +895,32 @@
         ]
       },
       {
-        "id": "Observation:shr-lab-HIVSupplementalTest.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-lab-HIVSupplementalTest.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -814,8 +940,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -829,6 +958,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -848,7 +981,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -900,6 +1033,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -919,8 +1056,8 @@
         "path": "Observation.value[x]",
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -933,6 +1070,9 @@
           {
             "code": "string"
           },
+          {
+            "code": "boolean"
+          },
           {
             "code": "Range"
           },
@@ -960,6 +1100,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -967,6 +1115,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -975,7 +1127,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -988,6 +1140,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -995,6 +1153,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -1025,10 +1187,14 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-TestInterpretationVS"
+            "reference": "http://standardhealthrecord.org/shr/lab/vs/TestInterpretationVS"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1036,6 +1202,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1053,6 +1223,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -1068,8 +1242,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1081,10 +1254,14 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -1092,6 +1269,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1100,7 +1281,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1111,6 +1292,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1133,7 +1320,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1143,6 +1330,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1150,6 +1341,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1158,7 +1353,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1172,6 +1367,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1179,6 +1378,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1187,7 +1390,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "1",
@@ -1256,7 +1459,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1285,7 +1488,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1367,30 +1570,82 @@
         ]
       },
       {
-        "id": "Observation:shr-lab-HIVSupplementalTest.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-lab-HIVSupplementalTest.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-lab-HIVSupplementalTest.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1446,8 +1701,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1509,7 +1764,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1538,7 +1793,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1570,7 +1825,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1580,6 +1835,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1630,7 +1891,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1693,7 +1954,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1722,7 +1983,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1764,6 +2025,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1771,6 +2038,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1790,8 +2061,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1828,6 +2099,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1835,6 +2110,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1843,7 +2122,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1856,6 +2135,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1878,7 +2163,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1891,6 +2176,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1898,6 +2189,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1905,6 +2200,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1913,7 +2212,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1989,7 +2288,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-HIVSupplementalTestResultVS"
+            "reference": "http://standardhealthrecord.org/shr/lab/vs/HIVSupplementalTestResultVS"
           }
         }
       },
@@ -2026,36 +2325,56 @@
         "isSummary": false
       },
       {
-        "id": "Observation:shr-lab-HIVSupplementalTest.extension:testrequest",
-        "path": "Observation.extension",
-        "sliceName": "testrequest",
+        "id": "Observation:shr-lab-HIVSupplementalTest.modifierExtension:observationnonoccurrencemodifier",
+        "path": "Observation.modifierExtension",
+        "sliceName": "observationnonoccurrencemodifier",
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest-extension"
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-observation-ObservationNonOccurrenceModifier-extension"
           }
         ],
-        "mustSupport": false,
-        "isModifier": false,
+        "mustSupport": true,
+        "isModifier": true,
         "isSummary": false
       },
       {
-        "id": "Observation:shr-lab-HIVSupplementalTest.modifierExtension:observationnonoccurrencemodifier",
-        "path": "Observation.modifierExtension",
-        "sliceName": "observationnonoccurrencemodifier",
+        "id": "Observation:shr-lab-HIVSupplementalTest.basedOn",
+        "path": "Observation.basedOn",
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-observation-ObservationNonOccurrenceModifier-extension"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
           }
-        ],
-        "mustSupport": true,
-        "isModifier": true,
-        "isSummary": false
+        ]
       },
       {
         "id": "Observation:shr-lab-HIVSupplementalTest.category",
@@ -2079,7 +2398,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-HIVSupplementalTestCodeVS"
+            "reference": "http://standardhealthrecord.org/shr/lab/vs/HIVSupplementalTestCodeVS"
           }
         }
       },
@@ -2108,12 +2427,16 @@
         ]
       },
       {
-        "id": "Observation:shr-lab-HIVSupplementalTest.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-lab-HIVSupplementalTest.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
@@ -2170,7 +2493,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-TestInterpretationVS"
+            "reference": "http://standardhealthrecord.org/shr/lab/vs/TestInterpretationVS"
           }
         }
       },
@@ -2186,7 +2509,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-lab-HIVSupplementalTestRequest.json b/lib/resources/standard_health_record/StructureDefinition-shr-lab-HIVSupplementalTestRequest.json
old mode 100755
new mode 100644
index 186d5aa..66fc74e
--- a/lib/resources/standard_health_record/StructureDefinition-shr-lab-HIVSupplementalTestRequest.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-lab-HIVSupplementalTestRequest.json
@@ -3,7 +3,7 @@
   "id": "shr-lab-HIVSupplementalTestRequest",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR HIVSupplementalTestRequest Profile</b></p>\n  <p>A request for a confirmatory or additional test for HIV infection.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.lab.HIVSupplementalTestRequest maps to ProcedureRequest:\n  Entry.Author maps to orderer\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Reason maps to reason[x].CodeableConcept\n  OccurrenceTime maps to orderedOn   // could potentially map Entry.DateEntered to authoredOn\n  ActionCode maps to code\n  RequestStatus maps to status\n  RequestedPerformanceTime maps to scheduled[x]\n  PriorityOfRequest maps to priority\n  RequestedPerformer maps to performer\n  BodySite maps to bodySite\n  TBD &quot;Specimen&quot; maps to specimen\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR HIVSupplementalTestRequest Profile</b></p>\n  <p>A request for a confirmatory or additional test for HIV infection.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.lab.HIVSupplementalTestRequest maps to ProcedureRequest:\n  Entry.Author maps to requester.agent\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Reason maps to reasonCode\n  OccurrenceTime maps to authoredOn   // or could potentially map Entry.DateEntered to authoredOn\n  ActionCode maps to code\n  RequestNotToPerformActionModifier maps to doNotPerform\n  RequestStatus maps to status\n  RequestedPerformanceTime maps to occurrence[x]\n  PriorityOfRequest maps to priority\n  RequestedPerformerType maps to performerType\n  RequestedPerformer maps to performer\n  BodySite maps to bodySite\n  &lt;TBD &quot;Specimen&quot;&gt; maps to specimen\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-HIVSupplementalTestRequest",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.lab.HIVSupplementalTestRequest"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR HIVSupplementalTestRequest Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.706Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,10 +27,24 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.399Z",
   "description": "A request for a confirmatory or additional test for HIV infection.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "v2",
+      "uri": "http://hl7.org/v2",
+      "name": "HL7 v2 Mapping"
+    },
+    {
+      "identity": "rim",
+      "uri": "http://hl7.org/v3",
+      "name": "RIM Mapping"
+    },
     {
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
@@ -38,11 +54,6 @@
       "identity": "quick",
       "uri": "http://wiki.siframework.org/CQF",
       "name": "Quality Improvement and Clinical Knowledge (QUICK)"
-    },
-    {
-      "identity": "rim",
-      "uri": "http://hl7.org/v3",
-      "name": "RIM Mapping"
     }
   ],
   "kind": "resource",
@@ -57,6 +68,9 @@
         "path": "ProcedureRequest",
         "short": "SHR HIVSupplementalTestRequest Profile",
         "definition": "A request for a confirmatory or additional test for HIV infection.",
+        "alias": [
+          "diagnostic request"
+        ],
         "min": 0,
         "max": "*",
         "constraint": [
@@ -98,6 +112,18 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Request"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": "Act[moodCode<=INT]"
+          },
           {
             "identity": "w5",
             "map": "clinical.general"
@@ -109,7 +135,7 @@
         "path": "ProcedureRequest.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -148,7 +174,7 @@
         "path": "ProcedureRequest.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -169,7 +195,7 @@
         "path": "ProcedureRequest.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -189,6 +215,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -203,7 +237,7 @@
         "path": "ProcedureRequest.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -237,7 +271,7 @@
         "path": "ProcedureRequest.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -266,16 +300,19 @@
         "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.extension",
         "path": "ProcedureRequest.extension",
         "slicing": {
-          "id": "224",
+          "id": "214",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -304,6 +341,7 @@
         "path": "ProcedureRequest.extension",
         "sliceName": "participant",
         "definition": "A statement about an actor who did (or did not) participate in a certain task or activity. Unlike a HealthcareInvolvement which continues over period of time, the participant is associated with doing or not doing a specific task, such admitting a patient, performing a procedure, or taking a measurement.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -336,6 +374,7 @@
         "path": "ProcedureRequest.extension",
         "sliceName": "performerinstructions",
         "definition": "Information for the performer of the test, if needed.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -368,6 +407,7 @@
         "path": "ProcedureRequest.extension",
         "sliceName": "patientinstructions",
         "definition": "Information for the patient, such as, where to get the test, how to prepare for the test, etc.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -399,16 +439,19 @@
         "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.modifierExtension",
         "path": "ProcedureRequest.modifierExtension",
         "slicing": {
-          "id": "225",
+          "id": "215",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -438,6 +481,7 @@
         "path": "ProcedureRequest.modifierExtension",
         "sliceName": "nonoccurrencemodifier",
         "definition": "When true, indicates either that the event or action documented in the entry did not occur, or the the thing documented is absent or does not exist.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -465,43 +509,12 @@
           }
         ]
       },
-      {
-        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.modifierExtension:requestnottoperformactionmodifier",
-        "path": "ProcedureRequest.modifierExtension",
-        "sliceName": "requestnottoperformactionmodifier",
-        "definition": "If true, the thing requested should not take place. For example, a request to NOT elevate the head of a bed using the code for elevating the bed, and setting RequestNotToPerformActionModifier to true. Other examples include do not ambulate, do not flush NG tube, do not take blood pressure on a certain arm, etc. If the Request.code and RequestAgainstModifier both contain negation, that will reinforce the prohibition, and should not be interpreted as a double negative that equals a positive.",
-        "alias": [
-          "extensions",
-          "user content"
-        ],
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "DomainResource.modifierExtension",
-          "min": 0,
-          "max": "*"
-        },
-        "type": [
-          {
-            "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-RequestNotToPerformActionModifier-extension"
-          }
-        ],
-        "mustSupport": true,
-        "isModifier": true,
-        "isSummary": false,
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "N/A"
-          }
-        ]
-      },
       {
         "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.identifier",
         "path": "ProcedureRequest.identifier",
-        "short": "Unique identifier for the request",
-        "definition": "Identifiers assigned to this order by the order or by the receiver.",
+        "short": "Identifiers assigned to this order",
+        "definition": "Identifiers assigned to this order instance by the orderer and/or the receiver and/or order fulfiller.",
+        "comment": "The identifier.type element is used to distinguish between the identifiers assigned by the orderer (known as the 'Placer' in HL7 v2) and the producer of the observations in response to the order (known as the 'Filler' in HL7 v2).  For further discussion and examples see the resource notes section below.",
         "min": 0,
         "max": "*",
         "type": [
@@ -511,6 +524,18 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.identifier"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC.2, ORC.3"
+          },
+          {
+            "identity": "rim",
+            "map": ".identifier"
+          },
           {
             "identity": "quick",
             "map": "ClinicalStatement.identifier"
@@ -522,397 +547,1150 @@
         ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.subject",
-        "path": "ProcedureRequest.subject",
-        "short": "Who the procedure should be done to",
-        "definition": "The person, animal or group that should receive the procedure.",
-        "min": 1,
-        "max": "1",
+        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.definition",
+        "path": "ProcedureRequest.definition",
+        "short": "Protocol or definition",
+        "definition": "Protocol or definition followed by this request.",
+        "alias": [
+          "protocol"
+        ],
+        "min": 0,
+        "max": "*",
         "type": [
           {
             "code": "Reference",
-            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-demographics-PersonOfRecord"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ActivityDefinition"
           },
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Group"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/PlanDefinition"
           }
         ],
         "isSummary": true,
         "mapping": [
           {
-            "identity": "quick",
-            "map": "ClinicalStatement.subject"
+            "identity": "workflow",
+            "map": "Request.definition"
           },
           {
-            "identity": "w5",
-            "map": "who.focus"
+            "identity": "v2",
+            "map": "Varies by domain"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=DEFN].target"
           }
         ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.code",
-        "path": "ProcedureRequest.code",
-        "short": "What procedure to perform",
-        "definition": "The specific procedure that is ordered. Use text if the exact nature of the procedure cannot be coded.",
-        "min": 1,
-        "max": "1",
+        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.basedOn",
+        "path": "ProcedureRequest.basedOn",
+        "short": "What request fulfills",
+        "definition": "Plan/proposal/order fulfilled by this request.",
+        "alias": [
+          "fulfills"
+        ],
+        "min": 0,
+        "max": "*",
         "type": [
           {
-            "code": "CodeableConcept",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Resource"
           }
         ],
         "isSummary": true,
-        "binding": {
-          "strength": "required",
-          "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-HIVSupplementalTestCodeVS"
-          }
-        },
         "mapping": [
           {
-            "identity": "quick",
-            "map": "Procedure.procedureCode"
+            "identity": "workflow",
+            "map": "Request.basedOn"
           },
           {
-            "identity": "w5",
-            "map": "class"
+            "identity": "v2",
+            "map": "ORC.8 (plus others)"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
           }
         ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.bodySite",
-        "path": "ProcedureRequest.bodySite",
-        "short": "What part of body to perform on",
-        "definition": "Indicates the sites on the subject's body where the procedure should be performed (I.e. the target sites).",
-        "comments": "Only used if not implicit in the code found in ProcedureRequest.type.",
-        "requirements": "Knowing where the procedure is made is important for tracking if multiple sites are possible.",
+        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.replaces",
+        "path": "ProcedureRequest.replaces",
+        "short": "What request replaces",
+        "definition": "The request takes the place of the referenced completed or terminated request(s).",
         "min": 0,
-        "max": "1",
+        "max": "*",
         "type": [
           {
-            "code": "CodeableConcept",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Resource"
           }
         ],
         "isSummary": true,
-        "binding": {
-          "strength": "required",
-          "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
-          }
-        },
         "mapping": [
           {
-            "identity": "rim",
-            "map": "targetSiteCode"
+            "identity": "workflow",
+            "map": "Request.replaces"
           },
           {
-            "identity": "quick",
-            "map": "Procedure.targetBodySite"
+            "identity": "v2",
+            "map": "Handled by message location of ORC (ORC.1=RO or RU)"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=RPLC].target"
           }
         ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.reason[x]",
-        "path": "ProcedureRequest.reason[x]",
-        "short": "Why procedure should occur",
-        "definition": "The reason why the procedure is being proposed or ordered. This procedure request may be motivated by a Condition for instance.",
+        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.requisition",
+        "path": "ProcedureRequest.requisition",
+        "short": "Composite Request ID",
+        "definition": "A shared identifier common to all procedure or diagnostic requests that were authorized more or less simultaneously by a single author, representing the composite or group identifier.",
+        "comment": "Requests are linked either by a \"basedOn\" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation.",
+        "requirements": "Some business processes need to know if multiple items were ordered as part of the same \"requisition\" for billing or other purposes.",
+        "alias": [
+          "grouperId",
+          "groupIdentifier"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "CodeableConcept",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+            "code": "Identifier"
           }
         ],
         "isSummary": true,
-        "binding": {
-          "strength": "example",
-          "description": "A code that explains the reason why a procedure is  required.",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/procedure-reason"
-          }
-        },
         "mapping": [
           {
-            "identity": "quick",
-            "map": "Action.indication.reason"
+            "identity": "v2",
+            "map": "ORC.4"
+          },
+          {
+            "identity": "rim",
+            "map": ".inboundRelationship(typeCode=COMP].source[moodCode=INT].identifier"
           }
         ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.scheduled[x]",
-        "path": "ProcedureRequest.scheduled[x]",
-        "short": "When procedure should occur",
-        "definition": "The timing schedule for the proposed or ordered procedure. The Schedule data type allows many different expressions.  E.g. \"Every 8 hours\"; \"Three times a day\"; \"1/2 an hour before breakfast for 10 days from 23-Dec 2011:\"; \"15 Oct 2013, 17 Oct 2013 and 1 Nov 2013\".",
-        "min": 0,
+        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.status",
+        "path": "ProcedureRequest.status",
+        "short": "draft | active | suspended | completed | entered-in-error | cancelled",
+        "definition": "The status of the order.",
+        "comment": "The status is generally fully in the control of the requester - they determine whether the order is draft or active and, after it has been activated, competed, cancelled or suspended. States relating to the activities of the performer are reflected on either the corresponding event (see [Event Pattern](event.html) for general discussion) or using the [Task](task.html) resource.\n\nThis element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
+        "min": 1,
         "max": "1",
         "type": [
           {
-            "code": "dateTime"
-          },
-          {
-            "code": "Period"
-          },
-          {
-            "code": "Timing"
+            "code": "code"
           }
         ],
+        "isModifier": true,
         "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ProcedureRequestStatus"
+            }
+          ],
+          "strength": "required",
+          "description": "The status of a procedure or diagnostic order.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/request-status"
+          }
+        },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.status"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC.5"
+          },
+          {
+            "identity": "rim",
+            "map": ".status"
+          },
           {
             "identity": "quick",
-            "map": "Procedure.procedureSchedule"
+            "map": "Action.currentStatus"
           },
           {
             "identity": "w5",
-            "map": "when.planned"
+            "map": "status"
           }
         ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.encounter",
-        "path": "ProcedureRequest.encounter",
-        "short": "Encounter request created during",
-        "definition": "The encounter within which the procedure proposal or request was created.",
-        "min": 0,
+        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.intent",
+        "path": "ProcedureRequest.intent",
+        "short": "proposal | plan | order +",
+        "definition": "Whether the request is a proposal, plan, an original order or a reflex order.",
+        "comment": "This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.",
+        "min": 1,
         "max": "1",
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+            "code": "code"
           }
         ],
+        "isModifier": true,
         "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ProcedureRequestIntent"
+            }
+          ],
+          "strength": "required",
+          "description": "The kind of procedure or diagnostic request",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/request-intent"
+          }
+        },
         "mapping": [
           {
-            "identity": "quick",
-            "map": "ClinicalStatement.encounter"
+            "identity": "workflow",
+            "map": "Request.intent"
+          },
+          {
+            "identity": "v2",
+            "map": "N/A"
+          },
+          {
+            "identity": "rim",
+            "map": ".moodCode (nuances beyond PRP/PLAN/RQO would need to be elsewhere)"
           },
           {
             "identity": "w5",
-            "map": "context"
+            "map": "class"
           }
         ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.performer",
-        "path": "ProcedureRequest.performer",
-        "short": "Who should perform the procedure",
-        "definition": "For example, the surgeon, anaethetist, endoscopist, etc.",
+        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.priority",
+        "path": "ProcedureRequest.priority",
+        "short": "routine | urgent | asap | stat",
+        "definition": "Indicates how quickly the ProcedureRequest should be addressed with respect to other requests.",
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
-          },
+            "code": "code"
+          }
+        ],
+        "meaningWhenMissing": "If missing, this task should be performed with normal priority",
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ProcedureRequestPriority"
+            }
+          ],
+          "strength": "required",
+          "description": "Identifies the level of importance to be assigned to actioning the request",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/request-priority"
+          }
+        },
+        "mapping": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
+            "identity": "workflow",
+            "map": "Request.priority"
           },
           {
-            "code": "Reference",
-            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-demographics-PersonOfRecord"
+            "identity": "v2",
+            "map": "TQ1.9"
           },
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
-          }
-        ],
-        "isSummary": true,
-        "mapping": [
+            "identity": "rim",
+            "map": ".priorityCode"
+          },
           {
             "identity": "w5",
-            "map": "who.actor"
+            "map": "class"
           }
         ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.status",
-        "path": "ProcedureRequest.status",
-        "short": "proposed | draft | requested | received | accepted | in-progress | completed | suspended | rejected | aborted",
-        "definition": "The status of the order.",
-        "min": 1,
+        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.doNotPerform",
+        "path": "ProcedureRequest.doNotPerform",
+        "short": "True if procedure should not be performed",
+        "definition": "Set this to true if the record is saying that the procedure should NOT be performed.",
+        "comment": "This element is labeled as a [modifier](conformance-rules.html#isModifier.html) because it indicates that a procedure shouldn't happen, instead of a request for it to happen.  In general, only the code and timeframe will be present, though occasional additional qualifiers such as body site or even performer could be included to narrow the scope of the prohibition.  If the ProcedureRequest.code and ProcedureRequest.doNotPerform both contain negation, that will reinforce prohibition and should not have a double negative interpretation.",
+        "requirements": "Used for do not ambulate, do not elevate head of bed, do not flush NG tube, do not take blood pressure on a certain arm, etc.",
+        "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "code"
+            "code": "boolean"
           }
         ],
+        "defaultValueBoolean": false,
         "isModifier": true,
         "isSummary": true,
-        "binding": {
-          "strength": "required",
-          "description": "The status of the request.",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/procedure-request-status"
-          }
-        },
         "mapping": [
           {
-            "identity": "quick",
-            "map": "Action.currentStatus"
-          },
-          {
-            "identity": "w5",
-            "map": "status"
+            "identity": "rim",
+            "map": ".actionNegationInd"
           }
         ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.supportingInfo",
-        "path": "ProcedureRequest.supportingInfo",
-        "short": "Extra information to use in performing request",
-        "definition": "Information that may be needed by/relevant to the performer in their execution of this request.",
+        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.category",
+        "path": "ProcedureRequest.category",
+        "short": "Classification of procedure",
+        "definition": "A code that classifies the procedure for searching, sorting and display purposes (e.g. \"Surgical Procedure\").",
+        "comment": "There may be multiple axis of categorization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what procedure request are retrieved and displayed.",
         "min": 0,
         "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ProcedureRequestCategory"
+            }
+          ],
+          "strength": "example",
+          "description": "Classification of the procedure",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/procedure-category"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=\"COMP].target[classCode=\"LIST\", moodCode=\"INT\"].code"
+          },
+          {
+            "identity": "w5",
+            "map": "class"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.code",
+        "path": "ProcedureRequest.code",
+        "short": "What is being requested/ordered",
+        "definition": "A code that identifies a particular procedure, diagnostic investigation, or panel of investigations, that have been requested.",
+        "comment": "Many laboratory and radiology procedure codes embed the specimen/organ system in the test ordeer name, for example,  serum or serum/plasma glucose, or a chest xray. The specimen may not be recorded separately from the test code.",
+        "min": 1,
+        "max": "1",
+        "type": [
+          {
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "strength": "required",
+          "valueSetReference": {
+            "reference": "http://standardhealthrecord.org/shr/lab/vs/HIVSupplementalTestCodeVS"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.code"
+          },
+          {
+            "identity": "v2",
+            "map": "Varies by domain"
+          },
+          {
+            "identity": "rim",
+            "map": ".code"
+          },
+          {
+            "identity": "quick",
+            "map": "Procedure.procedureCode"
+          },
+          {
+            "identity": "w5",
+            "map": "what"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.subject",
+        "path": "ProcedureRequest.subject",
+        "short": "Individual the service is ordered for",
+        "definition": "On whom or what the procedure or diagnostic is to be performed. This is usually a human patient, but can also be requested on animals, groups of humans or animals, devices such as dialysis machines, or even locations (typically for environmental scans).",
+        "min": 1,
+        "max": "1",
         "type": [
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Resource"
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-demographics-PersonOfRecord"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Group"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Location"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Device"
           }
         ],
-        "isSummary": true
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.subject"
+          },
+          {
+            "identity": "v2",
+            "map": "Accompanying PID segment"
+          },
+          {
+            "identity": "rim",
+            "map": ".participation[typeCode=SBJ].role"
+          },
+          {
+            "identity": "quick",
+            "map": "ClinicalStatement.subject"
+          },
+          {
+            "identity": "w5",
+            "map": "who.focus"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.context",
+        "path": "ProcedureRequest.context",
+        "short": "Encounter or Episode during which request was created",
+        "definition": "An encounter or episode of care that provides additional information about the healthcare context in which this request is made.",
+        "alias": [
+          "encounter"
+        ],
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.context"
+          },
+          {
+            "identity": "v2",
+            "map": "Accompanying PV1"
+          },
+          {
+            "identity": "rim",
+            "map": ".inboundRelationship(typeCode=COMP].source[classCode<=PCPR, moodCode=EVN]"
+          },
+          {
+            "identity": "quick",
+            "map": "ClinicalStatement.encounter"
+          },
+          {
+            "identity": "w5",
+            "map": "context"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.occurrence[x]",
+        "path": "ProcedureRequest.occurrence[x]",
+        "short": "When procedure should occur",
+        "definition": "The date/time at which the diagnostic testing should occur.",
+        "alias": [
+          "schedule"
+        ],
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "dateTime"
+          },
+          {
+            "code": "Period"
+          },
+          {
+            "code": "Timing"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.occurrence[x]"
+          },
+          {
+            "identity": "v2",
+            "map": "Accompanying TQ1/TQ2 segments"
+          },
+          {
+            "identity": "rim",
+            "map": ".effectiveTime"
+          },
+          {
+            "identity": "quick",
+            "map": "Procedure.procedureSchedule"
+          },
+          {
+            "identity": "w5",
+            "map": "when.planned"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.asNeeded[x]",
+        "path": "ProcedureRequest.asNeeded[x]",
+        "short": "Preconditions for procedure or diagnostic",
+        "definition": "If a CodeableConcept is present, it indicates the pre-condition for performing the procedure.  For example \"pain\", \"on flare-up\", etc.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "boolean"
+          },
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ProcedureAsNeededReason"
+            }
+          ],
+          "strength": "example",
+          "description": "A coded concept identifying the pre-condition that should hold prior to performing a procedure.  For example \"pain\", \"on flare-up\", etc.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/medication-as-needed-reason"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "boolean: precondition.negationInd (inversed - so negationInd = true means asNeeded=false CodeableConcept: precondition.observationEventCriterion[code=\"Assertion\"].value"
+          },
+          {
+            "identity": "quick",
+            "map": "Proposal.prnReason.reason"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.authoredOn",
+        "path": "ProcedureRequest.authoredOn",
+        "short": "Date request signed",
+        "definition": "When the request transitioned to being actionable.",
+        "alias": [
+          "orderedOn"
+        ],
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "dateTime"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.authoredOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC.9"
+          },
+          {
+            "identity": "rim",
+            "map": ".participation[typeCode=AUT].time"
+          },
+          {
+            "identity": "quick",
+            "map": "Proposal.proposedAtTime"
+          },
+          {
+            "identity": "w5",
+            "map": "when.recorded"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.requester",
+        "path": "ProcedureRequest.requester",
+        "short": "Who/what is requesting procedure or diagnostic",
+        "definition": "The individual who initiated the request and has responsibility for its activation.",
+        "comment": "This not the dispatcher, but rather who is the authorizer.",
+        "alias": [
+          "author",
+          "orderer"
+        ],
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "BackboneElement"
+          }
+        ],
+        "constraint": [
+          {
+            "key": "ele-1",
+            "severity": "error",
+            "human": "All FHIR elements must have a @value or children",
+            "expression": "children().count() > id.count()",
+            "xpath": "@value|f:*|h:div",
+            "source": "Element"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.requester"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC.12"
+          },
+          {
+            "identity": "rim",
+            "map": ".participation[typeCode=AUT].role"
+          },
+          {
+            "identity": "quick",
+            "map": "ClinicalStatement.statementAuthor"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.requester.id",
+        "path": "ProcedureRequest.requester.id",
+        "representation": [
+          "xmlAttr"
+        ],
+        "short": "xml:id (or equivalent in JSON)",
+        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Element.id",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.requester.extension",
+        "path": "ProcedureRequest.requester.extension",
+        "short": "Additional Content defined by implementations",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "Element.extension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.notes",
-        "path": "ProcedureRequest.notes",
-        "short": "Additional information about desired procedure",
-        "definition": "Any other notes associated with this proposal or order - e.g. provider instructions.",
+        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.requester.modifierExtension",
+        "path": "ProcedureRequest.requester.modifierExtension",
+        "short": "Extensions that cannot be ignored",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content",
+          "modifiers"
+        ],
         "min": 0,
         "max": "*",
+        "base": {
+          "path": "BackboneElement.modifierExtension",
+          "min": 0,
+          "max": "*"
+        },
         "type": [
           {
-            "code": "Annotation"
+            "code": "Extension"
+          }
+        ],
+        "isModifier": true,
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "N/A"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.requester.agent",
+        "path": "ProcedureRequest.requester.agent",
+        "short": "Individual making the request",
+        "definition": "The device, practitioner or organization who initiated the request.",
+        "min": 1,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Device"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-actor-Practitioner"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.requester.agent"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC.12"
+          },
+          {
+            "identity": "rim",
+            "map": ".player"
+          },
+          {
+            "identity": "quick",
+            "map": "ClinicalStatement.statementAuthor"
+          },
+          {
+            "identity": "w5",
+            "map": "who.author"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.requester.onBehalfOf",
+        "path": "ProcedureRequest.requester.onBehalfOf",
+        "short": "Organization agent is acting for",
+        "definition": "The organization the device or practitioner was acting on behalf of.",
+        "requirements": "Practitioners and Devices can be associated with multiple organizations.  This element indicates which organization they were acting on behalf of when authoring the request.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.requester.onBehalfOf"
+          },
+          {
+            "identity": "v2",
+            "map": "N/A"
+          },
+          {
+            "identity": "rim",
+            "map": ".scoper"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.performerType",
+        "path": "ProcedureRequest.performerType",
+        "short": "Performer role",
+        "definition": "Desired type of performer for doing the diagnostic testing.",
+        "comment": "this is a  role, not  a participation type.  I.e. does not describe the task, but describes the capacity.  For example, “compounding pharmacy” or “psychiatrist” or “internal referral”.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ProcedureRequestParticipantRole"
+            }
+          ],
+          "strength": "example",
+          "description": "Indicates specific responsibility of an individual within the care team, such as \"Primary physician\", \"Team coordinator\", \"Caregiver\", etc.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/participant-role"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.performerType"
+          },
+          {
+            "identity": "v2",
+            "map": "PRT"
+          },
+          {
+            "identity": "rim",
+            "map": ".participation[typeCode=PRF].role[scoper.determinerCode=KIND].code"
+          },
+          {
+            "identity": "w5",
+            "map": "who.actor"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.performer",
+        "path": "ProcedureRequest.performer",
+        "short": "Requested perfomer",
+        "definition": "The desired perfomer for doing the diagnostic testing.  For example, the surgeon, dermatopathologist, endoscopist, etc.",
+        "comment": "If needed, use an [extension](extensibility.html) for listing alternative performers and/or roles and/or preference.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-demographics-PersonOfRecord"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Device"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/HealthcareService"
           }
         ],
         "isSummary": true,
         "mapping": [
           {
-            "identity": "quick",
-            "map": "ClinicalStatement.additionalText"
+            "identity": "workflow",
+            "map": "Request.Performer"
+          },
+          {
+            "identity": "v2",
+            "map": "PRT"
+          },
+          {
+            "identity": "rim",
+            "map": ".participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]"
+          },
+          {
+            "identity": "w5",
+            "map": "who.actor"
           }
         ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.asNeeded[x]",
-        "path": "ProcedureRequest.asNeeded[x]",
-        "short": "Preconditions for procedure",
-        "definition": "If a CodeableConcept is present, it indicates the pre-condition for performing the procedure.",
+        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.reasonCode",
+        "path": "ProcedureRequest.reasonCode",
+        "short": "Explanation/Justification for test",
+        "definition": "An explanation or justification for why this diagnostic investigation is being requested in coded or textual form.   This is often for billing purposes.  May relate to the resources referred to in supportingInformation.",
+        "comment": "This may be used to decide how the diagnostic investigation will be performed, or even if it will be performed at all.   Use CodeableConcept text element if the data is free (uncoded) text as shown in the [CT Scan example](procedurerequest-example-di.html).",
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "boolean"
-          },
-          {
-            "code": "CodeableConcept"
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
           }
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ProcedureRequestReason"
+            }
+          ],
           "strength": "example",
-          "description": "A coded concept identifying the pre-condition that should hold prior to performing a procedure.  For example \"pain\", \"on flare-up\", etc."
+          "description": "Diagnosis or problem codes justifying the reason for requesting the procedure or diagnostic investigation.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/procedure-reason"
+          }
         },
         "mapping": [
           {
-            "identity": "quick",
-            "map": "Proposal.prnReason.reason"
+            "identity": "workflow",
+            "map": "Request.reasonCod"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC.16"
+          },
+          {
+            "identity": "rim",
+            "map": ".reasonCode"
+          },
+          {
+            "identity": "w5",
+            "map": "why"
           }
         ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.orderedOn",
-        "path": "ProcedureRequest.orderedOn",
-        "short": "When request was created",
-        "definition": "The time when the request was made.",
+        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.reasonReference",
+        "path": "ProcedureRequest.reasonReference",
+        "short": "Explanation/Justification for test",
+        "definition": "Indicates another resource that provides a justification for why this diagnostic investigation is being requested.   May relate to the resources referred to in supportingInformation.",
+        "comment": "This may be used to decide how the diagnostic investigation will be performed, or even if it will be performed at all.   Use CodeableConcept text element if the data is free (uncoded) text as shown in the [CT Scan example](procedurerequest-example-di.html).",
         "min": 0,
-        "max": "1",
+        "max": "*",
         "type": [
           {
-            "code": "dateTime"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Condition"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Observation"
           }
         ],
         "isSummary": true,
         "mapping": [
           {
-            "identity": "quick",
-            "map": "Proposal.proposedAtTime"
+            "identity": "workflow",
+            "map": "Request.reasonReference"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC.16"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=RSON].target"
           },
           {
             "identity": "w5",
-            "map": "when.recorded"
+            "map": "why"
           }
         ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.orderer",
-        "path": "ProcedureRequest.orderer",
-        "short": "Who made request",
-        "definition": "The healthcare professional responsible for proposing or ordering the procedure.",
+        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.supportingInfo",
+        "path": "ProcedureRequest.supportingInfo",
+        "short": "Additional clinical information",
+        "definition": "Additional clinical information about the patient or specimen that may influence the procedure or diagnostics or their interpretations.     This information includes diagnosis, clinical findings and other observations.  In laboratory ordering these are typically referred to as \"ask at order entry questions (AOEs)\".  This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example,  reporting the amount of inspired oxygen for blood gas measurements.",
+        "alias": [
+          "Ask at order entry question",
+          "AOE"
+        ],
         "min": 0,
-        "max": "1",
+        "max": "*",
         "type": [
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
-          },
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Resource"
+          }
+        ],
+        "mapping": [
           {
-            "code": "Reference",
-            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-demographics-PersonOfRecord"
+            "identity": "workflow",
+            "map": "Request.supportingInformation"
           },
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
+            "identity": "v2",
+            "map": "Accompanying segments"
           },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=PERT].target"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.specimen",
+        "path": "ProcedureRequest.specimen",
+        "short": "Procedure Samples",
+        "definition": "One or more specimens that the laboratory procedure will use.",
+        "comment": "Many diagnostic procedures need a specimen, but the request itself is not actually about the specimen. This element is for when the diagnostic is requested on already existing specimens and the request points to the specimen it applies to.    Conversely, If the request is entered first with an unknown specimen, The [Specimen](specimen.html) resource references to the ProcedureRequest.",
+        "min": 0,
+        "max": "*",
+        "type": [
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Device"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Specimen"
           }
         ],
         "isSummary": true,
         "mapping": [
           {
-            "identity": "quick",
-            "map": "ClinicalStatement.statementAuthor"
+            "identity": "v2",
+            "map": "SPM"
           },
           {
-            "identity": "w5",
-            "map": "who.author"
+            "identity": "rim",
+            "map": ".participation[typeCode=SPC].role"
           }
         ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.priority",
-        "path": "ProcedureRequest.priority",
-        "short": "routine | urgent | stat | asap",
-        "definition": "The clinical priority associated with this order.",
+        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.bodySite",
+        "path": "ProcedureRequest.bodySite",
+        "short": "Location on Body",
+        "definition": "Anatomic location where the procedure should be performed. This is the target site.",
+        "comment": "Only used if not implicit in the code found in ProcedureRequest.type.  If the use case requires BodySite to be handled as a separate resource instead of an inline coded element (e.g. to identify and track separately)  then use the standard extension [procedurerequest-targetBodySite](extension-procedurerequest-targetbodysite.html).",
+        "requirements": "Knowing where the procedure is performed is important for tracking if multiple sites are possible.",
+        "alias": [
+          "location"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "code"
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
           }
         ],
         "isSummary": true,
         "binding": {
           "strength": "required",
-          "description": "The priority of the request.",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/procedure-request-priority"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
           }
         },
         "mapping": [
+          {
+            "identity": "v2",
+            "map": "SPM"
+          },
+          {
+            "identity": "rim",
+            "map": "targetSiteCode"
+          },
           {
             "identity": "quick",
-            "map": "Proposal.urgency"
+            "map": "Procedure.targetBodySite"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.note",
+        "path": "ProcedureRequest.note",
+        "short": "Comments",
+        "definition": "Any other notes and comments made about the service request. For example, letting provider know that \"patient hates needles\" or other provider instructions.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Annotation"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.note"
           },
           {
-            "identity": "w5",
-            "map": "grade"
+            "identity": "v2",
+            "map": "NTE"
+          },
+          {
+            "identity": "rim",
+            "map": ".inboundRelationship(typeCode=SUBJ].source[classCode=ANNGEN, moodCode=EVN].value[xsi:type=ST]"
+          },
+          {
+            "identity": "quick",
+            "map": "ClinicalStatement.additionalText"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.relevantHistory",
+        "path": "ProcedureRequest.relevantHistory",
+        "short": "Request provenance",
+        "definition": "Key events in the history of the request.",
+        "comment": "This may not include provenances for all versions of the request – only those deemed “relevant” or important.\rThis SHALL NOT include the Provenance associated with this current version of the resource.  (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update.  Until then, it can be queried directly as the Provenance that points to this version using _revinclude\rAll Provenances should have some historical version of this Request as their subject.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Provenance"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.relevantHistory"
+          },
+          {
+            "identity": "v2",
+            "map": "N/A"
+          },
+          {
+            "identity": "rim",
+            "map": ".inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]"
           }
         ]
       }
@@ -991,20 +1769,20 @@
         "isSummary": false
       },
       {
-        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.modifierExtension:requestnottoperformactionmodifier",
-        "path": "ProcedureRequest.modifierExtension",
-        "sliceName": "requestnottoperformactionmodifier",
-        "min": 0,
-        "max": "1",
+        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.code",
+        "path": "ProcedureRequest.code",
         "type": [
           {
-            "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-RequestNotToPerformActionModifier-extension"
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
           }
         ],
-        "mustSupport": true,
-        "isModifier": true,
-        "isSummary": false
+        "binding": {
+          "strength": "required",
+          "valueSetReference": {
+            "reference": "http://standardhealthrecord.org/shr/lab/vs/HIVSupplementalTestCodeVS"
+          }
+        }
       },
       {
         "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.subject",
@@ -1017,60 +1795,50 @@
           {
             "code": "Reference",
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/Group"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Location"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Device"
           }
         ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.code",
-        "path": "ProcedureRequest.code",
+        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.context",
+        "path": "ProcedureRequest.context",
         "type": [
           {
-            "code": "CodeableConcept",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
-          }
-        ],
-        "binding": {
-          "strength": "required",
-          "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-HIVSupplementalTestCodeVS"
-          }
-        }
-      },
-      {
-        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.bodySite",
-        "path": "ProcedureRequest.bodySite",
-        "min": 0,
-        "max": "1",
-        "type": [
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
           {
-            "code": "CodeableConcept",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
-          }
-        ],
-        "binding": {
-          "strength": "required",
-          "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
-        }
+        ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.reason[x]",
-        "path": "ProcedureRequest.reason[x]",
-        "type": [
-          {
-            "code": "CodeableConcept",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
-          }
-        ]
+        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.requester",
+        "path": "ProcedureRequest.requester"
       },
       {
-        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.encounter",
-        "path": "ProcedureRequest.encounter",
+        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.requester.agent",
+        "path": "ProcedureRequest.requester.agent",
         "type": [
           {
             "code": "Reference",
-            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Device"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-actor-Practitioner"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
           }
         ]
       },
@@ -1090,39 +1858,49 @@
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-demographics-PersonOfRecord"
           },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Device"
+          },
           {
             "code": "Reference",
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/HealthcareService"
           }
         ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.status",
-        "path": "ProcedureRequest.status",
-        "min": 1,
-        "max": "1"
+        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.reasonCode",
+        "path": "ProcedureRequest.reasonCode",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+          }
+        ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.orderer",
-        "path": "ProcedureRequest.orderer",
+        "id": "ProcedureRequest:shr-lab-HIVSupplementalTestRequest.bodySite",
+        "path": "ProcedureRequest.bodySite",
+        "min": 0,
+        "max": "1",
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
-          },
-          {
-            "code": "Reference",
-            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-demographics-PersonOfRecord"
-          },
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
-          },
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Device"
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
           }
-        ]
+        ],
+        "binding": {
+          "strength": "required",
+          "valueSetReference": {
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
+          }
+        }
       }
     ]
   }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-lab-Test-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-lab-Test-extension.json
old mode 100755
new mode 100644
index 8971fa0..3e1934a
--- a/lib/resources/standard_health_record/StructureDefinition-shr-lab-Test-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-lab-Test-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.lab.Test"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Test Extension",
   "title": "SHR Test Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.040Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.006Z",
   "description": "A laboratory, radiologic, or other clinical test or measurement used to determine the presence, absence, or degree of a condition, or assess the function or health of an individual. This includes patient-generated data, such as pedometer readings.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-lab-Test.json b/lib/resources/standard_health_record/StructureDefinition-shr-lab-Test.json
old mode 100755
new mode 100644
index 7374ee6..018d7b8
--- a/lib/resources/standard_health_record/StructureDefinition-shr-lab-Test.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-lab-Test.json
@@ -3,7 +3,7 @@
   "id": "shr-lab-Test",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR Test Profile</b></p>\n  <p>A laboratory, radiologic, or other clinical test or measurement used to determine the presence, absence, or degree of a condition, or assess the function or health of an individual. This includes patient-generated data, such as pedometer readings.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.lab.Test maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  BodySite maps to bodySite\n  BodyPosition maps to http://hl7.org/fhir/StructureDefinition/observation-bodyPosition\n  Device maps to device\n  TBD &quot;Specimen&quot; maps to specimen\n  Interpretation maps to interpretation\n  ReferenceRange maps to referenceRange\n  ChangeFlag maps to http://hl7.org/fhir/StructureDefinition/observation-delta\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR Test Profile</b></p>\n  <p>A laboratory, radiologic, or other clinical test or measurement used to determine the presence, absence, or degree of a condition, or assess the function or health of an individual. This includes patient-generated data, such as pedometer readings.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.lab.Test maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  BodySite maps to bodySite\n  BodyPosition maps to http://hl7.org/fhir/StructureDefinition/observation-bodyPosition\n  Device maps to device\n  &lt;TBD &quot;Specimen&quot;&gt; maps to specimen\n  Interpretation maps to interpretation\n  ReferenceRange maps to referenceRange\n  ChangeFlag maps to http://hl7.org/fhir/StructureDefinition/observation-delta\n  TestRequest maps to basedOn\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-Test",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.lab.Test"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Test Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.560Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.373Z",
   "description": "A laboratory, radiologic, or other clinical test or measurement used to determine the presence, absence, or degree of a condition, or assess the function or health of an individual. This includes patient-generated data, such as pedometer readings.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR Test Profile",
         "definition": "A laboratory, radiologic, or other clinical test or measurement used to determine the presence, absence, or degree of a condition, or assess the function or health of an individual. This includes patient-generated data, such as pedometer readings.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-lab-Test.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "213",
+          "id": "204",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "bodyposition",
         "definition": "The position or physical attitude of the body.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "changeflag",
         "definition": "Indicator of significant change (delta) from the last or previous measurement.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -398,6 +435,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -430,6 +468,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -457,52 +496,23 @@
           }
         ]
       },
-      {
-        "id": "Observation:shr-lab-Test.extension:testrequest",
-        "path": "Observation.extension",
-        "sliceName": "testrequest",
-        "definition": "A record of a request (order) for a test to be performed.",
-        "alias": [
-          "extensions",
-          "user content"
-        ],
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "DomainResource.extension",
-          "min": 0,
-          "max": "*"
-        },
-        "type": [
-          {
-            "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest-extension"
-          }
-        ],
-        "mustSupport": false,
-        "isModifier": false,
-        "isSummary": false,
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "N/A"
-          }
-        ]
-      },
       {
         "id": "Observation:shr-lab-Test.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "214",
+          "id": "205",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -532,6 +542,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -562,8 +573,8 @@
       {
         "id": "Observation:shr-lab-Test.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -572,7 +583,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -587,6 +603,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-lab-Test.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-lab-Test.status",
         "extension": [
@@ -598,6 +671,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -609,6 +683,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -616,6 +696,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -635,8 +723,8 @@
         "path": "Observation.category",
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 0,
         "max": "*",
         "type": [
@@ -646,8 +734,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -669,6 +763,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -679,6 +776,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -686,6 +789,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -694,6 +805,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -705,7 +820,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -729,6 +844,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -744,20 +863,32 @@
         ]
       },
       {
-        "id": "Observation:shr-lab-Test.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-lab-Test.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -777,8 +908,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -792,6 +926,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -811,7 +949,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -863,6 +1001,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -882,8 +1024,8 @@
         "path": "Observation.value[x]",
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -896,6 +1038,9 @@
           {
             "code": "string"
           },
+          {
+            "code": "boolean"
+          },
           {
             "code": "Range"
           },
@@ -923,6 +1068,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -930,6 +1083,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -938,7 +1095,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -951,6 +1108,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -958,6 +1121,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -988,10 +1155,14 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-TestInterpretationVS"
+            "reference": "http://standardhealthrecord.org/shr/lab/vs/TestInterpretationVS"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -999,6 +1170,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1016,6 +1191,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -1031,8 +1210,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1044,10 +1222,14 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -1055,6 +1237,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1063,7 +1249,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1074,6 +1260,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1096,7 +1288,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1106,6 +1298,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1113,6 +1309,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1121,7 +1321,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1135,6 +1335,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1142,6 +1346,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1150,7 +1358,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "1",
@@ -1219,7 +1427,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1248,7 +1456,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1330,30 +1538,82 @@
         ]
       },
       {
-        "id": "Observation:shr-lab-Test.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-lab-Test.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-lab-Test.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1409,8 +1669,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1472,7 +1732,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1501,7 +1761,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1533,7 +1793,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1543,6 +1803,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1593,7 +1859,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1656,7 +1922,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1685,7 +1951,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1727,6 +1993,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1734,6 +2006,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1753,8 +2029,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1791,6 +2067,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1798,6 +2078,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1806,7 +2090,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1819,6 +2103,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1841,7 +2131,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1854,6 +2144,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1861,6 +2157,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1868,6 +2168,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1876,7 +2180,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1967,36 +2271,56 @@
         "isSummary": false
       },
       {
-        "id": "Observation:shr-lab-Test.extension:testrequest",
-        "path": "Observation.extension",
-        "sliceName": "testrequest",
+        "id": "Observation:shr-lab-Test.modifierExtension:observationnonoccurrencemodifier",
+        "path": "Observation.modifierExtension",
+        "sliceName": "observationnonoccurrencemodifier",
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest-extension"
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-observation-ObservationNonOccurrenceModifier-extension"
           }
         ],
-        "mustSupport": false,
-        "isModifier": false,
+        "mustSupport": true,
+        "isModifier": true,
         "isSummary": false
       },
       {
-        "id": "Observation:shr-lab-Test.modifierExtension:observationnonoccurrencemodifier",
-        "path": "Observation.modifierExtension",
-        "sliceName": "observationnonoccurrencemodifier",
+        "id": "Observation:shr-lab-Test.basedOn",
+        "path": "Observation.basedOn",
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-observation-ObservationNonOccurrenceModifier-extension"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
           }
-        ],
-        "mustSupport": true,
-        "isModifier": true,
-        "isSummary": false
+        ]
       },
       {
         "id": "Observation:shr-lab-Test.category",
@@ -2043,12 +2367,16 @@
         ]
       },
       {
-        "id": "Observation:shr-lab-Test.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-lab-Test.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
@@ -2105,7 +2433,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-TestInterpretationVS"
+            "reference": "http://standardhealthrecord.org/shr/lab/vs/TestInterpretationVS"
           }
         }
       },
@@ -2121,7 +2449,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-lab-TestRequest.json b/lib/resources/standard_health_record/StructureDefinition-shr-lab-TestRequest.json
old mode 100755
new mode 100644
index 9c1a5c5..18fd6c8
--- a/lib/resources/standard_health_record/StructureDefinition-shr-lab-TestRequest.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-lab-TestRequest.json
@@ -3,7 +3,7 @@
   "id": "shr-lab-TestRequest",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR TestRequest Profile</b></p>\n  <p>A record of a request (order) for a test to be performed.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.lab.TestRequest maps to ProcedureRequest:\n  Entry.Author maps to orderer\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Reason maps to reason[x].CodeableConcept\n  OccurrenceTime maps to orderedOn   // could potentially map Entry.DateEntered to authoredOn\n  ActionCode maps to code\n  RequestStatus maps to status\n  RequestedPerformanceTime maps to scheduled[x]\n  PriorityOfRequest maps to priority\n  RequestedPerformer maps to performer\n  BodySite maps to bodySite\n  TBD &quot;Specimen&quot; maps to specimen\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR TestRequest Profile</b></p>\n  <p>A record of a request (order) for a test to be performed.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.lab.TestRequest maps to ProcedureRequest:\n  Entry.Author maps to requester.agent\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Reason maps to reasonCode\n  OccurrenceTime maps to authoredOn   // or could potentially map Entry.DateEntered to authoredOn\n  ActionCode maps to code\n  RequestNotToPerformActionModifier maps to doNotPerform\n  RequestStatus maps to status\n  RequestedPerformanceTime maps to occurrence[x]\n  PriorityOfRequest maps to priority\n  RequestedPerformerType maps to performerType\n  RequestedPerformer maps to performer\n  BodySite maps to bodySite\n  &lt;TBD &quot;Specimen&quot;&gt; maps to specimen\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.lab.TestRequest"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR TestRequest Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.592Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,10 +27,24 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.376Z",
   "description": "A record of a request (order) for a test to be performed.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "v2",
+      "uri": "http://hl7.org/v2",
+      "name": "HL7 v2 Mapping"
+    },
+    {
+      "identity": "rim",
+      "uri": "http://hl7.org/v3",
+      "name": "RIM Mapping"
+    },
     {
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
@@ -38,11 +54,6 @@
       "identity": "quick",
       "uri": "http://wiki.siframework.org/CQF",
       "name": "Quality Improvement and Clinical Knowledge (QUICK)"
-    },
-    {
-      "identity": "rim",
-      "uri": "http://hl7.org/v3",
-      "name": "RIM Mapping"
     }
   ],
   "kind": "resource",
@@ -57,6 +68,9 @@
         "path": "ProcedureRequest",
         "short": "SHR TestRequest Profile",
         "definition": "A record of a request (order) for a test to be performed.",
+        "alias": [
+          "diagnostic request"
+        ],
         "min": 0,
         "max": "*",
         "constraint": [
@@ -98,6 +112,18 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Request"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": "Act[moodCode<=INT]"
+          },
           {
             "identity": "w5",
             "map": "clinical.general"
@@ -109,7 +135,7 @@
         "path": "ProcedureRequest.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -148,7 +174,7 @@
         "path": "ProcedureRequest.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -169,7 +195,7 @@
         "path": "ProcedureRequest.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -189,6 +215,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -203,7 +237,7 @@
         "path": "ProcedureRequest.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -237,7 +271,7 @@
         "path": "ProcedureRequest.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -266,16 +300,19 @@
         "id": "ProcedureRequest:shr-lab-TestRequest.extension",
         "path": "ProcedureRequest.extension",
         "slicing": {
-          "id": "216",
+          "id": "206",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -304,6 +341,7 @@
         "path": "ProcedureRequest.extension",
         "sliceName": "participant",
         "definition": "A statement about an actor who did (or did not) participate in a certain task or activity. Unlike a HealthcareInvolvement which continues over period of time, the participant is associated with doing or not doing a specific task, such admitting a patient, performing a procedure, or taking a measurement.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -336,6 +374,7 @@
         "path": "ProcedureRequest.extension",
         "sliceName": "performerinstructions",
         "definition": "Information for the performer of the test, if needed.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -368,6 +407,7 @@
         "path": "ProcedureRequest.extension",
         "sliceName": "patientinstructions",
         "definition": "Information for the patient, such as, where to get the test, how to prepare for the test, etc.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -399,16 +439,19 @@
         "id": "ProcedureRequest:shr-lab-TestRequest.modifierExtension",
         "path": "ProcedureRequest.modifierExtension",
         "slicing": {
-          "id": "217",
+          "id": "207",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -438,6 +481,7 @@
         "path": "ProcedureRequest.modifierExtension",
         "sliceName": "nonoccurrencemodifier",
         "definition": "When true, indicates either that the event or action documented in the entry did not occur, or the the thing documented is absent or does not exist.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -466,453 +510,1187 @@
         ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-TestRequest.modifierExtension:requestnottoperformactionmodifier",
-        "path": "ProcedureRequest.modifierExtension",
-        "sliceName": "requestnottoperformactionmodifier",
-        "definition": "If true, the thing requested should not take place. For example, a request to NOT elevate the head of a bed using the code for elevating the bed, and setting RequestNotToPerformActionModifier to true. Other examples include do not ambulate, do not flush NG tube, do not take blood pressure on a certain arm, etc. If the Request.code and RequestAgainstModifier both contain negation, that will reinforce the prohibition, and should not be interpreted as a double negative that equals a positive.",
-        "alias": [
-          "extensions",
-          "user content"
-        ],
+        "id": "ProcedureRequest:shr-lab-TestRequest.identifier",
+        "path": "ProcedureRequest.identifier",
+        "short": "Identifiers assigned to this order",
+        "definition": "Identifiers assigned to this order instance by the orderer and/or the receiver and/or order fulfiller.",
+        "comment": "The identifier.type element is used to distinguish between the identifiers assigned by the orderer (known as the 'Placer' in HL7 v2) and the producer of the observations in response to the order (known as the 'Filler' in HL7 v2).  For further discussion and examples see the resource notes section below.",
         "min": 0,
-        "max": "1",
-        "base": {
-          "path": "DomainResource.modifierExtension",
-          "min": 0,
-          "max": "*"
-        },
+        "max": "*",
         "type": [
           {
-            "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-RequestNotToPerformActionModifier-extension"
+            "code": "Identifier"
           }
         ],
-        "mustSupport": true,
-        "isModifier": true,
-        "isSummary": false,
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.identifier"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC.2, ORC.3"
+          },
           {
             "identity": "rim",
-            "map": "N/A"
+            "map": ".identifier"
+          },
+          {
+            "identity": "quick",
+            "map": "ClinicalStatement.identifier"
+          },
+          {
+            "identity": "w5",
+            "map": "id"
           }
         ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-TestRequest.identifier",
-        "path": "ProcedureRequest.identifier",
-        "short": "Unique identifier for the request",
-        "definition": "Identifiers assigned to this order by the order or by the receiver.",
+        "id": "ProcedureRequest:shr-lab-TestRequest.definition",
+        "path": "ProcedureRequest.definition",
+        "short": "Protocol or definition",
+        "definition": "Protocol or definition followed by this request.",
+        "alias": [
+          "protocol"
+        ],
         "min": 0,
         "max": "*",
         "type": [
           {
-            "code": "Identifier"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ActivityDefinition"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/PlanDefinition"
           }
         ],
         "isSummary": true,
         "mapping": [
           {
-            "identity": "quick",
-            "map": "ClinicalStatement.identifier"
+            "identity": "workflow",
+            "map": "Request.definition"
           },
           {
-            "identity": "w5",
-            "map": "id"
+            "identity": "v2",
+            "map": "Varies by domain"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=DEFN].target"
           }
         ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-TestRequest.subject",
-        "path": "ProcedureRequest.subject",
-        "short": "Who the procedure should be done to",
-        "definition": "The person, animal or group that should receive the procedure.",
-        "min": 1,
-        "max": "1",
+        "id": "ProcedureRequest:shr-lab-TestRequest.basedOn",
+        "path": "ProcedureRequest.basedOn",
+        "short": "What request fulfills",
+        "definition": "Plan/proposal/order fulfilled by this request.",
+        "alias": [
+          "fulfills"
+        ],
+        "min": 0,
+        "max": "*",
         "type": [
           {
             "code": "Reference",
-            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-demographics-PersonOfRecord"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Resource"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC.8 (plus others)"
           },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-TestRequest.replaces",
+        "path": "ProcedureRequest.replaces",
+        "short": "What request replaces",
+        "definition": "The request takes the place of the referenced completed or terminated request(s).",
+        "min": 0,
+        "max": "*",
+        "type": [
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Group"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Resource"
           }
         ],
         "isSummary": true,
         "mapping": [
           {
-            "identity": "quick",
-            "map": "ClinicalStatement.subject"
+            "identity": "workflow",
+            "map": "Request.replaces"
           },
           {
-            "identity": "w5",
-            "map": "who.focus"
+            "identity": "v2",
+            "map": "Handled by message location of ORC (ORC.1=RO or RU)"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=RPLC].target"
           }
         ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-TestRequest.code",
-        "path": "ProcedureRequest.code",
-        "short": "What procedure to perform",
-        "definition": "The specific procedure that is ordered. Use text if the exact nature of the procedure cannot be coded.",
-        "min": 1,
+        "id": "ProcedureRequest:shr-lab-TestRequest.requisition",
+        "path": "ProcedureRequest.requisition",
+        "short": "Composite Request ID",
+        "definition": "A shared identifier common to all procedure or diagnostic requests that were authorized more or less simultaneously by a single author, representing the composite or group identifier.",
+        "comment": "Requests are linked either by a \"basedOn\" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation.",
+        "requirements": "Some business processes need to know if multiple items were ordered as part of the same \"requisition\" for billing or other purposes.",
+        "alias": [
+          "grouperId",
+          "groupIdentifier"
+        ],
+        "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "CodeableConcept",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+            "code": "Identifier"
           }
         ],
         "isSummary": true,
-        "binding": {
-          "strength": "required",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/observation-codes"
-          }
-        },
         "mapping": [
           {
-            "identity": "quick",
-            "map": "Procedure.procedureCode"
+            "identity": "v2",
+            "map": "ORC.4"
           },
           {
-            "identity": "w5",
-            "map": "class"
+            "identity": "rim",
+            "map": ".inboundRelationship(typeCode=COMP].source[moodCode=INT].identifier"
           }
         ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-TestRequest.bodySite",
-        "path": "ProcedureRequest.bodySite",
-        "short": "What part of body to perform on",
-        "definition": "Indicates the sites on the subject's body where the procedure should be performed (I.e. the target sites).",
-        "comments": "Only used if not implicit in the code found in ProcedureRequest.type.",
-        "requirements": "Knowing where the procedure is made is important for tracking if multiple sites are possible.",
-        "min": 0,
+        "id": "ProcedureRequest:shr-lab-TestRequest.status",
+        "path": "ProcedureRequest.status",
+        "short": "draft | active | suspended | completed | entered-in-error | cancelled",
+        "definition": "The status of the order.",
+        "comment": "The status is generally fully in the control of the requester - they determine whether the order is draft or active and, after it has been activated, competed, cancelled or suspended. States relating to the activities of the performer are reflected on either the corresponding event (see [Event Pattern](event.html) for general discussion) or using the [Task](task.html) resource.\n\nThis element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
+        "min": 1,
         "max": "1",
         "type": [
           {
-            "code": "CodeableConcept",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+            "code": "code"
           }
         ],
+        "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ProcedureRequestStatus"
+            }
+          ],
           "strength": "required",
+          "description": "The status of a procedure or diagnostic order.",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
+            "reference": "http://hl7.org/fhir/ValueSet/request-status"
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.status"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC.5"
+          },
           {
             "identity": "rim",
-            "map": "targetSiteCode"
+            "map": ".status"
           },
           {
             "identity": "quick",
-            "map": "Procedure.targetBodySite"
+            "map": "Action.currentStatus"
+          },
+          {
+            "identity": "w5",
+            "map": "status"
           }
         ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-TestRequest.reason[x]",
-        "path": "ProcedureRequest.reason[x]",
-        "short": "Why procedure should occur",
-        "definition": "The reason why the procedure is being proposed or ordered. This procedure request may be motivated by a Condition for instance.",
-        "min": 0,
+        "id": "ProcedureRequest:shr-lab-TestRequest.intent",
+        "path": "ProcedureRequest.intent",
+        "short": "proposal | plan | order +",
+        "definition": "Whether the request is a proposal, plan, an original order or a reflex order.",
+        "comment": "This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.",
+        "min": 1,
         "max": "1",
         "type": [
           {
-            "code": "CodeableConcept",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+            "code": "code"
           }
         ],
+        "isModifier": true,
         "isSummary": true,
         "binding": {
-          "strength": "example",
-          "description": "A code that explains the reason why a procedure is  required.",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ProcedureRequestIntent"
+            }
+          ],
+          "strength": "required",
+          "description": "The kind of procedure or diagnostic request",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/procedure-reason"
+            "reference": "http://hl7.org/fhir/ValueSet/request-intent"
           }
         },
         "mapping": [
           {
-            "identity": "quick",
-            "map": "Action.indication.reason"
-          }
-        ]
-      },
-      {
-        "id": "ProcedureRequest:shr-lab-TestRequest.scheduled[x]",
-        "path": "ProcedureRequest.scheduled[x]",
-        "short": "When procedure should occur",
-        "definition": "The timing schedule for the proposed or ordered procedure. The Schedule data type allows many different expressions.  E.g. \"Every 8 hours\"; \"Three times a day\"; \"1/2 an hour before breakfast for 10 days from 23-Dec 2011:\"; \"15 Oct 2013, 17 Oct 2013 and 1 Nov 2013\".",
-        "min": 0,
-        "max": "1",
-        "type": [
-          {
-            "code": "dateTime"
+            "identity": "workflow",
+            "map": "Request.intent"
           },
           {
-            "code": "Period"
+            "identity": "v2",
+            "map": "N/A"
           },
           {
-            "code": "Timing"
-          }
-        ],
-        "isSummary": true,
-        "mapping": [
-          {
-            "identity": "quick",
-            "map": "Procedure.procedureSchedule"
+            "identity": "rim",
+            "map": ".moodCode (nuances beyond PRP/PLAN/RQO would need to be elsewhere)"
           },
           {
             "identity": "w5",
-            "map": "when.planned"
+            "map": "class"
           }
         ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-TestRequest.encounter",
-        "path": "ProcedureRequest.encounter",
-        "short": "Encounter request created during",
-        "definition": "The encounter within which the procedure proposal or request was created.",
+        "id": "ProcedureRequest:shr-lab-TestRequest.priority",
+        "path": "ProcedureRequest.priority",
+        "short": "routine | urgent | asap | stat",
+        "definition": "Indicates how quickly the ProcedureRequest should be addressed with respect to other requests.",
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+            "code": "code"
           }
         ],
+        "meaningWhenMissing": "If missing, this task should be performed with normal priority",
         "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ProcedureRequestPriority"
+            }
+          ],
+          "strength": "required",
+          "description": "Identifies the level of importance to be assigned to actioning the request",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/request-priority"
+          }
+        },
         "mapping": [
           {
-            "identity": "quick",
-            "map": "ClinicalStatement.encounter"
+            "identity": "workflow",
+            "map": "Request.priority"
+          },
+          {
+            "identity": "v2",
+            "map": "TQ1.9"
+          },
+          {
+            "identity": "rim",
+            "map": ".priorityCode"
           },
           {
             "identity": "w5",
-            "map": "context"
+            "map": "class"
           }
         ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-TestRequest.performer",
-        "path": "ProcedureRequest.performer",
-        "short": "Who should perform the procedure",
-        "definition": "For example, the surgeon, anaethetist, endoscopist, etc.",
+        "id": "ProcedureRequest:shr-lab-TestRequest.doNotPerform",
+        "path": "ProcedureRequest.doNotPerform",
+        "short": "True if procedure should not be performed",
+        "definition": "Set this to true if the record is saying that the procedure should NOT be performed.",
+        "comment": "This element is labeled as a [modifier](conformance-rules.html#isModifier.html) because it indicates that a procedure shouldn't happen, instead of a request for it to happen.  In general, only the code and timeframe will be present, though occasional additional qualifiers such as body site or even performer could be included to narrow the scope of the prohibition.  If the ProcedureRequest.code and ProcedureRequest.doNotPerform both contain negation, that will reinforce prohibition and should not have a double negative interpretation.",
+        "requirements": "Used for do not ambulate, do not elevate head of bed, do not flush NG tube, do not take blood pressure on a certain arm, etc.",
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
-          },
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
-          },
-          {
-            "code": "Reference",
-            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-demographics-PersonOfRecord"
-          },
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
+            "code": "boolean"
           }
         ],
+        "defaultValueBoolean": false,
+        "isModifier": true,
         "isSummary": true,
         "mapping": [
           {
-            "identity": "w5",
-            "map": "who.actor"
+            "identity": "rim",
+            "map": ".actionNegationInd"
           }
         ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-TestRequest.status",
-        "path": "ProcedureRequest.status",
-        "short": "proposed | draft | requested | received | accepted | in-progress | completed | suspended | rejected | aborted",
-        "definition": "The status of the order.",
-        "min": 1,
-        "max": "1",
+        "id": "ProcedureRequest:shr-lab-TestRequest.category",
+        "path": "ProcedureRequest.category",
+        "short": "Classification of procedure",
+        "definition": "A code that classifies the procedure for searching, sorting and display purposes (e.g. \"Surgical Procedure\").",
+        "comment": "There may be multiple axis of categorization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what procedure request are retrieved and displayed.",
+        "min": 0,
+        "max": "*",
         "type": [
           {
-            "code": "code"
+            "code": "CodeableConcept"
           }
         ],
-        "isModifier": true,
         "isSummary": true,
         "binding": {
-          "strength": "required",
-          "description": "The status of the request.",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ProcedureRequestCategory"
+            }
+          ],
+          "strength": "example",
+          "description": "Classification of the procedure",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/procedure-request-status"
+            "reference": "http://hl7.org/fhir/ValueSet/procedure-category"
           }
         },
         "mapping": [
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=\"COMP].target[classCode=\"LIST\", moodCode=\"INT\"].code"
+          },
+          {
+            "identity": "w5",
+            "map": "class"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-TestRequest.code",
+        "path": "ProcedureRequest.code",
+        "short": "What is being requested/ordered",
+        "definition": "A code that identifies a particular procedure, diagnostic investigation, or panel of investigations, that have been requested.",
+        "comment": "Many laboratory and radiology procedure codes embed the specimen/organ system in the test ordeer name, for example,  serum or serum/plasma glucose, or a chest xray. The specimen may not be recorded separately from the test code.",
+        "min": 1,
+        "max": "1",
+        "type": [
+          {
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "strength": "required",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/observation-codes"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.code"
+          },
+          {
+            "identity": "v2",
+            "map": "Varies by domain"
+          },
+          {
+            "identity": "rim",
+            "map": ".code"
+          },
           {
             "identity": "quick",
-            "map": "Action.currentStatus"
+            "map": "Procedure.procedureCode"
           },
           {
             "identity": "w5",
-            "map": "status"
+            "map": "what"
           }
         ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-TestRequest.supportingInfo",
-        "path": "ProcedureRequest.supportingInfo",
-        "short": "Extra information to use in performing request",
-        "definition": "Information that may be needed by/relevant to the performer in their execution of this request.",
+        "id": "ProcedureRequest:shr-lab-TestRequest.subject",
+        "path": "ProcedureRequest.subject",
+        "short": "Individual the service is ordered for",
+        "definition": "On whom or what the procedure or diagnostic is to be performed. This is usually a human patient, but can also be requested on animals, groups of humans or animals, devices such as dialysis machines, or even locations (typically for environmental scans).",
+        "min": 1,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-demographics-PersonOfRecord"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Group"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Location"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Device"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.subject"
+          },
+          {
+            "identity": "v2",
+            "map": "Accompanying PID segment"
+          },
+          {
+            "identity": "rim",
+            "map": ".participation[typeCode=SBJ].role"
+          },
+          {
+            "identity": "quick",
+            "map": "ClinicalStatement.subject"
+          },
+          {
+            "identity": "w5",
+            "map": "who.focus"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-TestRequest.context",
+        "path": "ProcedureRequest.context",
+        "short": "Encounter or Episode during which request was created",
+        "definition": "An encounter or episode of care that provides additional information about the healthcare context in which this request is made.",
+        "alias": [
+          "encounter"
+        ],
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Resource"
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
-        "isSummary": true
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.context"
+          },
+          {
+            "identity": "v2",
+            "map": "Accompanying PV1"
+          },
+          {
+            "identity": "rim",
+            "map": ".inboundRelationship(typeCode=COMP].source[classCode<=PCPR, moodCode=EVN]"
+          },
+          {
+            "identity": "quick",
+            "map": "ClinicalStatement.encounter"
+          },
+          {
+            "identity": "w5",
+            "map": "context"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-TestRequest.occurrence[x]",
+        "path": "ProcedureRequest.occurrence[x]",
+        "short": "When procedure should occur",
+        "definition": "The date/time at which the diagnostic testing should occur.",
+        "alias": [
+          "schedule"
+        ],
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "dateTime"
+          },
+          {
+            "code": "Period"
+          },
+          {
+            "code": "Timing"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.occurrence[x]"
+          },
+          {
+            "identity": "v2",
+            "map": "Accompanying TQ1/TQ2 segments"
+          },
+          {
+            "identity": "rim",
+            "map": ".effectiveTime"
+          },
+          {
+            "identity": "quick",
+            "map": "Procedure.procedureSchedule"
+          },
+          {
+            "identity": "w5",
+            "map": "when.planned"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-TestRequest.asNeeded[x]",
+        "path": "ProcedureRequest.asNeeded[x]",
+        "short": "Preconditions for procedure or diagnostic",
+        "definition": "If a CodeableConcept is present, it indicates the pre-condition for performing the procedure.  For example \"pain\", \"on flare-up\", etc.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "boolean"
+          },
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ProcedureAsNeededReason"
+            }
+          ],
+          "strength": "example",
+          "description": "A coded concept identifying the pre-condition that should hold prior to performing a procedure.  For example \"pain\", \"on flare-up\", etc.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/medication-as-needed-reason"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "boolean: precondition.negationInd (inversed - so negationInd = true means asNeeded=false CodeableConcept: precondition.observationEventCriterion[code=\"Assertion\"].value"
+          },
+          {
+            "identity": "quick",
+            "map": "Proposal.prnReason.reason"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-TestRequest.authoredOn",
+        "path": "ProcedureRequest.authoredOn",
+        "short": "Date request signed",
+        "definition": "When the request transitioned to being actionable.",
+        "alias": [
+          "orderedOn"
+        ],
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "dateTime"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.authoredOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC.9"
+          },
+          {
+            "identity": "rim",
+            "map": ".participation[typeCode=AUT].time"
+          },
+          {
+            "identity": "quick",
+            "map": "Proposal.proposedAtTime"
+          },
+          {
+            "identity": "w5",
+            "map": "when.recorded"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-TestRequest.requester",
+        "path": "ProcedureRequest.requester",
+        "short": "Who/what is requesting procedure or diagnostic",
+        "definition": "The individual who initiated the request and has responsibility for its activation.",
+        "comment": "This not the dispatcher, but rather who is the authorizer.",
+        "alias": [
+          "author",
+          "orderer"
+        ],
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "BackboneElement"
+          }
+        ],
+        "constraint": [
+          {
+            "key": "ele-1",
+            "severity": "error",
+            "human": "All FHIR elements must have a @value or children",
+            "expression": "children().count() > id.count()",
+            "xpath": "@value|f:*|h:div",
+            "source": "Element"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.requester"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC.12"
+          },
+          {
+            "identity": "rim",
+            "map": ".participation[typeCode=AUT].role"
+          },
+          {
+            "identity": "quick",
+            "map": "ClinicalStatement.statementAuthor"
+          }
+        ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-TestRequest.notes",
-        "path": "ProcedureRequest.notes",
-        "short": "Additional information about desired procedure",
-        "definition": "Any other notes associated with this proposal or order - e.g. provider instructions.",
+        "id": "ProcedureRequest:shr-lab-TestRequest.requester.id",
+        "path": "ProcedureRequest.requester.id",
+        "representation": [
+          "xmlAttr"
+        ],
+        "short": "xml:id (or equivalent in JSON)",
+        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Element.id",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-TestRequest.requester.extension",
+        "path": "ProcedureRequest.requester.extension",
+        "short": "Additional Content defined by implementations",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "Element.extension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-TestRequest.requester.modifierExtension",
+        "path": "ProcedureRequest.requester.modifierExtension",
+        "short": "Extensions that cannot be ignored",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content",
+          "modifiers"
+        ],
         "min": 0,
         "max": "*",
+        "base": {
+          "path": "BackboneElement.modifierExtension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "isModifier": true,
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "N/A"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-TestRequest.requester.agent",
+        "path": "ProcedureRequest.requester.agent",
+        "short": "Individual making the request",
+        "definition": "The device, practitioner or organization who initiated the request.",
+        "min": 1,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Device"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-actor-Practitioner"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.requester.agent"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC.12"
+          },
+          {
+            "identity": "rim",
+            "map": ".player"
+          },
+          {
+            "identity": "quick",
+            "map": "ClinicalStatement.statementAuthor"
+          },
+          {
+            "identity": "w5",
+            "map": "who.author"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-TestRequest.requester.onBehalfOf",
+        "path": "ProcedureRequest.requester.onBehalfOf",
+        "short": "Organization agent is acting for",
+        "definition": "The organization the device or practitioner was acting on behalf of.",
+        "requirements": "Practitioners and Devices can be associated with multiple organizations.  This element indicates which organization they were acting on behalf of when authoring the request.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.requester.onBehalfOf"
+          },
+          {
+            "identity": "v2",
+            "map": "N/A"
+          },
+          {
+            "identity": "rim",
+            "map": ".scoper"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-TestRequest.performerType",
+        "path": "ProcedureRequest.performerType",
+        "short": "Performer role",
+        "definition": "Desired type of performer for doing the diagnostic testing.",
+        "comment": "this is a  role, not  a participation type.  I.e. does not describe the task, but describes the capacity.  For example, “compounding pharmacy” or “psychiatrist” or “internal referral”.",
+        "min": 0,
+        "max": "1",
         "type": [
           {
-            "code": "Annotation"
+            "code": "CodeableConcept"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ProcedureRequestParticipantRole"
+            }
+          ],
+          "strength": "example",
+          "description": "Indicates specific responsibility of an individual within the care team, such as \"Primary physician\", \"Team coordinator\", \"Caregiver\", etc.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/participant-role"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.performerType"
+          },
+          {
+            "identity": "v2",
+            "map": "PRT"
+          },
+          {
+            "identity": "rim",
+            "map": ".participation[typeCode=PRF].role[scoper.determinerCode=KIND].code"
+          },
+          {
+            "identity": "w5",
+            "map": "who.actor"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-TestRequest.performer",
+        "path": "ProcedureRequest.performer",
+        "short": "Requested perfomer",
+        "definition": "The desired perfomer for doing the diagnostic testing.  For example, the surgeon, dermatopathologist, endoscopist, etc.",
+        "comment": "If needed, use an [extension](extensibility.html) for listing alternative performers and/or roles and/or preference.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-demographics-PersonOfRecord"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Device"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/HealthcareService"
           }
         ],
         "isSummary": true,
         "mapping": [
           {
-            "identity": "quick",
-            "map": "ClinicalStatement.additionalText"
+            "identity": "workflow",
+            "map": "Request.Performer"
+          },
+          {
+            "identity": "v2",
+            "map": "PRT"
+          },
+          {
+            "identity": "rim",
+            "map": ".participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]"
+          },
+          {
+            "identity": "w5",
+            "map": "who.actor"
           }
         ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-TestRequest.asNeeded[x]",
-        "path": "ProcedureRequest.asNeeded[x]",
-        "short": "Preconditions for procedure",
-        "definition": "If a CodeableConcept is present, it indicates the pre-condition for performing the procedure.",
+        "id": "ProcedureRequest:shr-lab-TestRequest.reasonCode",
+        "path": "ProcedureRequest.reasonCode",
+        "short": "Explanation/Justification for test",
+        "definition": "An explanation or justification for why this diagnostic investigation is being requested in coded or textual form.   This is often for billing purposes.  May relate to the resources referred to in supportingInformation.",
+        "comment": "This may be used to decide how the diagnostic investigation will be performed, or even if it will be performed at all.   Use CodeableConcept text element if the data is free (uncoded) text as shown in the [CT Scan example](procedurerequest-example-di.html).",
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "boolean"
-          },
-          {
-            "code": "CodeableConcept"
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
           }
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ProcedureRequestReason"
+            }
+          ],
           "strength": "example",
-          "description": "A coded concept identifying the pre-condition that should hold prior to performing a procedure.  For example \"pain\", \"on flare-up\", etc."
+          "description": "Diagnosis or problem codes justifying the reason for requesting the procedure or diagnostic investigation.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/procedure-reason"
+          }
         },
         "mapping": [
           {
-            "identity": "quick",
-            "map": "Proposal.prnReason.reason"
+            "identity": "workflow",
+            "map": "Request.reasonCod"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC.16"
+          },
+          {
+            "identity": "rim",
+            "map": ".reasonCode"
+          },
+          {
+            "identity": "w5",
+            "map": "why"
           }
         ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-TestRequest.orderedOn",
-        "path": "ProcedureRequest.orderedOn",
-        "short": "When request was created",
-        "definition": "The time when the request was made.",
+        "id": "ProcedureRequest:shr-lab-TestRequest.reasonReference",
+        "path": "ProcedureRequest.reasonReference",
+        "short": "Explanation/Justification for test",
+        "definition": "Indicates another resource that provides a justification for why this diagnostic investigation is being requested.   May relate to the resources referred to in supportingInformation.",
+        "comment": "This may be used to decide how the diagnostic investigation will be performed, or even if it will be performed at all.   Use CodeableConcept text element if the data is free (uncoded) text as shown in the [CT Scan example](procedurerequest-example-di.html).",
         "min": 0,
-        "max": "1",
+        "max": "*",
         "type": [
           {
-            "code": "dateTime"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Condition"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Observation"
           }
         ],
         "isSummary": true,
         "mapping": [
           {
-            "identity": "quick",
-            "map": "Proposal.proposedAtTime"
+            "identity": "workflow",
+            "map": "Request.reasonReference"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC.16"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=RSON].target"
           },
           {
             "identity": "w5",
-            "map": "when.recorded"
+            "map": "why"
           }
         ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-TestRequest.orderer",
-        "path": "ProcedureRequest.orderer",
-        "short": "Who made request",
-        "definition": "The healthcare professional responsible for proposing or ordering the procedure.",
+        "id": "ProcedureRequest:shr-lab-TestRequest.supportingInfo",
+        "path": "ProcedureRequest.supportingInfo",
+        "short": "Additional clinical information",
+        "definition": "Additional clinical information about the patient or specimen that may influence the procedure or diagnostics or their interpretations.     This information includes diagnosis, clinical findings and other observations.  In laboratory ordering these are typically referred to as \"ask at order entry questions (AOEs)\".  This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example,  reporting the amount of inspired oxygen for blood gas measurements.",
+        "alias": [
+          "Ask at order entry question",
+          "AOE"
+        ],
         "min": 0,
-        "max": "1",
+        "max": "*",
         "type": [
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
-          },
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Resource"
+          }
+        ],
+        "mapping": [
           {
-            "code": "Reference",
-            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-demographics-PersonOfRecord"
+            "identity": "workflow",
+            "map": "Request.supportingInformation"
           },
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
+            "identity": "v2",
+            "map": "Accompanying segments"
           },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=PERT].target"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-TestRequest.specimen",
+        "path": "ProcedureRequest.specimen",
+        "short": "Procedure Samples",
+        "definition": "One or more specimens that the laboratory procedure will use.",
+        "comment": "Many diagnostic procedures need a specimen, but the request itself is not actually about the specimen. This element is for when the diagnostic is requested on already existing specimens and the request points to the specimen it applies to.    Conversely, If the request is entered first with an unknown specimen, The [Specimen](specimen.html) resource references to the ProcedureRequest.",
+        "min": 0,
+        "max": "*",
+        "type": [
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Device"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Specimen"
           }
         ],
         "isSummary": true,
         "mapping": [
           {
-            "identity": "quick",
-            "map": "ClinicalStatement.statementAuthor"
+            "identity": "v2",
+            "map": "SPM"
           },
           {
-            "identity": "w5",
-            "map": "who.author"
+            "identity": "rim",
+            "map": ".participation[typeCode=SPC].role"
           }
         ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-TestRequest.priority",
-        "path": "ProcedureRequest.priority",
-        "short": "routine | urgent | stat | asap",
-        "definition": "The clinical priority associated with this order.",
+        "id": "ProcedureRequest:shr-lab-TestRequest.bodySite",
+        "path": "ProcedureRequest.bodySite",
+        "short": "Location on Body",
+        "definition": "Anatomic location where the procedure should be performed. This is the target site.",
+        "comment": "Only used if not implicit in the code found in ProcedureRequest.type.  If the use case requires BodySite to be handled as a separate resource instead of an inline coded element (e.g. to identify and track separately)  then use the standard extension [procedurerequest-targetBodySite](extension-procedurerequest-targetbodysite.html).",
+        "requirements": "Knowing where the procedure is performed is important for tracking if multiple sites are possible.",
+        "alias": [
+          "location"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "code"
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
           }
         ],
         "isSummary": true,
         "binding": {
           "strength": "required",
-          "description": "The priority of the request.",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/procedure-request-priority"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
           }
         },
         "mapping": [
+          {
+            "identity": "v2",
+            "map": "SPM"
+          },
+          {
+            "identity": "rim",
+            "map": "targetSiteCode"
+          },
           {
             "identity": "quick",
-            "map": "Proposal.urgency"
+            "map": "Procedure.targetBodySite"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-TestRequest.note",
+        "path": "ProcedureRequest.note",
+        "short": "Comments",
+        "definition": "Any other notes and comments made about the service request. For example, letting provider know that \"patient hates needles\" or other provider instructions.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Annotation"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.note"
           },
           {
-            "identity": "w5",
-            "map": "grade"
+            "identity": "v2",
+            "map": "NTE"
+          },
+          {
+            "identity": "rim",
+            "map": ".inboundRelationship(typeCode=SUBJ].source[classCode=ANNGEN, moodCode=EVN].value[xsi:type=ST]"
+          },
+          {
+            "identity": "quick",
+            "map": "ClinicalStatement.additionalText"
+          }
+        ]
+      },
+      {
+        "id": "ProcedureRequest:shr-lab-TestRequest.relevantHistory",
+        "path": "ProcedureRequest.relevantHistory",
+        "short": "Request provenance",
+        "definition": "Key events in the history of the request.",
+        "comment": "This may not include provenances for all versions of the request – only those deemed “relevant” or important.\rThis SHALL NOT include the Provenance associated with this current version of the resource.  (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update.  Until then, it can be queried directly as the Provenance that points to this version using _revinclude\rAll Provenances should have some historical version of this Request as their subject.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Provenance"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Request.relevantHistory"
+          },
+          {
+            "identity": "v2",
+            "map": "N/A"
+          },
+          {
+            "identity": "rim",
+            "map": ".inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]"
           }
         ]
       }
@@ -991,20 +1769,20 @@
         "isSummary": false
       },
       {
-        "id": "ProcedureRequest:shr-lab-TestRequest.modifierExtension:requestnottoperformactionmodifier",
-        "path": "ProcedureRequest.modifierExtension",
-        "sliceName": "requestnottoperformactionmodifier",
-        "min": 0,
-        "max": "1",
+        "id": "ProcedureRequest:shr-lab-TestRequest.code",
+        "path": "ProcedureRequest.code",
         "type": [
           {
-            "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-RequestNotToPerformActionModifier-extension"
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
           }
         ],
-        "mustSupport": true,
-        "isModifier": true,
-        "isSummary": false
+        "binding": {
+          "strength": "required",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/observation-codes"
+          }
+        }
       },
       {
         "id": "ProcedureRequest:shr-lab-TestRequest.subject",
@@ -1017,60 +1795,50 @@
           {
             "code": "Reference",
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/Group"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Location"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Device"
           }
         ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-TestRequest.code",
-        "path": "ProcedureRequest.code",
+        "id": "ProcedureRequest:shr-lab-TestRequest.context",
+        "path": "ProcedureRequest.context",
         "type": [
           {
-            "code": "CodeableConcept",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
-          }
-        ],
-        "binding": {
-          "strength": "required",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/observation-codes"
-          }
-        }
-      },
-      {
-        "id": "ProcedureRequest:shr-lab-TestRequest.bodySite",
-        "path": "ProcedureRequest.bodySite",
-        "min": 0,
-        "max": "1",
-        "type": [
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
           {
-            "code": "CodeableConcept",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
-          }
-        ],
-        "binding": {
-          "strength": "required",
-          "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
-        }
+        ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-TestRequest.reason[x]",
-        "path": "ProcedureRequest.reason[x]",
-        "type": [
-          {
-            "code": "CodeableConcept",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
-          }
-        ]
+        "id": "ProcedureRequest:shr-lab-TestRequest.requester",
+        "path": "ProcedureRequest.requester"
       },
       {
-        "id": "ProcedureRequest:shr-lab-TestRequest.encounter",
-        "path": "ProcedureRequest.encounter",
+        "id": "ProcedureRequest:shr-lab-TestRequest.requester.agent",
+        "path": "ProcedureRequest.requester.agent",
         "type": [
           {
             "code": "Reference",
-            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Device"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-actor-Practitioner"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
           }
         ]
       },
@@ -1090,39 +1858,49 @@
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-demographics-PersonOfRecord"
           },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Device"
+          },
           {
             "code": "Reference",
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/HealthcareService"
           }
         ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-TestRequest.status",
-        "path": "ProcedureRequest.status",
-        "min": 1,
-        "max": "1"
+        "id": "ProcedureRequest:shr-lab-TestRequest.reasonCode",
+        "path": "ProcedureRequest.reasonCode",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+          }
+        ]
       },
       {
-        "id": "ProcedureRequest:shr-lab-TestRequest.orderer",
-        "path": "ProcedureRequest.orderer",
+        "id": "ProcedureRequest:shr-lab-TestRequest.bodySite",
+        "path": "ProcedureRequest.bodySite",
+        "min": 0,
+        "max": "1",
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
-          },
-          {
-            "code": "Reference",
-            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-demographics-PersonOfRecord"
-          },
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
-          },
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Device"
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
           }
-        ]
+        ],
+        "binding": {
+          "strength": "required",
+          "valueSetReference": {
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
+          }
+        }
       }
     ]
   }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-CongenitalAbnormalities.json b/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-CongenitalAbnormalities.json
old mode 100755
new mode 100644
index 0cd7d42..e6b3650
--- a/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-CongenitalAbnormalities.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-CongenitalAbnormalities.json
@@ -3,7 +3,7 @@
   "id": "shr-lifehistory-CongenitalAbnormalities",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR CongenitalAbnormalities Profile</b></p>\n  <p>Any abnormality, genetic, anatomical, biochemical, evident at birth or during the neonatal period. Includes malformations, deformations, and chromosomal abnormalities.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.lifehistory.CongenitalAbnormalities maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR CongenitalAbnormalities Profile</b></p>\n  <p>Any abnormality, genetic, anatomical, biochemical, evident at birth or during the neonatal period. Includes malformations, deformations, and chromosomal abnormalities.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.lifehistory.CongenitalAbnormalities maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lifehistory-CongenitalAbnormalities",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.lifehistory.CongenitalAbnormalities"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR CongenitalAbnormalities Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.761Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.414Z",
   "description": "Any abnormality, genetic, anatomical, biochemical, evident at birth or during the neonatal period. Includes malformations, deformations, and chromosomal abnormalities.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR CongenitalAbnormalities Profile",
         "definition": "Any abnormality, genetic, anatomical, biochemical, evident at birth or during the neonatal period. Includes malformations, deformations, and chromosomal abnormalities.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-lifehistory-CongenitalAbnormalities.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "229",
+          "id": "219",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "codeableconcept",
         "definition": "A set of codes drawn from different coding systems, representing the same concept.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -357,7 +393,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lifehistory-CongenitalAbnormalitiesVS"
+            "reference": "http://standardhealthrecord.org/shr/lifehistory/vs/CongenitalAbnormalitiesVS"
           }
         },
         "mapping": [
@@ -372,6 +408,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -404,6 +441,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -435,16 +473,19 @@
         "id": "Observation:shr-lifehistory-CongenitalAbnormalities.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "230",
+          "id": "220",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -474,6 +515,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -504,8 +546,8 @@
       {
         "id": "Observation:shr-lifehistory-CongenitalAbnormalities.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -514,7 +556,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -529,6 +576,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-lifehistory-CongenitalAbnormalities.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-lifehistory-CongenitalAbnormalities.status",
         "extension": [
@@ -540,6 +644,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -551,6 +656,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -558,6 +669,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -577,8 +696,8 @@
         "path": "Observation.category",
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 0,
         "max": "*",
         "type": [
@@ -588,8 +707,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -611,6 +736,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -629,6 +757,12 @@
         },
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -636,6 +770,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -644,6 +786,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -655,7 +801,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -679,6 +825,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -694,20 +844,32 @@
         ]
       },
       {
-        "id": "Observation:shr-lifehistory-CongenitalAbnormalities.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-lifehistory-CongenitalAbnormalities.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -727,8 +889,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -742,6 +907,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -761,7 +930,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -813,6 +982,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -832,8 +1005,8 @@
         "path": "Observation.value[x]",
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -846,6 +1019,9 @@
           {
             "code": "string"
           },
+          {
+            "code": "boolean"
+          },
           {
             "code": "Range"
           },
@@ -873,6 +1049,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -880,6 +1064,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -888,7 +1076,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -901,6 +1089,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -908,6 +1102,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -935,6 +1133,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -942,6 +1146,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -949,6 +1157,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -966,6 +1178,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -981,8 +1197,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -991,6 +1206,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -998,6 +1219,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -1005,6 +1230,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1013,7 +1242,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1024,6 +1253,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1046,7 +1281,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1056,6 +1291,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1063,6 +1302,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1071,7 +1314,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1085,6 +1328,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1092,6 +1339,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1100,7 +1351,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1169,7 +1420,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1198,7 +1449,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1280,30 +1531,82 @@
         ]
       },
       {
-        "id": "Observation:shr-lifehistory-CongenitalAbnormalities.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-lifehistory-CongenitalAbnormalities.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-lifehistory-CongenitalAbnormalities.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1359,8 +1662,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1422,7 +1725,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1451,7 +1754,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1483,7 +1786,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1493,6 +1796,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1543,7 +1852,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1606,7 +1915,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1635,7 +1944,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1677,6 +1986,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1684,6 +1999,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1703,8 +2022,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1741,6 +2060,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1748,6 +2071,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1756,7 +2083,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1769,6 +2096,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1791,7 +2124,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1804,6 +2137,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1811,6 +2150,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1818,6 +2161,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1826,7 +2173,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1870,7 +2217,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lifehistory-CongenitalAbnormalitiesVS"
+            "reference": "http://standardhealthrecord.org/shr/lifehistory/vs/CongenitalAbnormalitiesVS"
           }
         }
       },
@@ -1975,12 +2322,16 @@
         ]
       },
       {
-        "id": "Observation:shr-lifehistory-CongenitalAbnormalities.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-lifehistory-CongenitalAbnormalities.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-EducationalAttainment.json b/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-EducationalAttainment.json
old mode 100755
new mode 100644
index b4e5e1e..fded600
--- a/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-EducationalAttainment.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-EducationalAttainment.json
@@ -3,7 +3,7 @@
   "id": "shr-lifehistory-EducationalAttainment",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR EducationalAttainment Profile</b></p>\n  <p>Educational attainment or level of education of individuals.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.lifehistory.EducationalAttainment maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR EducationalAttainment Profile</b></p>\n  <p>Educational attainment or level of education of individuals.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.lifehistory.EducationalAttainment maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lifehistory-EducationalAttainment",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.lifehistory.EducationalAttainment"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR EducationalAttainment Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.786Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.421Z",
   "description": "Educational attainment or level of education of individuals.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR EducationalAttainment Profile",
         "definition": "Educational attainment or level of education of individuals.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-lifehistory-EducationalAttainment.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "231",
+          "id": "221",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "codeableconcept",
         "definition": "A set of codes drawn from different coding systems, representing the same concept.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -357,7 +393,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lifehistory-EducationalAttainmentVS"
+            "reference": "http://standardhealthrecord.org/shr/lifehistory/vs/EducationalAttainmentVS"
           }
         },
         "mapping": [
@@ -372,6 +408,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -404,6 +441,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -435,16 +473,19 @@
         "id": "Observation:shr-lifehistory-EducationalAttainment.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "232",
+          "id": "222",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -474,6 +515,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -504,8 +546,8 @@
       {
         "id": "Observation:shr-lifehistory-EducationalAttainment.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -514,7 +556,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -529,6 +576,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-lifehistory-EducationalAttainment.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-lifehistory-EducationalAttainment.status",
         "extension": [
@@ -540,6 +644,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -551,6 +656,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -558,6 +669,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -577,8 +696,8 @@
         "path": "Observation.category",
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 0,
         "max": "*",
         "type": [
@@ -588,8 +707,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -611,6 +736,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -629,6 +757,12 @@
         },
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -636,6 +770,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -644,6 +786,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -655,7 +801,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -679,6 +825,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -694,20 +844,32 @@
         ]
       },
       {
-        "id": "Observation:shr-lifehistory-EducationalAttainment.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-lifehistory-EducationalAttainment.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -727,8 +889,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -742,6 +907,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -761,7 +930,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -813,6 +982,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -832,8 +1005,8 @@
         "path": "Observation.value[x]",
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -846,6 +1019,9 @@
           {
             "code": "string"
           },
+          {
+            "code": "boolean"
+          },
           {
             "code": "Range"
           },
@@ -873,6 +1049,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -880,6 +1064,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -888,7 +1076,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -901,6 +1089,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -908,6 +1102,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -935,6 +1133,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -942,6 +1146,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -949,6 +1157,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -966,6 +1178,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -981,8 +1197,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -991,6 +1206,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -998,6 +1219,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -1005,6 +1230,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1013,7 +1242,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1024,6 +1253,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1046,7 +1281,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1056,6 +1291,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1063,6 +1302,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1071,7 +1314,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1085,6 +1328,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1092,6 +1339,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1100,7 +1351,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1169,7 +1420,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1198,7 +1449,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1280,30 +1531,82 @@
         ]
       },
       {
-        "id": "Observation:shr-lifehistory-EducationalAttainment.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-lifehistory-EducationalAttainment.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-lifehistory-EducationalAttainment.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1359,8 +1662,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1422,7 +1725,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1451,7 +1754,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1483,7 +1786,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1493,6 +1796,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1543,7 +1852,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1606,7 +1915,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1635,7 +1944,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1677,6 +1986,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1684,6 +1999,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1703,8 +2022,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1741,6 +2060,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1748,6 +2071,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1756,7 +2083,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1769,6 +2096,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1791,7 +2124,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1804,6 +2137,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1811,6 +2150,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1818,6 +2161,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1826,7 +2173,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1870,7 +2217,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lifehistory-EducationalAttainmentVS"
+            "reference": "http://standardhealthrecord.org/shr/lifehistory/vs/EducationalAttainmentVS"
           }
         }
       },
@@ -1975,12 +2322,16 @@
         ]
       },
       {
-        "id": "Observation:shr-lifehistory-EducationalAttainment.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-lifehistory-EducationalAttainment.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-Employer-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-Employer-extension.json
old mode 100755
new mode 100644
index 251b792..1e3fb00
--- a/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-Employer-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-Employer-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.lifehistory.Employer"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Employer Extension",
   "title": "SHR Employer Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.848Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.436Z",
   "description": "A person or entity which hires the services of another.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-Employment.json b/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-Employment.json
old mode 100755
new mode 100644
index 0801aad..44ececd
--- a/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-Employment.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-Employment.json
@@ -3,7 +3,7 @@
   "id": "shr-lifehistory-Employment",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR Employment Profile</b></p>\n  <p>Engagement in an activity or service for profit, wages, salary, or as a service to others.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.lifehistory.Employment maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR Employment Profile</b></p>\n  <p>Engagement in an activity or service for profit, wages, salary, or as a service to others.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.lifehistory.Employment maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lifehistory-Employment",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.lifehistory.Employment"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Employment Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.836Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.434Z",
   "description": "Engagement in an activity or service for profit, wages, salary, or as a service to others.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR Employment Profile",
         "definition": "Engagement in an activity or service for profit, wages, salary, or as a service to others.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-lifehistory-Employment.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "235",
+          "id": "225",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -398,6 +435,7 @@
         "path": "Observation.extension",
         "sliceName": "employmentstatus",
         "definition": "Condition of employment including full- or part-time, temporary or permanent, and unemployment.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -430,6 +468,7 @@
         "path": "Observation.extension",
         "sliceName": "employer",
         "definition": "A person or entity which hires the services of another.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -462,6 +501,7 @@
         "path": "Observation.extension",
         "sliceName": "occurrencetime",
         "definition": "The point in time or span of time in which something happens.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -493,16 +533,19 @@
         "id": "Observation:shr-lifehistory-Employment.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "236",
+          "id": "226",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -532,6 +575,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -562,8 +606,8 @@
       {
         "id": "Observation:shr-lifehistory-Employment.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -572,7 +616,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -587,6 +636,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-lifehistory-Employment.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-lifehistory-Employment.status",
         "extension": [
@@ -598,6 +704,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -609,6 +716,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -616,6 +729,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -635,8 +756,8 @@
         "path": "Observation.category",
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 0,
         "max": "*",
         "type": [
@@ -646,8 +767,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -669,6 +796,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -687,6 +817,12 @@
         },
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -694,6 +830,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -702,6 +846,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -713,7 +861,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -737,6 +885,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -752,20 +904,32 @@
         ]
       },
       {
-        "id": "Observation:shr-lifehistory-Employment.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-lifehistory-Employment.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -785,8 +949,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -800,6 +967,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -819,7 +990,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -871,6 +1042,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -890,8 +1065,8 @@
         "path": "Observation.value[x]",
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -904,6 +1079,9 @@
           {
             "code": "string"
           },
+          {
+            "code": "boolean"
+          },
           {
             "code": "Range"
           },
@@ -931,6 +1109,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -938,6 +1124,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -946,7 +1136,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -959,6 +1149,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -966,6 +1162,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -993,6 +1193,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1000,6 +1206,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1007,6 +1217,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1024,6 +1238,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -1039,8 +1257,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1049,6 +1266,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -1056,6 +1279,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -1063,6 +1290,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1071,7 +1302,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1082,6 +1313,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1104,7 +1341,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1114,6 +1351,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1121,6 +1362,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1129,7 +1374,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1143,6 +1388,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1150,6 +1399,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1158,7 +1411,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1227,7 +1480,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1256,7 +1509,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1338,30 +1591,82 @@
         ]
       },
       {
-        "id": "Observation:shr-lifehistory-Employment.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-lifehistory-Employment.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-lifehistory-Employment.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1417,8 +1722,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1480,7 +1785,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1509,7 +1814,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1541,7 +1846,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1551,6 +1856,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1601,7 +1912,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1664,7 +1975,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1693,7 +2004,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1735,6 +2046,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1742,6 +2059,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1761,8 +2082,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1799,6 +2120,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1806,6 +2131,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1814,7 +2143,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1827,6 +2156,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1849,7 +2184,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1862,6 +2197,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1869,6 +2210,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1876,6 +2221,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1884,7 +2233,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -2059,12 +2408,16 @@
         ]
       },
       {
-        "id": "Observation:shr-lifehistory-Employment.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-lifehistory-Employment.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-EmploymentStatus-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-EmploymentStatus-extension.json
old mode 100755
new mode 100644
index 11ff55c..69ebd30
--- a/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-EmploymentStatus-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-EmploymentStatus-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.lifehistory.EmploymentStatus"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR EmploymentStatus Extension",
   "title": "SHR EmploymentStatus Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.848Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.435Z",
   "description": "Condition of employment including full- or part-time, temporary or permanent, and unemployment.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -170,7 +170,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lifehistory-EmploymentStatusVS"
+            "reference": "http://standardhealthrecord.org/shr/lifehistory/vs/EmploymentStatusVS"
           }
         },
         "mapping": [
@@ -221,7 +221,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lifehistory-EmploymentStatusVS"
+            "reference": "http://standardhealthrecord.org/shr/lifehistory/vs/EmploymentStatusVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-MilitaryBranch-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-MilitaryBranch-extension.json
old mode 100755
new mode 100644
index 34f226e..9e83c79
--- a/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-MilitaryBranch-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-MilitaryBranch-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.lifehistory.MilitaryBranch"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR MilitaryBranch Extension",
   "title": "SHR MilitaryBranch Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.871Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.440Z",
   "description": "The branch of the US military that the subject has served.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -170,7 +170,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lifehistory-USMilitaryBranchVS"
+            "reference": "http://standardhealthrecord.org/shr/lifehistory/vs/USMilitaryBranchVS"
           }
         },
         "mapping": [
@@ -221,7 +221,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lifehistory-USMilitaryBranchVS"
+            "reference": "http://standardhealthrecord.org/shr/lifehistory/vs/USMilitaryBranchVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-MilitaryService.json b/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-MilitaryService.json
old mode 100755
new mode 100644
index 3ebc319..9cc8b55
--- a/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-MilitaryService.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-MilitaryService.json
@@ -3,7 +3,7 @@
   "id": "shr-lifehistory-MilitaryService",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR MilitaryService Profile</b></p>\n  <p>History of service in the US military.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.lifehistory.MilitaryService maps to DiagnosticReport:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  CodeableConcept maps to codedDiagnosis\n  Observation maps to result\n  TBD &quot;Specimen&quot; maps to specimen\n  Interpretation maps to conclusion\n  ObservationCategory maps to category\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR MilitaryService Profile</b></p>\n  <p>History of service in the US military.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.lifehistory.MilitaryService maps to DiagnosticReport:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  CodeableConcept maps to codedDiagnosis\n  Observation maps to result\n  &lt;TBD &quot;Specimen&quot;&gt; maps to specimen\n  Interpretation maps to conclusion\n  ObservationCategory maps to category\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lifehistory-MilitaryService",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.lifehistory.MilitaryService"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR MilitaryService Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.860Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,15 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.439Z",
   "description": "History of service in the US military.",
   "purpose": "To support reporting for any diagnostic report into a clinical data repository.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -58,7 +64,7 @@
         "path": "DiagnosticReport",
         "short": "SHR MilitaryService Profile",
         "definition": "History of service in the US military.",
-        "comments": "This is intended to capture a single report, and is not suitable for use in displaying summary information that covers multiple reports.  For example, this resource has not been designed for laboratory cumulative reporting formats nor detailed structured reports for sequencing.",
+        "comment": "This is intended to capture a single report, and is not suitable for use in displaying summary information that covers multiple reports.  For example, this resource has not been designed for laboratory cumulative reporting formats nor detailed structured reports for sequencing.",
         "alias": [
           "Report",
           "Test",
@@ -108,6 +114,10 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
           {
             "identity": "v2",
             "map": "ORU -> OBR"
@@ -127,7 +137,7 @@
         "path": "DiagnosticReport.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -166,7 +176,7 @@
         "path": "DiagnosticReport.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -187,7 +197,7 @@
         "path": "DiagnosticReport.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -207,6 +217,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -221,7 +239,7 @@
         "path": "DiagnosticReport.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -255,7 +273,7 @@
         "path": "DiagnosticReport.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -284,16 +302,19 @@
         "id": "DiagnosticReport:shr-lifehistory-MilitaryService.extension",
         "path": "DiagnosticReport.extension",
         "slicing": {
-          "id": "238",
+          "id": "228",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -322,6 +343,7 @@
         "path": "DiagnosticReport.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -354,6 +376,7 @@
         "path": "DiagnosticReport.extension",
         "sliceName": "observationcode",
         "definition": "A term from a controlled vocabulary that defines the data element (the question, not the answer) as specifically as possible. The specific code should always align with the concept of the element, but may be more specific. For example, the concept associated with medications is code for 'medication used', but the ObservationCode is the code for the particular medication used. For tests, ObservationCode identifies the specific test being performed, and for observations, the specific question being asked.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -435,7 +458,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -494,6 +516,7 @@
         "path": "DiagnosticReport.extension",
         "sliceName": "militarystatus",
         "definition": "The current connection to the US military.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -526,6 +549,7 @@
         "path": "DiagnosticReport.extension",
         "sliceName": "militaryservicedischargestatus",
         "definition": "How the subject was formally discharged from the US Military.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -558,6 +582,7 @@
         "path": "DiagnosticReport.extension",
         "sliceName": "militarybranch",
         "definition": "The branch of the US military that the subject has served.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -590,6 +615,7 @@
         "path": "DiagnosticReport.extension",
         "sliceName": "militaryserviceera",
         "definition": "The time period of US military service.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -622,6 +648,7 @@
         "path": "DiagnosticReport.extension",
         "sliceName": "serviceconnecteddisability",
         "definition": "Percentage disability resulting from US Military Service.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -654,7 +681,7 @@
         "path": "DiagnosticReport.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -682,11 +709,14 @@
       {
         "id": "DiagnosticReport:shr-lifehistory-MilitaryService.identifier",
         "path": "DiagnosticReport.identifier",
-        "short": "Id for external references to this report",
-        "definition": "The local ID assigned to the report by the order filler, usually by the Information System of the diagnostic service provider.",
+        "short": "Business identifier for report",
+        "definition": "Identifiers assigned to this report by the performer or other systems.",
+        "comment": "Usually assigned by the Information System of the diagnostic service provider (filler id).",
         "requirements": "Need to know what identifier to use when making queries about this report from the source laboratory, and for linking to the report outside FHIR context.",
         "alias": [
-          "ReportID"
+          "ReportID",
+          "Filler ID",
+          "Placer ID"
         ],
         "min": 0,
         "max": "*",
@@ -697,6 +727,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBR-51"
@@ -711,12 +745,65 @@
           }
         ]
       },
+      {
+        "id": "DiagnosticReport:shr-lifehistory-MilitaryService.basedOn",
+        "path": "DiagnosticReport.basedOn",
+        "short": "What was requested",
+        "definition": "Details concerning a test or procedure requested.",
+        "comment": "Note: Usually there is one test request for each result, however in some circumstances multiple test requests may be represented using a single test result resource. Note that there are also cases where one request leads to multiple reports.",
+        "requirements": "This allows tracing of authorization for the report and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Request"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC? OBR-2/3?"
+          },
+          {
+            "identity": "rim",
+            "map": "outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "DiagnosticReport:shr-lifehistory-MilitaryService.status",
         "path": "DiagnosticReport.status",
-        "short": "registered | partial | final | corrected | appended | cancelled | entered-in-error",
+        "short": "registered | partial | preliminary | final +",
         "definition": "The status of the diagnostic report as a whole.",
-        "comments": "This is labeled as \"Is Modifier\" because applications need to take appropriate action if a report is withdrawn.",
+        "comment": "This is labeled as \"Is Modifier\" because applications need to take appropriate action if a report is withdrawn.",
         "requirements": "Diagnostic services routinely issue provisional/incomplete reports, and sometimes withdraw previously released reports.",
         "min": 1,
         "max": "1",
@@ -728,6 +815,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "DiagnosticReportStatus"
+            }
+          ],
           "strength": "required",
           "description": "The status of the diagnostic report as a whole.",
           "valueSetReference": {
@@ -735,6 +828,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
           {
             "identity": "v2",
             "map": "OBR-25 (not 1:1 mapping)"
@@ -754,12 +851,12 @@
         "path": "DiagnosticReport.category",
         "short": "Service category",
         "definition": "A code that classifies the clinical discipline, department or diagnostic service that created the report (e.g. cardiology, biochemistry, hematology, MRI). This is used for searching, sorting and display purposes.",
-        "comments": "The level of granularity is defined by the category concepts in the value set. More fine-grained filtering can be performed using the metadata and/or terminology hierarchy in DiagnosticReport.code.",
+        "comment": "The level of granularity is defined by the category concepts in the value set. More fine-grained filtering can be performed using the metadata and/or terminology hierarchy in DiagnosticReport.code.",
         "alias": [
           "Department",
           "Sub-department",
-          "service",
-          "discipline"
+          "Service",
+          "Discipline"
         ],
         "min": 0,
         "max": "1",
@@ -796,6 +893,9 @@
         "path": "DiagnosticReport.code",
         "short": "Name/Code for this diagnostic report",
         "definition": "A code or name that describes this diagnostic report.",
+        "alias": [
+          "Type"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -805,6 +905,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "DiagnosticReportCodes"
+            }
+          ],
           "strength": "preferred",
           "description": "Codes that describe Diagnostic Reports.",
           "valueSetReference": {
@@ -812,6 +918,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
           {
             "identity": "v2",
             "map": "OBR-4 (HL7 v2 doesn't provide an easy way to indicate both the ordered test and the performed panel)"
@@ -829,7 +939,7 @@
       {
         "id": "DiagnosticReport:shr-lifehistory-MilitaryService.subject",
         "path": "DiagnosticReport.subject",
-        "short": "The subject of the report, usually, but not always, the patient",
+        "short": "The subject of the report - usually, but not always, the patient",
         "definition": "The subject of the report. Usually, but not always, this is a patient. However diagnostic services also perform analyses on specimens collected from a variety of other sources.",
         "requirements": "SHALL know the subject context.",
         "alias": [
@@ -857,6 +967,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3 (no HL7 v2 mapping for Group or Device)"
@@ -872,20 +986,33 @@
         ]
       },
       {
-        "id": "DiagnosticReport:shr-lifehistory-MilitaryService.encounter",
-        "path": "DiagnosticReport.encounter",
+        "id": "DiagnosticReport:shr-lifehistory-MilitaryService.context",
+        "path": "DiagnosticReport.context",
         "short": "Health care event when test ordered",
-        "definition": "The link to the health care event (encounter) when the order was made.",
+        "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) which this DiagnosticReport per is about.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
+        "requirements": "Links the request to the Encounter context.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1-19"
@@ -903,13 +1030,14 @@
       {
         "id": "DiagnosticReport:shr-lifehistory-MilitaryService.effective[x]",
         "path": "DiagnosticReport.effective[x]",
-        "short": "Clinically Relevant time/time-period for report",
+        "short": "Clinically relevant time/time-period for report",
         "definition": "The time or time-period the observed values are related to. When the subject of the report is a patient, this is usually either the time of the procedure or of specimen collection(s), but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "If the diagnostic procedure was performed on the patient, this is the time it was performed. If there are specimens, the diagnostically relevant time can be derived from the specimen collection times, but the specimen information is not always available, and the exact relationship between the specimens and the diagnostically relevant time is not always automatic.",
+        "comment": "If the diagnostic procedure was performed on the patient, this is the time it was performed. If there are specimens, the diagnostically relevant time can be derived from the specimen collection times, but the specimen information is not always available, and the exact relationship between the specimens and the diagnostically relevant time is not always automatic.",
         "requirements": "Need to know where in the patient history to file/present this report.",
         "alias": [
           "Observation time",
-          "Effective Time"
+          "Effective Time",
+          "Occurrence"
         ],
         "min": 0,
         "max": "1",
@@ -923,6 +1051,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBR-7"
@@ -942,7 +1074,7 @@
         "path": "DiagnosticReport.issued",
         "short": "DateTime this version was released",
         "definition": "The date and time that this version of the report was released from the source diagnostic service.",
-        "comments": "May be different from the update time of the resource itself, because that is the status of the record (potentially a secondary copy), not the actual release time of the report.",
+        "comment": "May be different from the update time of the resource itself, because that is the status of the record (potentially a secondary copy), not the actual release time of the report.",
         "requirements": "Clinicians need to be able to check the date that the report was released.",
         "alias": [
           "Date Created",
@@ -975,10 +1107,8 @@
       {
         "id": "DiagnosticReport:shr-lifehistory-MilitaryService.performer",
         "path": "DiagnosticReport.performer",
-        "short": "Responsible Diagnostic Service",
-        "definition": "The diagnostic service that is responsible for issuing the report.",
-        "comments": "This is not necessarily the source of the atomic data items. It is the entity that takes responsibility for the clinical report.",
-        "requirements": "Need to know whom to contact if there are queries about the results. Also may need to track the source of reports for secondary data analysis.",
+        "short": "Participants in producing the report",
+        "definition": "Indicates who or what participated in producing the report.",
         "alias": [
           "Laboratory",
           "Service",
@@ -990,23 +1120,32 @@
         "max": "*",
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
-          },
+            "code": "BackboneElement"
+          }
+        ],
+        "constraint": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
+            "key": "ele-1",
+            "severity": "error",
+            "human": "All FHIR elements must have a @value or children",
+            "expression": "children().count() > id.count()",
+            "xpath": "@value|f:*|h:div",
+            "source": "Element"
           }
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "PRT-8 (where this PRT-4-Participation = \"PO\")"
           },
           {
             "identity": "rim",
-            "map": "participation[typeCode=AUT].role[classCode=ASSIGN].scoper"
+            "map": ".participation[typeCode=PRF]"
           },
           {
             "identity": "w5",
@@ -1015,36 +1154,166 @@
         ]
       },
       {
-        "id": "DiagnosticReport:shr-lifehistory-MilitaryService.request",
-        "path": "DiagnosticReport.request",
-        "short": "What was requested",
-        "definition": "Details concerning a test or procedure requested.",
-        "comments": "Note: Usually there is one test request for each result, however in some circumstances multiple test requests may be represented using a single test result resource. Note that there are also cases where one request leads to multiple reports.",
-        "requirements": "Need to be able to track completion of requests based on reports issued and also to report what diagnostic tests were requested (not always the same as what is delivered).",
+        "id": "DiagnosticReport:shr-lifehistory-MilitaryService.performer.id",
+        "path": "DiagnosticReport.performer.id",
+        "representation": [
+          "xmlAttr"
+        ],
+        "short": "xml:id (or equivalent in JSON)",
+        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Element.id",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "DiagnosticReport:shr-lifehistory-MilitaryService.performer.extension",
+        "path": "DiagnosticReport.performer.extension",
+        "short": "Additional Content defined by implementations",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content"
+        ],
         "min": 0,
         "max": "*",
+        "base": {
+          "path": "Element.extension",
+          "min": 0,
+          "max": "*"
+        },
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DiagnosticRequest"
+            "code": "Extension"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "DiagnosticReport:shr-lifehistory-MilitaryService.performer.modifierExtension",
+        "path": "DiagnosticReport.performer.modifierExtension",
+        "short": "Extensions that cannot be ignored",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content",
+          "modifiers"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "BackboneElement.modifierExtension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "isModifier": true,
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "N/A"
+          }
+        ]
+      },
+      {
+        "id": "DiagnosticReport:shr-lifehistory-MilitaryService.performer.role",
+        "path": "DiagnosticReport.performer.role",
+        "short": "Type of performer",
+        "definition": "Describes the type of participation (e.g.  a responsible party, author, or verifier).",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Role"
+            }
+          ],
+          "strength": "example",
+          "description": "Indicate a role of diagnostic report performer",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/performer-role"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer.role"
+          },
+          {
+            "identity": "v2",
+            "map": "PRT-8 (where this PRT-4-Participation = \"PO\")"
           },
+          {
+            "identity": "rim",
+            "map": ".functionCode"
+          }
+        ]
+      },
+      {
+        "id": "DiagnosticReport:shr-lifehistory-MilitaryService.performer.actor",
+        "path": "DiagnosticReport.performer.actor",
+        "short": "Practitioner or Organization  participant",
+        "definition": "The reference to the  practitioner or organization involved in producing the report. For example, the diagnostic service that is responsible for issuing the report.",
+        "comment": "This is not necessarily the source of the atomic data items. It is the entity that takes responsibility for the clinical report.",
+        "requirements": "Need to know whom to contact if there are queries about the results. Also may need to track the source of reports for secondary data analysis.",
+        "min": 1,
+        "max": "1",
+        "type": [
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
           },
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer.actor"
+          },
           {
             "identity": "v2",
-            "map": "ORC? OBR-2/3?"
+            "map": "PRT-8 (where this PRT-4-Participation = \"PO\")"
           },
           {
             "identity": "rim",
-            "map": "outboundRelationship[typeCode=FLFS].target"
+            "map": ".role"
           }
         ]
       },
@@ -1053,7 +1322,7 @@
         "path": "DiagnosticReport.specimen",
         "short": "Specimens this report is based on",
         "definition": "Details about the specimens on which this diagnostic report is based.",
-        "comments": "If the specimen is sufficiently specified with a code in the test result name, then this additional data may be redundant. If there are multiple specimens, these may be represented per Observation or group.",
+        "comment": "If the specimen is sufficiently specified with a code in the test result name, then this additional data may be redundant. If there are multiple specimens, these may be represented per observation or group.",
         "requirements": "Need to be able to report information about the collected specimens on which the report is based.",
         "min": 0,
         "max": "*",
@@ -1115,7 +1384,7 @@
         "path": "DiagnosticReport.imagingStudy",
         "short": "Reference to full details of imaging associated with the diagnostic report",
         "definition": "One or more links to full details of any imaging performed during the diagnostic investigation. Typically, this is imaging performed by DICOM enabled modalities, but this is not required. A fully enabled PACS viewer can use this information to provide views of the source images.",
-        "comments": "ImagingStudy and ImageManifest and the image element are somewhat overlapping - typically, the list of image references in the image element will also be found in one of the imaging study resources. However each caters to different types of displays for different types of purposes. Neither, either, or both may be provided.",
+        "comment": "ImagingStudy and ImageManifest and the image element are somewhat overlapping - typically, the list of image references in the image element will also be found in one of the imaging study resources. However each caters to different types of displays for different types of purposes. Neither, either, or both may be provided.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1207,7 +1476,7 @@
         "path": "DiagnosticReport.image.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1236,7 +1505,7 @@
         "path": "DiagnosticReport.image.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1268,7 +1537,7 @@
         "path": "DiagnosticReport.image.comment",
         "short": "Comment about the image (e.g. explanation)",
         "definition": "A comment about the image. Typically, this is used to provide an explanation for why the image is included, or to draw the viewer's attention to important features.",
-        "comments": "The comment should be displayed with the image. It would be common for the report to include additional discussion of the image contents in other sections such as the conclusion.",
+        "comment": "The comment should be displayed with the image. It would be common for the report to include additional discussion of the image contents in other sections such as the conclusion.",
         "requirements": "The provider of the report should make a comment about each image included in the report.",
         "min": 0,
         "max": "1",
@@ -1346,8 +1615,14 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AdjunctDiagnosis"
+            }
+          ],
           "strength": "example",
-          "description": "Diagnoses codes provided as adjuncts to the report.",
+          "description": "Diagnosis codes provided as adjuncts to the report.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/clinical-findings"
           }
@@ -1368,8 +1643,8 @@
         "path": "DiagnosticReport.presentedForm",
         "short": "Entire report as issued",
         "definition": "Rich text representation of the entire result as issued by the diagnostic service. Multiple formats are allowed but they SHALL be semantically equivalent.",
-        "comments": "\"application/pdf\" is recommended as the most reliable and interoperable in this context.",
-        "requirements": "Gives Laboratory the ability to provide its own fully formatted report for clinical fidelity.",
+        "comment": "\"application/pdf\" is recommended as the most reliable and interoperable in this context.",
+        "requirements": "Gives laboratory the ability to provide its own fully formatted report for clinical fidelity.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1559,12 +1834,16 @@
         ]
       },
       {
-        "id": "DiagnosticReport:shr-lifehistory-MilitaryService.encounter",
-        "path": "DiagnosticReport.encounter",
+        "id": "DiagnosticReport:shr-lifehistory-MilitaryService.context",
+        "path": "DiagnosticReport.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-MilitaryServiceDischargeStatus-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-MilitaryServiceDischargeStatus-extension.json
old mode 100755
new mode 100644
index ce9817c..a30e447
--- a/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-MilitaryServiceDischargeStatus-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-MilitaryServiceDischargeStatus-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.lifehistory.MilitaryServiceDischargeStatus"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR MilitaryServiceDischargeStatus Extension",
   "title": "SHR MilitaryServiceDischargeStatus Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.871Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.440Z",
   "description": "How the subject was formally discharged from the US Military.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -170,7 +170,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lifehistory-MilitaryServiceDischargeStatusVS"
+            "reference": "http://standardhealthrecord.org/shr/lifehistory/vs/MilitaryServiceDischargeStatusVS"
           }
         },
         "mapping": [
@@ -221,7 +221,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lifehistory-MilitaryServiceDischargeStatusVS"
+            "reference": "http://standardhealthrecord.org/shr/lifehistory/vs/MilitaryServiceDischargeStatusVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-MilitaryServiceEra-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-MilitaryServiceEra-extension.json
old mode 100755
new mode 100644
index 6a78b95..947924e
--- a/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-MilitaryServiceEra-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-MilitaryServiceEra-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.lifehistory.MilitaryServiceEra"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR MilitaryServiceEra Extension",
   "title": "SHR MilitaryServiceEra Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.871Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.440Z",
   "description": "The time period of US military service.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -170,7 +170,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lifehistory-MilitaryServiceEraVS"
+            "reference": "http://standardhealthrecord.org/shr/lifehistory/vs/MilitaryServiceEraVS"
           }
         },
         "mapping": [
@@ -221,7 +221,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lifehistory-MilitaryServiceEraVS"
+            "reference": "http://standardhealthrecord.org/shr/lifehistory/vs/MilitaryServiceEraVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-MilitaryStatus-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-MilitaryStatus-extension.json
old mode 100755
new mode 100644
index 221a543..6772cdc
--- a/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-MilitaryStatus-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-MilitaryStatus-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.lifehistory.MilitaryStatus"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR MilitaryStatus Extension",
   "title": "SHR MilitaryStatus Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.871Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.440Z",
   "description": "The current connection to the US military.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-MilitaryStatus.json b/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-MilitaryStatus.json
old mode 100755
new mode 100644
index a0c6bec..0eae0b2
--- a/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-MilitaryStatus.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-MilitaryStatus.json
@@ -3,7 +3,7 @@
   "id": "shr-lifehistory-MilitaryStatus",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR MilitaryStatus Profile</b></p>\n  <p>The current connection to the US military.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.lifehistory.MilitaryStatus maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR MilitaryStatus Profile</b></p>\n  <p>The current connection to the US military.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.lifehistory.MilitaryStatus maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lifehistory-MilitaryStatus",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.lifehistory.MilitaryStatus"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR MilitaryStatus Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.877Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.448Z",
   "description": "The current connection to the US military.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR MilitaryStatus Profile",
         "definition": "The current connection to the US military.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-lifehistory-MilitaryStatus.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "239",
+          "id": "229",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "codeableconcept",
         "definition": "A set of codes drawn from different coding systems, representing the same concept.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -357,7 +393,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lifehistory-MilitaryStatusVS"
+            "reference": "http://standardhealthrecord.org/shr/lifehistory/vs/MilitaryStatusVS"
           }
         },
         "mapping": [
@@ -372,6 +408,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -404,6 +441,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -435,16 +473,19 @@
         "id": "Observation:shr-lifehistory-MilitaryStatus.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "240",
+          "id": "230",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -474,6 +515,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -504,8 +546,8 @@
       {
         "id": "Observation:shr-lifehistory-MilitaryStatus.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -514,7 +556,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -529,6 +576,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-lifehistory-MilitaryStatus.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-lifehistory-MilitaryStatus.status",
         "extension": [
@@ -540,6 +644,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -551,6 +656,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -558,6 +669,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -577,8 +696,8 @@
         "path": "Observation.category",
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 0,
         "max": "*",
         "type": [
@@ -588,8 +707,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -611,6 +736,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -621,6 +749,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -628,6 +762,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -636,6 +778,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -647,7 +793,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -671,6 +817,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -686,20 +836,32 @@
         ]
       },
       {
-        "id": "Observation:shr-lifehistory-MilitaryStatus.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-lifehistory-MilitaryStatus.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -719,8 +881,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -734,6 +899,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -753,7 +922,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -805,6 +974,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -824,8 +997,8 @@
         "path": "Observation.value[x]",
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -838,6 +1011,9 @@
           {
             "code": "string"
           },
+          {
+            "code": "boolean"
+          },
           {
             "code": "Range"
           },
@@ -865,6 +1041,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -872,6 +1056,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -880,7 +1068,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -893,6 +1081,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -900,6 +1094,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -927,6 +1125,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -934,6 +1138,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -941,6 +1149,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -958,6 +1170,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -973,8 +1189,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -983,6 +1198,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -990,6 +1211,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -997,6 +1222,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1005,7 +1234,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1016,6 +1245,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1038,7 +1273,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1048,6 +1283,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1055,6 +1294,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1063,7 +1306,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1077,6 +1320,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1084,6 +1331,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1092,7 +1343,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1161,7 +1412,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1190,7 +1441,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1272,30 +1523,82 @@
         ]
       },
       {
-        "id": "Observation:shr-lifehistory-MilitaryStatus.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-lifehistory-MilitaryStatus.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-lifehistory-MilitaryStatus.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1351,8 +1654,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1414,7 +1717,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1443,7 +1746,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1475,7 +1778,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1485,6 +1788,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1535,7 +1844,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1598,7 +1907,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1627,7 +1936,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1669,6 +1978,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1676,6 +1991,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1695,8 +2014,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1733,6 +2052,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1740,6 +2063,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1748,7 +2075,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1761,6 +2088,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1783,7 +2116,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1796,6 +2129,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1803,6 +2142,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1810,6 +2153,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1818,7 +2165,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1862,7 +2209,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lifehistory-MilitaryStatusVS"
+            "reference": "http://standardhealthrecord.org/shr/lifehistory/vs/MilitaryStatusVS"
           }
         }
       },
@@ -1959,12 +2306,16 @@
         ]
       },
       {
-        "id": "Observation:shr-lifehistory-MilitaryStatus.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-lifehistory-MilitaryStatus.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-Occupation.json b/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-Occupation.json
old mode 100755
new mode 100644
index 9db377e..012052d
--- a/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-Occupation.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-Occupation.json
@@ -3,7 +3,7 @@
   "id": "shr-lifehistory-Occupation",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR Occupation Profile</b></p>\n  <p>The principal activity that a person does to earn money, specifying the job performed by the subject, for example, accountant, programmer analyst, patient care associate, staff nurse, etc.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.lifehistory.Occupation maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR Occupation Profile</b></p>\n  <p>The principal activity that a person does to earn money, specifying the job performed by the subject, for example, accountant, programmer analyst, patient care associate, staff nurse, etc.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.lifehistory.Occupation maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lifehistory-Occupation",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.lifehistory.Occupation"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Occupation Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.811Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.428Z",
   "description": "The principal activity that a person does to earn money, specifying the job performed by the subject, for example, accountant, programmer analyst, patient care associate, staff nurse, etc.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR Occupation Profile",
         "definition": "The principal activity that a person does to earn money, specifying the job performed by the subject, for example, accountant, programmer analyst, patient care associate, staff nurse, etc.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-lifehistory-Occupation.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "233",
+          "id": "223",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "codeableconcept",
         "definition": "A set of codes drawn from different coding systems, representing the same concept.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -372,6 +408,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -404,6 +441,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -435,16 +473,19 @@
         "id": "Observation:shr-lifehistory-Occupation.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "234",
+          "id": "224",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -474,6 +515,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -504,8 +546,8 @@
       {
         "id": "Observation:shr-lifehistory-Occupation.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -514,7 +556,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -529,6 +576,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-lifehistory-Occupation.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-lifehistory-Occupation.status",
         "extension": [
@@ -540,6 +644,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -551,6 +656,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -558,6 +669,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -577,8 +696,8 @@
         "path": "Observation.category",
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 0,
         "max": "*",
         "type": [
@@ -588,8 +707,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -611,6 +736,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -629,6 +757,12 @@
         },
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -636,6 +770,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -644,6 +786,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -655,7 +801,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -679,6 +825,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -694,20 +844,32 @@
         ]
       },
       {
-        "id": "Observation:shr-lifehistory-Occupation.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-lifehistory-Occupation.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -727,8 +889,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -742,6 +907,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -761,7 +930,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -813,6 +982,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -832,8 +1005,8 @@
         "path": "Observation.value[x]",
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -846,6 +1019,9 @@
           {
             "code": "string"
           },
+          {
+            "code": "boolean"
+          },
           {
             "code": "Range"
           },
@@ -873,6 +1049,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -880,6 +1064,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -888,7 +1076,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -901,6 +1089,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -908,6 +1102,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -935,6 +1133,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -942,6 +1146,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -949,6 +1157,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -966,6 +1178,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -981,8 +1197,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -991,6 +1206,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -998,6 +1219,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -1005,6 +1230,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1013,7 +1242,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1024,6 +1253,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1046,7 +1281,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1056,6 +1291,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1063,6 +1302,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1071,7 +1314,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1085,6 +1328,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1092,6 +1339,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1100,7 +1351,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1169,7 +1420,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1198,7 +1449,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1280,30 +1531,82 @@
         ]
       },
       {
-        "id": "Observation:shr-lifehistory-Occupation.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-lifehistory-Occupation.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-lifehistory-Occupation.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1359,8 +1662,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1422,7 +1725,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1451,7 +1754,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1483,7 +1786,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1493,6 +1796,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1543,7 +1852,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1606,7 +1915,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1635,7 +1944,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1677,6 +1986,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1684,6 +1999,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1703,8 +2022,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1741,6 +2060,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1748,6 +2071,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1756,7 +2083,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1769,6 +2096,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1791,7 +2124,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1804,6 +2137,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1811,6 +2150,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1818,6 +2161,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1826,7 +2173,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1975,12 +2322,16 @@
         ]
       },
       {
-        "id": "Observation:shr-lifehistory-Occupation.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-lifehistory-Occupation.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-PrenatalExposure.json b/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-PrenatalExposure.json
old mode 100755
new mode 100644
index 4783718..94d16d8
--- a/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-PrenatalExposure.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-PrenatalExposure.json
@@ -3,7 +3,7 @@
   "id": "shr-lifehistory-PrenatalExposure",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR PrenatalExposure Profile</b></p>\n  <p>Fetal contact with a dangerous substance via the mother.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.lifehistory.PrenatalExposure maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR PrenatalExposure Profile</b></p>\n  <p>Fetal contact with a dangerous substance via the mother.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.lifehistory.PrenatalExposure maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lifehistory-PrenatalExposure",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.lifehistory.PrenatalExposure"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR PrenatalExposure Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.734Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.406Z",
   "description": "Fetal contact with a dangerous substance via the mother.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR PrenatalExposure Profile",
         "definition": "Fetal contact with a dangerous substance via the mother.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-lifehistory-PrenatalExposure.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "227",
+          "id": "217",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -398,6 +435,7 @@
         "path": "Observation.extension",
         "sliceName": "setting",
         "definition": "Description of the place or type of surroundings where something is positioned or where an event takes place.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -430,6 +468,7 @@
         "path": "Observation.extension",
         "sliceName": "location",
         "definition": "A position, site, or point in space where something can be found.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -462,6 +501,7 @@
         "path": "Observation.extension",
         "sliceName": "frequency",
         "definition": "How many occurrences of an event per unit of time.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -494,6 +534,7 @@
         "path": "Observation.extension",
         "sliceName": "substance",
         "definition": "Any matter of defined composition that has discrete existence, whose origin may be biological, mineral or chemical.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -575,7 +616,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -617,7 +657,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lifehistory-TeratogenVS"
+            "reference": "http://standardhealthrecord.org/shr/lifehistory/vs/TeratogenVS"
           }
         },
         "mapping": [
@@ -632,6 +672,7 @@
         "path": "Observation.extension",
         "sliceName": "generalizedlikelihood",
         "definition": "Quantitative or qualitative measure of likelihood.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -664,6 +705,7 @@
         "path": "Observation.extension",
         "sliceName": "exposuresourceorvector",
         "definition": "Where the substance originated. Vectors include animals (e.g., tick, mosquito, cats, livestock) capable of transmitting an infectious agent among vertebrates. Sources could include food, contaminated drinking water, air, radon gas in the home, etc.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -696,6 +738,7 @@
         "path": "Observation.extension",
         "sliceName": "exposurereason",
         "definition": "Why the exposure occurred.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -728,6 +771,7 @@
         "path": "Observation.extension",
         "sliceName": "exposuremethod",
         "definition": "How the exposure occurred, e.g. cutaneous contact, injection, ingestion, sexual contact, inhalation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -760,6 +804,7 @@
         "path": "Observation.extension",
         "sliceName": "routeintobody",
         "definition": "The way a substance enters an organism after contact, particularly, the route of drug administration.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -792,6 +837,7 @@
         "path": "Observation.extension",
         "sliceName": "test",
         "definition": "A laboratory, radiologic, or other clinical test or measurement used to determine the presence, absence, or degree of a condition, or assess the function or health of an individual. This includes patient-generated data, such as pedometer readings.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -824,6 +870,7 @@
         "path": "Observation.extension",
         "sliceName": "gestationaltemporalcontext",
         "definition": "A named gestational time period, or a gestational age.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -855,16 +902,19 @@
         "id": "Observation:shr-lifehistory-PrenatalExposure.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "228",
+          "id": "218",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -894,6 +944,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -924,8 +975,8 @@
       {
         "id": "Observation:shr-lifehistory-PrenatalExposure.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -934,7 +985,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -949,6 +1005,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-lifehistory-PrenatalExposure.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-lifehistory-PrenatalExposure.status",
         "extension": [
@@ -960,6 +1073,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -971,6 +1085,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -978,6 +1098,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -996,17 +1124,20 @@
         "id": "Observation:shr-lifehistory-PrenatalExposure.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "226",
+          "id": "216",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 1,
         "max": "*",
         "type": [
@@ -1016,8 +1147,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -1081,6 +1218,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -1099,6 +1239,12 @@
         },
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1106,6 +1252,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1114,6 +1268,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -1125,7 +1283,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -1149,6 +1307,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -1164,20 +1326,32 @@
         ]
       },
       {
-        "id": "Observation:shr-lifehistory-PrenatalExposure.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-lifehistory-PrenatalExposure.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -1197,8 +1371,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -1212,6 +1389,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -1231,7 +1412,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -1283,6 +1464,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -1302,8 +1487,8 @@
         "path": "Observation.value[x]",
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1316,6 +1501,9 @@
           {
             "code": "string"
           },
+          {
+            "code": "boolean"
+          },
           {
             "code": "Range"
           },
@@ -1343,6 +1531,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1350,6 +1546,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1358,7 +1558,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1371,6 +1571,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1378,6 +1584,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -1405,6 +1615,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1412,6 +1628,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1419,6 +1639,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1436,6 +1660,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -1451,8 +1679,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1461,6 +1688,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -1468,6 +1701,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -1475,6 +1712,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1483,7 +1724,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1494,6 +1735,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1516,7 +1763,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1526,6 +1773,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1533,6 +1784,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1541,7 +1796,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1555,6 +1810,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1562,6 +1821,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1570,7 +1833,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1639,7 +1902,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1668,7 +1931,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1750,30 +2013,82 @@
         ]
       },
       {
-        "id": "Observation:shr-lifehistory-PrenatalExposure.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-lifehistory-PrenatalExposure.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-lifehistory-PrenatalExposure.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1829,8 +2144,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1892,7 +2207,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1921,7 +2236,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1953,7 +2268,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1963,6 +2278,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -2013,7 +2334,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -2076,7 +2397,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -2105,7 +2426,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -2147,6 +2468,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -2154,6 +2481,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -2173,8 +2504,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -2211,6 +2542,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -2218,6 +2553,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -2226,7 +2565,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -2239,6 +2578,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -2261,7 +2606,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -2274,6 +2619,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -2281,6 +2632,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -2288,6 +2643,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -2296,7 +2655,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -2420,7 +2779,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lifehistory-TeratogenVS"
+            "reference": "http://standardhealthrecord.org/shr/lifehistory/vs/TeratogenVS"
           }
         }
       },
@@ -2556,9 +2915,12 @@
         "id": "Observation:shr-lifehistory-PrenatalExposure.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "226",
+          "id": "216",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -2657,12 +3019,16 @@
         ]
       },
       {
-        "id": "Observation:shr-lifehistory-PrenatalExposure.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-lifehistory-PrenatalExposure.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-ServiceConnectedDisability-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-ServiceConnectedDisability-extension.json
old mode 100755
new mode 100644
index 52db941..6322be2
--- a/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-ServiceConnectedDisability-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-ServiceConnectedDisability-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.lifehistory.ServiceConnectedDisability"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ServiceConnectedDisability Extension",
   "title": "SHR ServiceConnectedDisability Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.871Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.440Z",
   "description": "Percentage disability resulting from US Military Service.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -105,9 +106,12 @@
         "id": "Extension:serviceconnecteddisability.extension",
         "path": "Extension.extension",
         "slicing": {
-          "id": "237",
+          "id": "227",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -161,7 +165,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-Travel.json b/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-Travel.json
old mode 100755
new mode 100644
index 1f8ace5..667ed42
--- a/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-Travel.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-lifehistory-Travel.json
@@ -3,7 +3,7 @@
   "id": "shr-lifehistory-Travel",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR Travel Profile</b></p>\n  <p>Trip to a foreign country or an area, particularly when a health risk is involved.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.lifehistory.Travel maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR Travel Profile</b></p>\n  <p>Trip to a foreign country or an area, particularly when a health risk is involved.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.lifehistory.Travel maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lifehistory-Travel",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.lifehistory.Travel"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Travel Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.904Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.456Z",
   "description": "Trip to a foreign country or an area, particularly when a health risk is involved.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR Travel Profile",
         "definition": "Trip to a foreign country or an area, particularly when a health risk is involved.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-lifehistory-Travel.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "242",
+          "id": "232",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -398,6 +435,7 @@
         "path": "Observation.extension",
         "sliceName": "setting",
         "definition": "Description of the place or type of surroundings where something is positioned or where an event takes place.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -430,6 +468,7 @@
         "path": "Observation.extension",
         "sliceName": "location",
         "definition": "A position, site, or point in space where something can be found.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -462,6 +501,7 @@
         "path": "Observation.extension",
         "sliceName": "frequency",
         "definition": "How many occurrences of an event per unit of time.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -493,16 +533,19 @@
         "id": "Observation:shr-lifehistory-Travel.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "243",
+          "id": "233",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -532,6 +575,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -562,8 +606,8 @@
       {
         "id": "Observation:shr-lifehistory-Travel.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -572,7 +616,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -587,6 +636,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-lifehistory-Travel.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-lifehistory-Travel.status",
         "extension": [
@@ -598,6 +704,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -609,6 +716,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -616,6 +729,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -634,17 +755,20 @@
         "id": "Observation:shr-lifehistory-Travel.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "241",
+          "id": "231",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 1,
         "max": "*",
         "type": [
@@ -654,8 +778,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -698,6 +828,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -716,6 +849,12 @@
         },
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -723,6 +862,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -731,6 +878,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -742,7 +893,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -766,6 +917,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -781,20 +936,32 @@
         ]
       },
       {
-        "id": "Observation:shr-lifehistory-Travel.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-lifehistory-Travel.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -814,8 +981,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -829,6 +999,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -848,7 +1022,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -900,6 +1074,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -919,8 +1097,8 @@
         "path": "Observation.value[x]",
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -933,6 +1111,9 @@
           {
             "code": "string"
           },
+          {
+            "code": "boolean"
+          },
           {
             "code": "Range"
           },
@@ -960,6 +1141,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -967,6 +1156,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -975,7 +1168,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -988,6 +1181,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -995,6 +1194,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -1022,6 +1225,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1029,6 +1238,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1036,6 +1249,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1053,6 +1270,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -1068,8 +1289,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1078,6 +1298,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -1085,6 +1311,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -1092,6 +1322,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1100,7 +1334,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1111,6 +1345,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1133,7 +1373,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1143,6 +1383,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1150,6 +1394,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1158,7 +1406,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1172,6 +1420,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1179,6 +1431,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1187,7 +1443,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1256,7 +1512,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1285,7 +1541,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1367,30 +1623,82 @@
         ]
       },
       {
-        "id": "Observation:shr-lifehistory-Travel.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-lifehistory-Travel.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-lifehistory-Travel.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1446,8 +1754,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1509,7 +1817,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1538,7 +1846,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1570,7 +1878,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1580,6 +1888,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1630,7 +1944,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1693,7 +2007,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1722,7 +2036,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1764,6 +2078,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1771,6 +2091,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1790,8 +2114,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1828,6 +2152,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1835,6 +2163,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1843,7 +2175,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1856,6 +2188,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1878,7 +2216,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1891,6 +2229,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1898,6 +2242,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1905,6 +2253,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1913,7 +2265,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -2039,9 +2391,12 @@
         "id": "Observation:shr-lifehistory-Travel.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "241",
+          "id": "231",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -2119,12 +2474,16 @@
         ]
       },
       {
-        "id": "Observation:shr-lifehistory-Travel.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-lifehistory-Travel.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-medication-Adherence-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-medication-Adherence-extension.json
old mode 100755
new mode 100644
index 6f2fc89..53750fa
--- a/lib/resources/standard_health_record/StructureDefinition-shr-medication-Adherence-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-medication-Adherence-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.medication.Adherence"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Adherence Extension",
   "title": "SHR Adherence Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.269Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.271Z",
   "description": "A statement of the ability and cooperation of the patient in taking medicine or supplement as recommended or prescribed. This includes correct timing, dosage, and frequency.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -105,9 +106,12 @@
         "id": "Extension:adherence.extension",
         "path": "Extension.extension",
         "slicing": {
-          "id": "181",
+          "id": "178",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -213,7 +217,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-medication-AdherenceLevel-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-medication-AdherenceLevel-extension.json
old mode 100755
new mode 100644
index e6cec73..93159a9
--- a/lib/resources/standard_health_record/StructureDefinition-shr-medication-AdherenceLevel-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-medication-AdherenceLevel-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.medication.AdherenceLevel"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR AdherenceLevel Extension",
   "title": "SHR AdherenceLevel Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.269Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.271Z",
   "description": "The frequency that the stated treatment plan, prescription, or protocol is followed.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -170,7 +170,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeFrequencyVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeFrequencyVS"
           }
         },
         "mapping": [
@@ -221,7 +221,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeFrequencyVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeFrequencyVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-medication-MaximumDosePerTimePeriod.json b/lib/resources/standard_health_record/StructureDefinition-shr-medication-MaximumDosePerTimePeriod.json
new file mode 100644
index 0000000..2ea2be2
--- /dev/null
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-medication-MaximumDosePerTimePeriod.json
@@ -0,0 +1,238 @@
+{
+  "resourceType": "StructureDefinition",
+  "id": "shr-medication-MaximumDosePerTimePeriod",
+  "text": {
+    "status": "generated",
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR MaximumDosePerTimePeriod Profile</b></p>\n  <p>The maximum amount of a medication to be taken in a given period of time.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.medication.MaximumDosePerTimePeriod maps to Ratio:\n  AmountOfMedication maps to numerator\n  Duration maps to denominator\n</pre></p>\n</div>"
+  },
+  "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-medication-MaximumDosePerTimePeriod",
+  "identifier": [
+    {
+      "system": "http://standardhealthrecord.org",
+      "value": "shr.medication.MaximumDosePerTimePeriod"
+    }
+  ],
+  "version": "0.0.1",
+  "name": "SHR MaximumDosePerTimePeriod Profile",
+  "status": "draft",
+  "date": "2017-04-18T15:12:22.275Z",
+  "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
+  "contact": [
+    {
+      "telecom": [
+        {
+          "system": "url",
+          "value": "http://www.standardhealthrecord.org"
+        }
+      ]
+    }
+  ],
+  "description": "The maximum amount of a medication to be taken in a given period of time.",
+  "purpose": "Need to able to capture ratios for some measurements (titers) and some rates (costs).",
+  "fhirVersion": "3.0.0",
+  "mapping": [
+    {
+      "identity": "v2",
+      "uri": "http://hl7.org/v2",
+      "name": "HL7 v2 Mapping"
+    },
+    {
+      "identity": "rim",
+      "uri": "http://hl7.org/v3",
+      "name": "RIM Mapping"
+    }
+  ],
+  "kind": "complex-type",
+  "abstract": false,
+  "type": "Ratio",
+  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Ratio",
+  "derivation": "constraint",
+  "snapshot": {
+    "element": [
+      {
+        "id": "Ratio:shr-medication-MaximumDosePerTimePeriod",
+        "path": "Ratio",
+        "short": "SHR MaximumDosePerTimePeriod Profile",
+        "definition": "The maximum amount of a medication to be taken in a given period of time.",
+        "min": 0,
+        "max": "*",
+        "condition": [
+          "ele-1"
+        ],
+        "constraint": [
+          {
+            "key": "ele-1",
+            "severity": "error",
+            "human": "All FHIR elements must have a @value or children",
+            "expression": "children().count() > id.count()",
+            "xpath": "@value|f:*|h:div",
+            "source": "Element"
+          },
+          {
+            "key": "rat-1",
+            "severity": "error",
+            "human": "Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present",
+            "expression": "(numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())",
+            "xpath": "(count(f:numerator) = count(f:denominator)) and ((count(f:numerator) > 0) or (count(f:extension) > 0))"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          },
+          {
+            "identity": "v2",
+            "map": "N/A"
+          },
+          {
+            "identity": "rim",
+            "map": "RTO"
+          }
+        ]
+      },
+      {
+        "id": "Ratio:shr-medication-MaximumDosePerTimePeriod.id",
+        "path": "Ratio.id",
+        "representation": [
+          "xmlAttr"
+        ],
+        "short": "xml:id (or equivalent in JSON)",
+        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Element.id",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "Ratio:shr-medication-MaximumDosePerTimePeriod.extension",
+        "path": "Ratio.extension",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
+        "short": "Additional Content defined by implementations",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "Element.extension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "Ratio:shr-medication-MaximumDosePerTimePeriod.numerator",
+        "path": "Ratio.numerator",
+        "short": "Numerator value",
+        "definition": "The value of the numerator.",
+        "min": 1,
+        "max": "1",
+        "type": [
+          {
+            "code": "Quantity",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-Quantity"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".numerator"
+          }
+        ]
+      },
+      {
+        "id": "Ratio:shr-medication-MaximumDosePerTimePeriod.denominator",
+        "path": "Ratio.denominator",
+        "short": "Denominator value",
+        "definition": "The value of the denominator.",
+        "min": 1,
+        "max": "1",
+        "type": [
+          {
+            "code": "Quantity",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-Duration"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".denominator"
+          }
+        ]
+      }
+    ]
+  },
+  "differential": {
+    "element": [
+      {
+        "id": "Ratio:shr-medication-MaximumDosePerTimePeriod",
+        "path": "Ratio",
+        "short": "SHR MaximumDosePerTimePeriod Profile",
+        "definition": "The maximum amount of a medication to be taken in a given period of time."
+      },
+      {
+        "id": "Ratio:shr-medication-MaximumDosePerTimePeriod.numerator",
+        "path": "Ratio.numerator",
+        "min": 1,
+        "max": "1",
+        "type": [
+          {
+            "code": "Quantity",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-Quantity"
+          }
+        ]
+      },
+      {
+        "id": "Ratio:shr-medication-MaximumDosePerTimePeriod.denominator",
+        "path": "Ratio.denominator",
+        "min": 1,
+        "max": "1",
+        "type": [
+          {
+            "code": "Quantity",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-Duration"
+          }
+        ]
+      }
+    ]
+  }
+}
\ No newline at end of file
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-medication-Medication.json b/lib/resources/standard_health_record/StructureDefinition-shr-medication-Medication.json
old mode 100755
new mode 100644
index d61d9c2..4c4fc2f
--- a/lib/resources/standard_health_record/StructureDefinition-shr-medication-Medication.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-medication-Medication.json
@@ -3,7 +3,7 @@
   "id": "shr-medication-Medication",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR Medication Profile</b></p>\n  <p>A type of prescription drug or over-the-counter drug that is used to prevent, treat, or relieve symptoms of a disease or abnormal condition, but excluding vaccines.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.medication.Medication maps to Medication:\n  CodeableConcept maps to code\n  DoseForm maps to product.form\n  Ingredient maps to product.ingredient.item[x].CodeableConcept\n  Ingredient.IngredientAmount maps to product.ingredient.amount.numerator\n  Ingredient.AmountOfMedication maps to product.ingredient.amount.denominator\n  Brand maps to isBrand\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR Medication Profile</b></p>\n  <p>A type of prescription drug or over-the-counter drug that is used to prevent, treat, or relieve symptoms of a disease or abnormal condition, but excluding vaccines.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.medication.Medication maps to Medication:\n  CodeableConcept maps to code\n  DoseForm maps to form\n  Ingredient maps to ingredient.item[x].CodeableConcept\n  Ingredient.IngredientAmount maps to ingredient.amount.numerator\n  Ingredient.AmountOfMedication maps to ingredient.amount.denominator\n  Ingredient.IsActiveIngredient maps to ingredient.isActive\n  Brand maps to isBrand\n  OverTheCounter maps to isOverTheCounter\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-medication-Medication",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.medication.Medication"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Medication Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.233Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.267Z",
   "description": "A type of prescription drug or over-the-counter drug that is used to prevent, treat, or relieve symptoms of a disease or abnormal condition, but excluding vaccines.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "script10.6",
@@ -122,7 +123,7 @@
         "path": "Medication.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -161,7 +162,7 @@
         "path": "Medication.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -182,7 +183,7 @@
         "path": "Medication.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -202,6 +203,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -216,7 +225,7 @@
         "path": "Medication.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -250,7 +259,7 @@
         "path": "Medication.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -278,17 +287,9 @@
       {
         "id": "Medication:shr-medication-Medication.extension",
         "path": "Medication.extension",
-        "slicing": {
-          "id": "180",
-          "discriminator": [
-            "url"
-          ],
-          "ordered": false,
-          "rules": "open"
-        },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -312,44 +313,12 @@
           }
         ]
       },
-      {
-        "id": "Medication:shr-medication-Medication.extension:overthecounter",
-        "path": "Medication.extension",
-        "sliceName": "overthecounter",
-        "definition": "True if the medication is available to consumers without a prescription.",
-        "alias": [
-          "extensions",
-          "user content"
-        ],
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "DomainResource.extension",
-          "min": 0,
-          "max": "*"
-        },
-        "type": [
-          {
-            "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-medication-OverTheCounter-extension"
-          }
-        ],
-        "mustSupport": false,
-        "isModifier": false,
-        "isSummary": false,
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "N/A"
-          }
-        ]
-      },
       {
         "id": "Medication:shr-medication-Medication.modifierExtension",
         "path": "Medication.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -379,7 +348,7 @@
         "path": "Medication.code",
         "short": "Codes that identify this medication",
         "definition": "A code (or set of codes) that specify this medication, or a textual description if no code is available. Usage note: This could be a standard medication code such as a code from RxNorm, SNOMED CT, IDMP etc. It could also be a national or local formulary code, optionally with translations to other code systems.",
-        "comments": "Depending on the context of use, the code that was actually selected by the user (prescriber, dispenser, etc.) should be marked as \"primary\". Other codes can only be literal translations to alternative code systems, or codes at a lower level of granularity (e.g. a generic code for a vendor-specific primary one).",
+        "comment": "Depending on the context of use, the code that was actually selected by the user (prescriber, dispenser, etc.) will have the coding.userSelected set to true.  As described in the coding datatype: \"A coding may be marked as a \"userSelected\" if a user selected the particular coded value in a user interface (e.g. the user selects an item in a pick-list). If a user selected coding exists, it is the preferred choice for performing translations etc.",
         "min": 1,
         "max": "1",
         "type": [
@@ -390,10 +359,9 @@
         ],
         "isSummary": true,
         "binding": {
-          "strength": "example",
-          "description": "A coded concept that defines the type of a medication",
+          "strength": "required",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/medication-codes"
+            "reference": "http://standardhealthrecord.org/shr/medication/vs/MedicationVS"
           }
         },
         "mapping": [
@@ -416,44 +384,49 @@
         ]
       },
       {
-        "id": "Medication:shr-medication-Medication.isBrand",
-        "path": "Medication.isBrand",
-        "short": "True if a brand",
-        "definition": "Set to true if the item is attributable to a specific manufacturer.",
+        "id": "Medication:shr-medication-Medication.status",
+        "path": "Medication.status",
+        "short": "active | inactive | entered-in-error",
+        "definition": "A code to indicate if the medication is in active use.",
+        "comment": "This status is not intended to specify if a medication is part of a formulary.",
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "boolean"
+            "code": "code"
           }
         ],
         "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MedicationStatus"
+            }
+          ],
+          "strength": "required",
+          "description": "A coded concept defining if the medication is in active use",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/medication-status"
+          }
+        },
         "mapping": [
-          {
-            "identity": "script10.6",
-            "map": "no mapping"
-          },
           {
             "identity": "rim",
-            "map": "true if .player.scopingRole[typeCode=MANU] exists"
-          },
-          {
-            "identity": "w5",
-            "map": "class"
+            "map": ".statusCode"
           }
         ]
       },
       {
-        "id": "Medication:shr-medication-Medication.manufacturer",
-        "path": "Medication.manufacturer",
-        "short": "Manufacturer of the item",
-        "definition": "Describes the details of the manufacturer.",
+        "id": "Medication:shr-medication-Medication.isBrand",
+        "path": "Medication.isBrand",
+        "short": "True if a brand",
+        "definition": "Set to true if the item is attributable to a specific manufacturer.",
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
+            "code": "boolean"
           }
         ],
         "isSummary": true,
@@ -462,147 +435,79 @@
             "identity": "script10.6",
             "map": "no mapping"
           },
-          {
-            "identity": "v2",
-            "map": "RXD-20-Substance Manufacturer Name / RXG-21-Substance Manufacturer Name / RXA-17-Substance Manufacturer Name"
-          },
           {
             "identity": "rim",
-            "map": ".player.scopingRole[typeCode=MANU].scoper"
+            "map": "true if .player.scopingRole[typeCode=MANU] exists"
           },
           {
             "identity": "w5",
-            "map": "who.actor"
+            "map": "class"
           }
         ]
       },
       {
-        "id": "Medication:shr-medication-Medication.product",
-        "path": "Medication.product",
-        "short": "Administrable medication details",
-        "definition": "Information that only applies to products (not packages).",
+        "id": "Medication:shr-medication-Medication.isOverTheCounter",
+        "path": "Medication.isOverTheCounter",
+        "short": "True if medication does not require a prescription",
+        "definition": "Set to true if the medication can be obtained without an order from a prescriber.",
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "BackboneElement"
-          }
-        ],
-        "constraint": [
-          {
-            "key": "ele-1",
-            "severity": "error",
-            "human": "All FHIR elements must have a @value or children",
-            "expression": "children().count() > id.count()",
-            "xpath": "@value|f:*|h:div",
-            "source": "Element"
+            "code": "boolean"
           }
         ],
+        "isSummary": true,
         "mapping": [
           {
-            "identity": "script10.6",
-            "map": "//element(*,DrugCodedType)/"
+            "identity": "rim",
+            "map": "NA"
           },
           {
-            "identity": "rim",
-            "map": ".player [classCode != CONT]"
+            "identity": "w5",
+            "map": "class"
           }
         ]
       },
       {
-        "id": "Medication:shr-medication-Medication.product.id",
-        "path": "Medication.product.id",
-        "representation": [
-          "xmlAttr"
-        ],
-        "short": "xml:id (or equivalent in JSON)",
-        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+        "id": "Medication:shr-medication-Medication.manufacturer",
+        "path": "Medication.manufacturer",
+        "short": "Manufacturer of the item",
+        "definition": "Describes the details of the manufacturer of the medication product.  This is not intended to represent the distributor of a medication product.",
         "min": 0,
         "max": "1",
-        "base": {
-          "path": "Element.id",
-          "min": 0,
-          "max": "1"
-        },
         "type": [
           {
-            "code": "string"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
           }
         ],
+        "isSummary": true,
         "mapping": [
           {
-            "identity": "rim",
-            "map": "n/a"
-          }
-        ]
-      },
-      {
-        "id": "Medication:shr-medication-Medication.product.extension",
-        "path": "Medication.product.extension",
-        "short": "Additional Content defined by implementations",
-        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
-        "alias": [
-          "extensions",
-          "user content"
-        ],
-        "min": 0,
-        "max": "*",
-        "base": {
-          "path": "Element.extension",
-          "min": 0,
-          "max": "*"
-        },
-        "type": [
+            "identity": "script10.6",
+            "map": "no mapping"
+          },
           {
-            "code": "Extension"
-          }
-        ],
-        "mapping": [
+            "identity": "v2",
+            "map": "RXD-20-Substance Manufacturer Name / RXG-21-Substance Manufacturer Name / RXA-17-Substance Manufacturer Name"
+          },
           {
             "identity": "rim",
-            "map": "n/a"
-          }
-        ]
-      },
-      {
-        "id": "Medication:shr-medication-Medication.product.modifierExtension",
-        "path": "Medication.product.modifierExtension",
-        "short": "Extensions that cannot be ignored",
-        "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
-        "alias": [
-          "extensions",
-          "user content",
-          "modifiers"
-        ],
-        "min": 0,
-        "max": "*",
-        "base": {
-          "path": "BackboneElement.modifierExtension",
-          "min": 0,
-          "max": "*"
-        },
-        "type": [
-          {
-            "code": "Extension"
-          }
-        ],
-        "isModifier": true,
-        "isSummary": true,
-        "mapping": [
+            "map": ".player.scopingRole[typeCode=MANU].scoper"
+          },
           {
-            "identity": "rim",
-            "map": "N/A"
+            "identity": "w5",
+            "map": "who.actor"
           }
         ]
       },
       {
-        "id": "Medication:shr-medication-Medication.product.form",
-        "path": "Medication.product.form",
+        "id": "Medication:shr-medication-Medication.form",
+        "path": "Medication.form",
         "short": "powder | tablets | capsule +",
         "definition": "Describes the form of the item.  Powder; tablets; capsule.",
-        "comments": "When Medication is referenced from MedicationRequest, this is the ordered form.  When Medication is referenced within MedicationDispense, this is the dispensed form.  When Medication is referenced within MedicationAdministration, this is administered form.",
+        "comment": "When Medication is referenced from MedicationRequest, this is the ordered form.  When Medication is referenced within MedicationDispense, this is the dispensed form.  When Medication is referenced within MedicationAdministration, this is administered form.",
         "min": 0,
         "max": "1",
         "type": [
@@ -612,6 +517,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MedicationForm"
+            }
+          ],
           "strength": "example",
           "description": "A coded concept defining the form of a medication",
           "valueSetReference": {
@@ -634,11 +545,11 @@
         ]
       },
       {
-        "id": "Medication:shr-medication-Medication.product.ingredient",
-        "path": "Medication.product.ingredient",
+        "id": "Medication:shr-medication-Medication.ingredient",
+        "path": "Medication.ingredient",
         "short": "Active or inactive ingredient",
         "definition": "Identifies a particular constituent of interest in the product.",
-        "comments": "The ingredients need not be a complete list; usually only active ingredients are listed.",
+        "comment": "The ingredients need not be a complete list.  If an ingredient is not specified, this does not indicate whether an ingredient is present or absent.  If an ingredient is specified it does not mean that all ingredients are specified.  It is possible to specify both inactive and active ingredients.",
         "min": 0,
         "max": "*",
         "type": [
@@ -664,8 +575,8 @@
         ]
       },
       {
-        "id": "Medication:shr-medication-Medication.product.ingredient.id",
-        "path": "Medication.product.ingredient.id",
+        "id": "Medication:shr-medication-Medication.ingredient.id",
+        "path": "Medication.ingredient.id",
         "representation": [
           "xmlAttr"
         ],
@@ -691,11 +602,11 @@
         ]
       },
       {
-        "id": "Medication:shr-medication-Medication.product.ingredient.extension",
-        "path": "Medication.product.ingredient.extension",
+        "id": "Medication:shr-medication-Medication.ingredient.extension",
+        "path": "Medication.ingredient.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -720,11 +631,11 @@
         ]
       },
       {
-        "id": "Medication:shr-medication-Medication.product.ingredient.modifierExtension",
-        "path": "Medication.product.ingredient.modifierExtension",
+        "id": "Medication:shr-medication-Medication.ingredient.modifierExtension",
+        "path": "Medication.ingredient.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -752,12 +663,15 @@
         ]
       },
       {
-        "id": "Medication:shr-medication-Medication.product.ingredient.item[x]",
-        "path": "Medication.product.ingredient.item[x]",
+        "id": "Medication:shr-medication-Medication.ingredient.item[x]",
+        "path": "Medication.ingredient.item[x]",
         "slicing": {
-          "id": "179",
+          "id": "177",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -788,8 +702,8 @@
         ]
       },
       {
-        "id": "Medication:shr-medication-Medication.product.ingredient.itemCodeableConcept:shr-core-CodeableConcept",
-        "path": "Medication.product.ingredient.itemCodeableConcept",
+        "id": "Medication:shr-medication-Medication.ingredient.itemCodeableConcept:shr-core-CodeableConcept",
+        "path": "Medication.ingredient.itemCodeableConcept",
         "sliceName": "shr-core-CodeableConcept",
         "short": "The product contained",
         "definition": "The actual ingredient - either a substance (simple ingredient) or another medication.",
@@ -800,71 +714,64 @@
             "code": "CodeableConcept",
             "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
           }
-        ]
+        ],
+        "binding": {
+          "strength": "required",
+          "valueSetReference": {
+            "reference": "http://standardhealthrecord.org/shr/medication/vs/MedicationVS"
+          }
+        }
       },
       {
-        "id": "Medication:shr-medication-Medication.product.ingredient.amount",
-        "path": "Medication.product.ingredient.amount",
-        "short": "Quantity of ingredient present",
-        "definition": "Specifies how many (or how much) of the items there are in this Medication.  For example, 250 mg per tablet.  This is expressed as a ratio where the numerator is 250mg and the denominator is 1 tablet.",
+        "id": "Medication:shr-medication-Medication.ingredient.isActive",
+        "path": "Medication.ingredient.isActive",
+        "short": "Active ingredient indicator",
+        "definition": "Indication of whether this ingredient affects the therapeutic action of the drug.",
+        "requirements": "True indicates that the ingredient affects the therapeutic action of the drug (i.e. active). \rFalse indicates that the ingredient does not affect the therapeutic action of the drug (i.e. inactive).",
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "Ratio"
+            "code": "boolean"
           }
         ],
         "mapping": [
-          {
-            "identity": "script10.6",
-            "map": "//element(*,DrugCodedType)/Strength"
-          },
-          {
-            "identity": "v2",
-            "map": "RXC-3-Component Amount & RXC-4-Component Units  if medication: RXO-2-Requested Give Amount - Minimum & RXO-4-Requested Give Units / RXO-3-Requested Give Amount - Maximum & RXO-4-Requested Give Units / RXO-11-Requested Dispense Amount & RXO-12-Requested Dispense Units / RXE-3-Give Amount - Minimum & RXE-5-Give Units / RXE-4-Give Amount - Maximum & RXE-5-Give Units / RXE-10-Dispense Amount & RXE-10-Dispense Units"
-          },
           {
             "identity": "rim",
-            "map": ".quantity"
+            "map": "NA"
           }
         ]
       },
       {
-        "id": "Medication:shr-medication-Medication.product.batch",
-        "path": "Medication.product.batch",
-        "short": "Identifies a single production run",
-        "definition": "Information about a group of medication produced or packaged from one production run.",
+        "id": "Medication:shr-medication-Medication.ingredient.amount",
+        "path": "Medication.ingredient.amount",
+        "short": "Quantity of ingredient present",
+        "definition": "Specifies how many (or how much) of the items there are in this Medication.  For example, 250 mg per tablet.  This is expressed as a ratio where the numerator is 250mg and the denominator is 1 tablet.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
-            "code": "BackboneElement"
-          }
-        ],
-        "constraint": [
-          {
-            "key": "ele-1",
-            "severity": "error",
-            "human": "All FHIR elements must have a @value or children",
-            "expression": "children().count() > id.count()",
-            "xpath": "@value|f:*|h:div",
-            "source": "Element"
+            "code": "Ratio"
           }
         ],
         "mapping": [
           {
             "identity": "script10.6",
-            "map": "no mapping"
+            "map": "//element(*,DrugCodedType)/Strength"
+          },
+          {
+            "identity": "v2",
+            "map": "RXC-3-Component Amount & RXC-4-Component Units  if medication: RXO-2-Requested Give Amount - Minimum & RXO-4-Requested Give Units / RXO-3-Requested Give Amount - Maximum & RXO-4-Requested Give Units / RXO-11-Requested Dispense Amount & RXO-12-Requested Dispense Units / RXE-3-Give Amount - Minimum & RXE-5-Give Units / RXE-4-Give Amount - Maximum & RXE-5-Give Units / RXE-10-Dispense Amount & RXE-10-Dispense Units"
           },
           {
             "identity": "rim",
-            "map": "participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].id"
+            "map": ".quantity"
           }
         ]
       },
       {
-        "id": "Medication:shr-medication-Medication.product.batch.id",
-        "path": "Medication.product.batch.id",
+        "id": "Medication:shr-medication-Medication.ingredient.amount.id",
+        "path": "Medication.ingredient.amount.id",
         "representation": [
           "xmlAttr"
         ],
@@ -890,11 +797,21 @@
         ]
       },
       {
-        "id": "Medication:shr-medication-Medication.product.batch.extension",
-        "path": "Medication.product.batch.extension",
+        "id": "Medication:shr-medication-Medication.ingredient.amount.extension",
+        "path": "Medication.ingredient.amount.extension",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -919,88 +836,44 @@
         ]
       },
       {
-        "id": "Medication:shr-medication-Medication.product.batch.modifierExtension",
-        "path": "Medication.product.batch.modifierExtension",
-        "short": "Extensions that cannot be ignored",
-        "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
-        "alias": [
-          "extensions",
-          "user content",
-          "modifiers"
-        ],
-        "min": 0,
-        "max": "*",
-        "base": {
-          "path": "BackboneElement.modifierExtension",
-          "min": 0,
-          "max": "*"
-        },
-        "type": [
-          {
-            "code": "Extension"
-          }
-        ],
-        "isModifier": true,
-        "isSummary": true,
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "N/A"
-          }
-        ]
-      },
-      {
-        "id": "Medication:shr-medication-Medication.product.batch.lotNumber",
-        "path": "Medication.product.batch.lotNumber",
-        "short": "Identifier assigned to batch",
-        "definition": "The assigned lot number of a batch of the specified product.",
+        "id": "Medication:shr-medication-Medication.ingredient.amount.numerator",
+        "path": "Medication.ingredient.amount.numerator",
+        "short": "Numerator value",
+        "definition": "The value of the numerator.",
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "string"
+            "code": "Quantity",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-Quantity"
           }
         ],
+        "isSummary": true,
         "mapping": [
-          {
-            "identity": "script10.6",
-            "map": "no mapping"
-          },
-          {
-            "identity": "v2",
-            "map": "RXA-15 Substance Lot Number / RXG-19 Substance Lot Number"
-          },
           {
             "identity": "rim",
-            "map": "Not Mapped"
+            "map": ".numerator"
           }
         ]
       },
       {
-        "id": "Medication:shr-medication-Medication.product.batch.expirationDate",
-        "path": "Medication.product.batch.expirationDate",
-        "short": "When batch will expire",
-        "definition": "When this specific batch of product will expire.",
+        "id": "Medication:shr-medication-Medication.ingredient.amount.denominator",
+        "path": "Medication.ingredient.amount.denominator",
+        "short": "Denominator value",
+        "definition": "The value of the denominator.",
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "dateTime"
+            "code": "Quantity",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-Quantity"
           }
         ],
+        "isSummary": true,
         "mapping": [
-          {
-            "identity": "script10.6",
-            "map": "no mapping"
-          },
-          {
-            "identity": "v2",
-            "map": "RXA-16 Substance Expiration Date / RXG-20 Substance Expiration Date"
-          },
           {
             "identity": "rim",
-            "map": "participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].expirationTime"
+            "map": ".denominator"
           }
         ]
       },
@@ -1069,7 +942,7 @@
         "path": "Medication.package.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1098,7 +971,7 @@
         "path": "Medication.package.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1138,10 +1011,16 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MedicationContainer"
+            }
+          ],
           "strength": "example",
           "description": "A coded concept defining the kind of container a medication package is packaged in",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/medication-package-form-codes"
+            "reference": "http://hl7.org/fhir/ValueSet/medication-package-form"
           }
         },
         "mapping": [
@@ -1220,7 +1099,7 @@
         "path": "Medication.package.content.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1249,7 +1128,7 @@
         "path": "Medication.package.content.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1326,6 +1205,201 @@
             "map": ".quantity"
           }
         ]
+      },
+      {
+        "id": "Medication:shr-medication-Medication.package.batch",
+        "path": "Medication.package.batch",
+        "short": "Identifies a single production run",
+        "definition": "Information about a group of medication produced or packaged from one production run.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "BackboneElement"
+          }
+        ],
+        "constraint": [
+          {
+            "key": "ele-1",
+            "severity": "error",
+            "human": "All FHIR elements must have a @value or children",
+            "expression": "children().count() > id.count()",
+            "xpath": "@value|f:*|h:div",
+            "source": "Element"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "script10.6",
+            "map": "no mapping"
+          },
+          {
+            "identity": "rim",
+            "map": "participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].id"
+          }
+        ]
+      },
+      {
+        "id": "Medication:shr-medication-Medication.package.batch.id",
+        "path": "Medication.package.batch.id",
+        "representation": [
+          "xmlAttr"
+        ],
+        "short": "xml:id (or equivalent in JSON)",
+        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Element.id",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "Medication:shr-medication-Medication.package.batch.extension",
+        "path": "Medication.package.batch.extension",
+        "short": "Additional Content defined by implementations",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "Element.extension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "Medication:shr-medication-Medication.package.batch.modifierExtension",
+        "path": "Medication.package.batch.modifierExtension",
+        "short": "Extensions that cannot be ignored",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content",
+          "modifiers"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "BackboneElement.modifierExtension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "isModifier": true,
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "N/A"
+          }
+        ]
+      },
+      {
+        "id": "Medication:shr-medication-Medication.package.batch.lotNumber",
+        "path": "Medication.package.batch.lotNumber",
+        "short": "Identifier assigned to batch",
+        "definition": "The assigned lot number of a batch of the specified product.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "script10.6",
+            "map": "no mapping"
+          },
+          {
+            "identity": "v2",
+            "map": "RXA-15 Substance Lot Number / RXG-19 Substance Lot Number"
+          },
+          {
+            "identity": "rim",
+            "map": ".id"
+          }
+        ]
+      },
+      {
+        "id": "Medication:shr-medication-Medication.package.batch.expirationDate",
+        "path": "Medication.package.batch.expirationDate",
+        "short": "When batch will expire",
+        "definition": "When this specific batch of product will expire.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "dateTime"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "script10.6",
+            "map": "no mapping"
+          },
+          {
+            "identity": "v2",
+            "map": "RXA-16 Substance Expiration Date / RXG-20 Substance Expiration Date"
+          },
+          {
+            "identity": "rim",
+            "map": "participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].expirationTime"
+          }
+        ]
+      },
+      {
+        "id": "Medication:shr-medication-Medication.image",
+        "path": "Medication.image",
+        "short": "Picture of the medication",
+        "definition": "Photo(s) or graphic representation(s) of the medication.",
+        "requirements": "Note that \"image\" is only applicable when the medication.code represents a physical item (e.g. Amoxil 250 mg capsule) and not an abstract item (e.g. amoxicillin 250 mg).",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Attachment"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".participation[typeCode=SUBJ].role[classCode=MANU],source[classCode=OBS,moodCode=EVN,code=\"type of image\"].value(ED.image)"
+          }
+        ]
       }
     ]
   },
@@ -1337,22 +1411,6 @@
         "short": "SHR Medication Profile",
         "definition": "A type of prescription drug or over-the-counter drug that is used to prevent, treat, or relieve symptoms of a disease or abnormal condition, but excluding vaccines."
       },
-      {
-        "id": "Medication:shr-medication-Medication.extension:overthecounter",
-        "path": "Medication.extension",
-        "sliceName": "overthecounter",
-        "min": 0,
-        "max": "1",
-        "type": [
-          {
-            "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-medication-OverTheCounter-extension"
-          }
-        ],
-        "mustSupport": false,
-        "isModifier": false,
-        "isSummary": false
-      },
       {
         "id": "Medication:shr-medication-Medication.code",
         "path": "Medication.code",
@@ -1363,15 +1421,17 @@
             "code": "CodeableConcept",
             "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
           }
-        ]
-      },
-      {
-        "id": "Medication:shr-medication-Medication.product",
-        "path": "Medication.product"
+        ],
+        "binding": {
+          "strength": "required",
+          "valueSetReference": {
+            "reference": "http://standardhealthrecord.org/shr/medication/vs/MedicationVS"
+          }
+        }
       },
       {
-        "id": "Medication:shr-medication-Medication.product.form",
-        "path": "Medication.product.form",
+        "id": "Medication:shr-medication-Medication.form",
+        "path": "Medication.form",
         "type": [
           {
             "code": "CodeableConcept",
@@ -1380,16 +1440,19 @@
         ]
       },
       {
-        "id": "Medication:shr-medication-Medication.product.ingredient",
-        "path": "Medication.product.ingredient"
+        "id": "Medication:shr-medication-Medication.ingredient",
+        "path": "Medication.ingredient"
       },
       {
-        "id": "Medication:shr-medication-Medication.product.ingredient.item[x]",
-        "path": "Medication.product.ingredient.item[x]",
+        "id": "Medication:shr-medication-Medication.ingredient.item[x]",
+        "path": "Medication.ingredient.item[x]",
         "slicing": {
-          "id": "179",
+          "id": "177",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -1402,13 +1465,43 @@
         ]
       },
       {
-        "id": "Medication:shr-medication-Medication.product.ingredient.itemCodeableConcept:shr-core-CodeableConcept",
-        "path": "Medication.product.ingredient.itemCodeableConcept",
+        "id": "Medication:shr-medication-Medication.ingredient.itemCodeableConcept:shr-core-CodeableConcept",
+        "path": "Medication.ingredient.itemCodeableConcept",
         "type": [
           {
             "code": "CodeableConcept",
             "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
           }
+        ],
+        "binding": {
+          "strength": "required",
+          "valueSetReference": {
+            "reference": "http://standardhealthrecord.org/shr/medication/vs/MedicationVS"
+          }
+        }
+      },
+      {
+        "id": "Medication:shr-medication-Medication.ingredient.amount",
+        "path": "Medication.ingredient.amount"
+      },
+      {
+        "id": "Medication:shr-medication-Medication.ingredient.amount.numerator",
+        "path": "Medication.ingredient.amount.numerator",
+        "type": [
+          {
+            "code": "Quantity",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-Quantity"
+          }
+        ]
+      },
+      {
+        "id": "Medication:shr-medication-Medication.ingredient.amount.denominator",
+        "path": "Medication.ingredient.amount.denominator",
+        "type": [
+          {
+            "code": "Quantity",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-Quantity"
+          }
         ]
       }
     ]
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-medication-MedicationAfterChange-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-medication-MedicationAfterChange-extension.json
old mode 100755
new mode 100644
index ee3aebf..54c9378
--- a/lib/resources/standard_health_record/StructureDefinition-shr-medication-MedicationAfterChange-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-medication-MedicationAfterChange-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.medication.MedicationAfterChange"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR MedicationAfterChange Extension",
   "title": "SHR MedicationAfterChange Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.404Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.291Z",
   "description": "A medication taken, after the change.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-medication-MedicationBeforeChange-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-medication-MedicationBeforeChange-extension.json
old mode 100755
new mode 100644
index 46c6dda..901ee2e
--- a/lib/resources/standard_health_record/StructureDefinition-shr-medication-MedicationBeforeChange-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-medication-MedicationBeforeChange-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.medication.MedicationBeforeChange"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR MedicationBeforeChange Extension",
   "title": "SHR MedicationBeforeChange Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.403Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.291Z",
   "description": "The medication taken, prior to the change.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-medication-MedicationChange.json b/lib/resources/standard_health_record/StructureDefinition-shr-medication-MedicationChange.json
old mode 100755
new mode 100644
index 4a3184b..cde823d
--- a/lib/resources/standard_health_record/StructureDefinition-shr-medication-MedicationChange.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-medication-MedicationChange.json
@@ -12,8 +12,10 @@
       "value": "shr.medication.MedicationChange"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR MedicationChange Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.403Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,10 +27,9 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.291Z",
   "description": "Description of a modification or change of a medication or dosage.",
   "purpose": "Need some way to safely (without breaking interoperability) allow implementers to exchange content not supported by the initial set of declared resources.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "rim",
@@ -114,7 +115,7 @@
         "path": "Basic.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -153,7 +154,7 @@
         "path": "Basic.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -174,7 +175,7 @@
         "path": "Basic.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -194,6 +195,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -208,7 +217,7 @@
         "path": "Basic.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -242,7 +251,7 @@
         "path": "Basic.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -271,16 +280,19 @@
         "id": "Basic:shr-medication-MedicationChange.extension",
         "path": "Basic.extension",
         "slicing": {
-          "id": "189",
+          "id": "186",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -309,6 +321,7 @@
         "path": "Basic.extension",
         "sliceName": "effectivedate",
         "definition": "The date when something is to take effect.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -341,6 +354,7 @@
         "path": "Basic.extension",
         "sliceName": "typeofchange",
         "definition": "Whether the change is a dose change, switch to a new medication, or discontinuation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -373,6 +387,7 @@
         "path": "Basic.extension",
         "sliceName": "medicationbeforechange",
         "definition": "The medication taken, prior to the change.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -405,6 +420,7 @@
         "path": "Basic.extension",
         "sliceName": "medicationafterchange",
         "definition": "A medication taken, after the change.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -437,7 +453,7 @@
         "path": "Basic.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -491,8 +507,8 @@
         "path": "Basic.code",
         "short": "Kind of Resource",
         "definition": "Identifies the 'type' of resource - equivalent to the resource name for other resources.",
-        "comments": "Because resource references will only be able to indicate 'Basic', the type of reference will need to be specified in a Profile identified as part of the resource.  Refer to the resource notes section for information on appropriate terminologies for this code.",
-        "requirements": "Must be able to distinguish different types of \"basic\" resources.",
+        "comment": "Because resource references will only be able to indicate 'Basic', the type of reference will need to be specified in a Profile identified as part of the resource.  Refer to the resource notes section for information on appropriate terminologies for this code.\n\nThis element is labeled as a modifier because the it defines the meaning of the resource and cannot be ignored.",
+        "requirements": "Must be able to distinguish different types of Basic resources.",
         "min": 1,
         "max": "1",
         "type": [
@@ -511,6 +527,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BasicResourceType"
+            }
+          ],
           "strength": "example",
           "description": "Codes for identifying types of resources not yet defined by FHIR",
           "valueSetReference": {
@@ -533,7 +555,7 @@
         "path": "Basic.subject",
         "short": "Identifies the focus of this resource",
         "definition": "Identifies the patient, practitioner, device or any other resource that is the \"focus\" of this resource.",
-        "comments": "Optional as not all resources potential resources will have subjects.  Resources associated with multiple subjects can handle this via extension.",
+        "comment": "Optional as not all potential resources will have subjects.  Resources associated with multiple subjects can handle this via extension.",
         "requirements": "Needed for partitioning the resource by Patient.",
         "min": 0,
         "max": "1",
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-medication-MedicationNotAdministered.json b/lib/resources/standard_health_record/StructureDefinition-shr-medication-MedicationNotAdministered.json
old mode 100755
new mode 100644
index 56fe62d..4786925
--- a/lib/resources/standard_health_record/StructureDefinition-shr-medication-MedicationNotAdministered.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-medication-MedicationNotAdministered.json
@@ -3,7 +3,7 @@
   "id": "shr-medication-MedicationNotAdministered",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR MedicationNotAdministered Profile</b></p>\n  <p>A record of a medication NOT administered. Recorded when deviating from the care plan.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.medication.MedicationNotAdministered maps to MedicationStatement:\n  Medication maps to medication[x].Reference\n  PeriodOfUse maps to effective[x].Period\n  Reason maps to reasonForUseCodeableConcept\n  MedicationNotUsedModifier maps to notTaken\n  MedicationNotUsedModifier.Reason maps to reasonNotTaken\n  Dosage.AmountPerDose.Quantity maps to dosage.dose[x].SimpleQuantity\n  Dosage.AmountPerDose.TBD &quot;Range&quot; maps to dosage.dose[x].Range\n  Dosage.TimingOfDoses maps to dosage.timing\n  Dosage.DoseAsNeededIndicator maps to dosage.asNeeded[x].boolean\n  Dosage.DoseInstructionsText maps to dosage.text\n  Dosage.AdditionalDoseInstruction maps to dosage.additionalInstructions\n  Dosage.RouteIntoBody maps to dosage.route\n  Dosage.AdministrationMethod maps to dosage.method\n  Dosage.AdministrationBodySite maps to dosage.site\n  Dosage.MaximumDosePerTimePeriod maps to dosage.maxDosePerPeriod\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR MedicationNotAdministered Profile</b></p>\n  <p>A record of a medication NOT administered. Recorded when deviating from the care plan.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.medication.MedicationNotAdministered maps to MedicationStatement:\n  Medication maps to medication[x].Reference\n  PeriodOfUse maps to effective[x].Period\n  Reason maps to reasonCode\n  MedicationNotUsedModifier maps to taken\n  MedicationNotUsedModifier.Reason maps to reasonNotTaken\n  constrain dosage to 0..1\n  Dosage.AmountPerDose.Quantity maps to dosage.dose[x].SimpleQuantity\n  Dosage.AmountPerDose.&lt;TBD &quot;Range&quot;&gt; maps to dosage.dose[x].Range\n  Dosage.TimingOfDoses maps to dosage.timing\n  Dosage.DoseAsNeededIndicator maps to dosage.asNeeded[x].boolean\n  Dosage.DoseInstructionsText maps to dosage.text\n  Dosage.AdditionalDoseInstruction maps to dosage.additionalInstruction\n  Dosage.RouteIntoBody maps to dosage.route\n  Dosage.AdministrationMethod maps to dosage.method\n  Dosage.AdministrationBodySite maps to dosage.site\n  Dosage.MaximumDosePerTimePeriod maps to dosage.maxDosePerPeriod\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-medication-MedicationNotAdministered",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.medication.MedicationNotAdministered"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR MedicationNotAdministered Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.282Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,10 +27,14 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.273Z",
   "description": "A record of a medication NOT administered. Recorded when deviating from the care plan.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
     {
       "identity": "rim",
       "uri": "http://hl7.org/v3",
@@ -57,7 +63,7 @@
         "path": "MedicationStatement",
         "short": "SHR MedicationNotAdministered Profile",
         "definition": "A record of a medication NOT administered. Recorded when deviating from the care plan.",
-        "comments": "When interpreting a medicationStatement, the value of the status and NotTaken needed to be considered:\rMedicationStatement.status + MedicationStatement.wasNotTaken\rStatus=Active + NotTaken=T = Not currently taking\rStatus=Completed + NotTaken=T = Not taken in the past\rStatus=Intended + NotTaken=T = No intention of taking\rStatus=Active + NotTaken=F = Taking, but not as prescribed\rStatus=Active + NotTaken=F = Taking\rStatus=Intended +NotTaken= F = Will be taking (not started)\rStatus=Completed + NotTaken=F = Taken in past\rStatus=In Error + NotTaken=N/A = In Error.",
+        "comment": "When interpreting a medicationStatement, the value of the status and NotTaken needed to be considered:\rMedicationStatement.status + MedicationStatement.wasNotTaken\rStatus=Active + NotTaken=T = Not currently taking\rStatus=Completed + NotTaken=T = Not taken in the past\rStatus=Intended + NotTaken=T = No intention of taking\rStatus=Active + NotTaken=F = Taking, but not as prescribed\rStatus=Active + NotTaken=F = Taking\rStatus=Intended +NotTaken= F = Will be taking (not started)\rStatus=Completed + NotTaken=F = Taken in past\rStatus=In Error + NotTaken=N/A = In Error.",
         "min": 0,
         "max": "*",
         "constraint": [
@@ -96,9 +102,9 @@
           {
             "key": "mst-1",
             "severity": "error",
-            "human": "Reason not taken is only permitted if notTaken is Yes",
-            "expression": "reasonNotTaken.empty() or notTaken='y'",
-            "xpath": "not(exists(f:reasonNotTaken) and (f:notTaken/@value='n' or f:notTaken/@value='unk'))"
+            "human": "Reason not taken is only permitted if Taken is No",
+            "expression": "reasonNotTaken.exists().not() or (taken = 'n')",
+            "xpath": "not(exists(f:reasonNotTaken)) or f:taken/@value='n'"
           }
         ],
         "mapping": [
@@ -106,6 +112,10 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "..Event"
+          },
           {
             "identity": "rim",
             "map": "SubstanceAdministration"
@@ -121,7 +131,7 @@
         "path": "MedicationStatement.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -160,7 +170,7 @@
         "path": "MedicationStatement.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -181,7 +191,7 @@
         "path": "MedicationStatement.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -201,6 +211,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -215,7 +233,7 @@
         "path": "MedicationStatement.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -249,7 +267,7 @@
         "path": "MedicationStatement.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -279,7 +297,7 @@
         "path": "MedicationStatement.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -308,7 +326,7 @@
         "path": "MedicationStatement.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -345,10 +363,15 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…identifer"
+          },
           {
             "identity": "rim",
-            "map": "SubstanceAdministration.id"
+            "map": ".id"
           },
           {
             "identity": "w5",
@@ -356,12 +379,121 @@
           }
         ]
       },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.basedOn",
+        "path": "MedicationStatement.basedOn",
+        "short": "Fulfils plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…basedOn"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target[classCode=SBADM or PROC or PCPR or OBS, moodCode=RQO orPLAN or PRP]"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.partOf",
+        "path": "MedicationStatement.partOf",
+        "short": "Part of referenced event",
+        "definition": "A larger event of which this particular event is a component or step.",
+        "requirements": "This should not be used when indicating which resource a MedicationStatement has been derived from.  If that is the use case, then MedicationStatement.derivedFrom should be used.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationAdministration"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationDispense"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationStatement"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Procedure"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Observation"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…part of"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=COMP]/target[classCode=SPLY or SBADM or PROC or OBS,moodCode=EVN]"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.context",
+        "path": "MedicationStatement.context",
+        "short": "Encounter / Episode associated with MedicationStatement",
+        "definition": "The encounter or episode of care that establishes the context for this MedicationStatement.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…context"
+          },
+          {
+            "identity": "rim",
+            "map": ".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code=\"type of encounter or episode\"]"
+          }
+        ]
+      },
       {
         "id": "MedicationStatement:shr-medication-MedicationNotAdministered.status",
         "path": "MedicationStatement.status",
         "short": "active | completed | entered-in-error | intended | stopped | on-hold",
         "definition": "A code representing the patient or other source's judgment about the state of the medication used that this statement is about.  Generally this will be active or completed.",
-        "comments": "MedicationStatement is a statement at a point in time.  The status is only representative at the point when it was asserted.  The value set for MedicationStatement.status contains codes that assert the status of the use of the medication by the patient (for example, stopped or on hold) as well as codes that assert the status of the medication statement itself (for example, entered in error).",
+        "comment": "MedicationStatement is a statement at a point in time.  The status is only representative at the point when it was asserted.  The value set for MedicationStatement.status contains codes that assert the status of the use of the medication by the patient (for example, stopped or on hold) as well as codes that assert the status of the medication statement itself (for example, entered in error).\n\nThis element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "min": 1,
         "max": "1",
         "type": [
@@ -372,6 +504,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MedicationStatementStatus"
+            }
+          ],
           "strength": "required",
           "description": "A coded concept indicating the current status of a MedicationStatement.",
           "valueSetReference": {
@@ -379,6 +517,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…status"
+          },
           {
             "identity": "rim",
             "map": ".statusCode"
@@ -389,12 +531,49 @@
           }
         ]
       },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.category",
+        "path": "MedicationStatement.category",
+        "short": "Type of medication usage",
+        "definition": "Indicates where type of medication statement and where the medication is expected to be consumed or administered.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MedicationStatementCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "A coded concept identifying where the medication included in the medicationstatement is expected to be consumed or administered",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/medication-statement-category"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code=\"type of medication usage\"].value"
+          },
+          {
+            "identity": "w5",
+            "map": "class"
+          }
+        ]
+      },
       {
         "id": "MedicationStatement:shr-medication-MedicationNotAdministered.medication[x]",
         "path": "MedicationStatement.medication[x]",
         "short": "What medication was taken",
         "definition": "Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.",
-        "comments": "If only a code is specified, then it needs to be a code for a specific product.  If more information is required, then the use of the medication resource is recommended.  Note: do not use Medication.name to describe the medication this statement concerns. When the only available information is a text description of the medication, Medication.code.text should be used.",
+        "comment": "If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended.  For example if you require form or lot number, then you must reference the Medication resource. .",
         "min": 1,
         "max": "1",
         "type": [
@@ -405,6 +584,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MedicationCode"
+            }
+          ],
           "strength": "example",
           "description": "A coded concept identifying the substance or product being taken.",
           "valueSetReference": {
@@ -412,9 +597,13 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…code"
+          },
           {
             "identity": "rim",
-            "map": "SubstanceAdministration>Component>SubstanceAdministrationRequest.consumable"
+            "map": ".participation[typeCode=CSM].role[classCode=ADMM or MANU]"
           },
           {
             "identity": "w5",
@@ -423,61 +612,56 @@
         ]
       },
       {
-        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.subject",
-        "path": "MedicationStatement.subject",
-        "short": "Who is/was taking  the medication",
-        "definition": "The person, animal or group who is/was taking the medication.",
+        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.effective[x]",
+        "path": "MedicationStatement.effective[x]",
+        "short": "The date/time or interval when the medication was taken",
+        "definition": "The interval of time during which it is being asserted that the patient was taking the medication (or was not taking, when the wasNotGiven element is true).",
+        "comment": "This attribute reflects the period over which the patient consumed the medication and is expected to be populated on the majority of Medication Statements. If the medication is still being taken at the time the statement is recorded, the \"end\" date will be omitted.",
         "min": 1,
         "max": "1",
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient"
-          },
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Group"
+            "code": "Period",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-PeriodOfUse"
           }
         ],
         "isSummary": true,
         "mapping": [
           {
-            "identity": "v2",
-            "map": "PID-3-Patient ID List"
+            "identity": "workflow",
+            "map": "…occurrence[x]"
           },
           {
             "identity": "rim",
-            "map": "SubstanceAdministration->subject->Patient"
+            "map": ".effectiveTime"
           },
           {
             "identity": "w5",
-            "map": "who.focus"
+            "map": "when.done"
           }
         ]
       },
       {
-        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.effective[x]",
-        "path": "MedicationStatement.effective[x]",
-        "short": "Over what period was medication consumed?",
-        "definition": "The interval of time during which it is being asserted that the patient was taking the medication (or was not taking, when the wasNotGiven element is true).",
-        "comments": "If the medication is still being taken at the time the statement is recorded, the \"end\" date will be omitted.",
-        "min": 1,
+        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.dateAsserted",
+        "path": "MedicationStatement.dateAsserted",
+        "short": "When the statement was asserted?",
+        "definition": "The date when the medication statement was asserted by the information source.",
+        "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "Period",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-PeriodOfUse"
+            "code": "dateTime"
           }
         ],
         "isSummary": true,
         "mapping": [
           {
             "identity": "rim",
-            "map": "SubstanceAdministration.effectiveTime"
+            "map": ".participation[typeCode=AUT].time"
           },
           {
             "identity": "w5",
-            "map": "when.done"
+            "map": "when.recorded"
           }
         ]
       },
@@ -509,7 +693,7 @@
         "mapping": [
           {
             "identity": "rim",
-            "map": ".participation[typeCode=INF].role[classCode=PAT, or  codes for Practioner or Related Person (if PAT is the informer, then syntax for self-reported =true)"
+            "map": ".participation[typeCode=INF].role[classCode=PAT, or codes for Practioner or Related Person (if PAT is the informer, then syntax for self-reported =true)"
           },
           {
             "identity": "w5",
@@ -518,51 +702,69 @@
         ]
       },
       {
-        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.derivedFrom",
-        "path": "MedicationStatement.derivedFrom",
-        "short": "Additional supporting information",
-        "definition": "Allows linking the MedicationStatement to the underlying MedicationRequest, or to other information that supports or is used to derive the MedicationStatement.",
-        "comments": "Likely references would be to MedicationRequest, MedicationDispense, Claim, Observation or QuestionnaireAnswers.",
-        "min": 0,
-        "max": "*",
+        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.subject",
+        "path": "MedicationStatement.subject",
+        "short": "Who is/was taking  the medication",
+        "definition": "The person, animal or group who is/was taking the medication.",
+        "min": 1,
+        "max": "1",
         "type": [
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Resource"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Group"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…subject"
+          },
+          {
+            "identity": "v2",
+            "map": "PID-3-Patient ID List"
+          },
           {
             "identity": "rim",
-            "map": ".outboundRelationship[typeCode=SPRT]/target[classCode=ACT,moodCode=EVN]"
+            "map": ".participation[typeCode=SBJ].role[classCode=PAT]"
+          },
+          {
+            "identity": "w5",
+            "map": "who"
           }
         ]
       },
       {
-        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.dateAsserted",
-        "path": "MedicationStatement.dateAsserted",
-        "short": "When the statement was asserted?",
-        "definition": "The date when the medication statement was asserted by the information source.",
+        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.derivedFrom",
+        "path": "MedicationStatement.derivedFrom",
+        "short": "Additional supporting information",
+        "definition": "Allows linking the MedicationStatement to the underlying MedicationRequest, or to other information that supports or is used to derive the MedicationStatement.",
+        "comment": "Likely references would be to MedicationRequest, MedicationDispense, Claim, Observation or QuestionnaireAnswers.  The most common use cases for deriving a MedicationStatement comes from creating a MedicationStatement from a MedicationRequest or from a lab observation or a claim.  it should be noted that the amount of information that is available varies from the type resource that you derive the MedicationStatement from.",
         "min": 0,
-        "max": "1",
+        "max": "*",
         "type": [
           {
-            "code": "dateTime"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Resource"
           }
         ],
-        "isSummary": true,
         "mapping": [
           {
             "identity": "rim",
-            "map": ".participation[typeCode=AUT].time"
+            "map": ".outboundRelationship[typeCode=SPRT]/target[classCode=ACT,moodCode=EVN]"
           }
         ]
       },
       {
-        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.notTaken",
-        "path": "MedicationStatement.notTaken",
-        "short": "y | n | unk",
+        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.taken",
+        "path": "MedicationStatement.taken",
+        "short": "y | n | unk | na",
         "definition": "Indicator of the certainty of whether the medication was taken by the patient.",
+        "comment": "This element is labeled as a modifier because it indicates that the medication was not taken.",
         "min": 1,
         "max": "1",
         "type": [
@@ -573,12 +775,28 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MedicationStatementTaken"
+            }
+          ],
           "strength": "required",
           "description": "A coded concept identifying level of certainty if patient has taken or has not taken the medication",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/medication-statement-nottaken"
+            "reference": "http://hl7.org/fhir/ValueSet/medication-statement-taken"
           }
-        }
+        },
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…notDone"
+          },
+          {
+            "identity": "rim",
+            "map": ".actionNegationInd"
+          }
+        ]
       },
       {
         "id": "MedicationStatement:shr-medication-MedicationNotAdministered.reasonNotTaken",
@@ -599,22 +817,22 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-medication-ReasonMedicationNotUsedVS"
+            "reference": "http://standardhealthrecord.org/shr/medication/vs/ReasonMedicationNotUsedVS"
           }
         },
         "mapping": [
           {
             "identity": "rim",
-            "map": "SubstanceAdministration->Reason->Observation->Value"
+            "map": ".outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code=\"reason not taken\"].value"
           }
         ]
       },
       {
-        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.reasonForUseCodeableConcept",
-        "path": "MedicationStatement.reasonForUseCodeableConcept",
+        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.reasonCode",
+        "path": "MedicationStatement.reasonCode",
         "short": "Reason for why the medication is being/was taken",
         "definition": "A reason for why the medication is being/was taken.",
-        "comments": "This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonForUseReference.",
+        "comment": "This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonForUseReference.",
         "min": 1,
         "max": "1",
         "type": [
@@ -624,6 +842,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MedicationReason"
+            }
+          ],
           "strength": "example",
           "description": "A coded concept identifying why the medication is being taken.",
           "valueSetReference": {
@@ -631,18 +855,26 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…reasoneCodeableConcept"
+          },
           {
             "identity": "rim",
             "map": ".reasonCode"
+          },
+          {
+            "identity": "w5",
+            "map": "why"
           }
         ]
       },
       {
-        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.reasonForUseReference",
-        "path": "MedicationStatement.reasonForUseReference",
+        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.reasonReference",
+        "path": "MedicationStatement.reasonReference",
         "short": "Condition or observation that supports why the medication is being/was taken",
         "definition": "Condition or observation that supports why the medication is being/was taken.",
-        "comments": "This is a reference to a condition that is the reason why the medication is being/was taken.  If only a code exists, use reasonForUseCode.",
+        "comment": "This is a reference to a condition that is the reason why the medication is being/was taken.  If only a code exists, use reasonForUseCode.",
         "min": 0,
         "max": "*",
         "type": [
@@ -656,9 +888,17 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…reasonReference"
+          },
           {
             "identity": "rim",
-            "map": "not mapped"
+            "map": ".outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code=\"reason for use\"].value"
+          },
+          {
+            "identity": "w5",
+            "map": "why"
           }
         ]
       },
@@ -675,6 +915,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…note"
+          },
           {
             "identity": "rim",
             "map": ".inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code=\"annotation\"].value"
@@ -682,47 +926,454 @@
         ]
       },
       {
-        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.category",
-        "path": "MedicationStatement.category",
-        "short": "Type of medication usage",
-        "definition": "Indicates where type of medication statement and where the medication is expected to be consumed or administered.",
+        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.dosage",
+        "path": "MedicationStatement.dosage",
+        "short": "Details of how medication is/was taken or should be taken",
+        "definition": "Indicates how the medication is/was or should be taken by the patient.",
+        "comment": "The dates included in the dosage on a Medication Statement reflect the dates for a given dose.  For example, \"from November 1, 2016 to November 3, 2016, take one tablet daily and from November 4, 2016 to November 7, 2016, take two tablets daily.\"  It is expected that this specificity may only be populated where the patient brings in their labeled container or where the Medication Statement is derived from a MedicationRequest.",
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "code"
+            "code": "Dosage"
           }
         ],
-        "binding": {
-          "strength": "example",
-          "description": "A coded concept identifying where the medication included in the medicationstatement is expected to be consumed or administered",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/medication-statement-category"
-          }
-        },
         "mapping": [
           {
             "identity": "rim",
-            "map": "not mapped"
+            "map": "refer dosageInstruction mapping"
           }
         ]
       },
       {
-        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.dosage",
-        "path": "MedicationStatement.dosage",
-        "short": "Details of how medication was taken",
-        "definition": "Indicates how the medication is/was used by the patient.",
-        "min": 0,
-        "max": "*",
-        "type": [
-          {
-            "code": "DosageInstruction"
-          }
+        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.dosage.id",
+        "path": "MedicationStatement.dosage.id",
+        "representation": [
+          "xmlAttr"
         ],
-        "mapping": [
+        "short": "xml:id (or equivalent in JSON)",
+        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Element.id",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.dosage.extension",
+        "path": "MedicationStatement.dosage.extension",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
+        "short": "Additional Content defined by implementations",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "Element.extension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.dosage.sequence",
+        "path": "MedicationStatement.dosage.sequence",
+        "short": "The order of the dosage instructions",
+        "definition": "Indicates the order in which the dosage instructions should be applied or interpreted.",
+        "requirements": "If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent.  If the sequence number is different, then the Dosages are intended to be sequential.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "integer"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
           {
             "identity": "rim",
-            "map": "SubstanceAdministration>Component>SubstanceAdministrationRequest"
+            "map": ".text"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.dosage.text",
+        "path": "MedicationStatement.dosage.text",
+        "short": "Free text dosage instructions e.g. SIG",
+        "definition": "Free text dosage instructions e.g. SIG.",
+        "requirements": "Free text dosage instructions can be used for cases where the instructions are too complex to code.  The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated.  If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing.",
+        "min": 0,
+        "max": "0",
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".text"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.dosage.additionalInstruction",
+        "path": "MedicationStatement.dosage.additionalInstruction",
+        "short": "Supplemental instruction - e.g. \"with meals\"",
+        "definition": "Supplemental instruction - e.g. \"with meals\".",
+        "requirements": "Additional instruction such as \"Swallow with plenty of water\" which may or may not be coded.",
+        "min": 0,
+        "max": "0",
+        "type": [
+          {
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "strength": "required",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/additional-instructions-codes"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".text"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.dosage.patientInstruction",
+        "path": "MedicationStatement.dosage.patientInstruction",
+        "short": "Patient or consumer oriented instructions",
+        "definition": "Instructions in terms that are understood by the patient or consumer.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".text"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.dosage.timing",
+        "path": "MedicationStatement.dosage.timing",
+        "short": "When medication should be administered",
+        "definition": "When medication should be administered.",
+        "comment": "This attribute may not always be populated while the Dosage.text is expected to be populated.  If both are populated, then the Dosage.text should reflect the content of the Dosage.timing.",
+        "requirements": "The timing schedule for giving the medication to the patient. The Schedule data type allows many different expressions. For example: \"Every 8 hours\"; \"Three times a day\"; \"1/2 an hour before breakfast for 10 days from 23-Dec 2011:\"; \"15 Oct 2013, 17 Oct 2013 and 1 Nov 2013\".  Sometimes, a rate can imply duration when expressed as total volume / duration (e.g.  500mL/2 hours implies a duration of 2 hours).  However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.",
+        "min": 0,
+        "max": "0",
+        "type": [
+          {
+            "code": "Timing"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".effectiveTime"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.dosage.asNeeded[x]",
+        "path": "MedicationStatement.dosage.asNeeded[x]",
+        "short": "Take \"as needed\" (for x)",
+        "definition": "Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).",
+        "comment": "Can express \"as needed\" without a reason by setting the Boolean = True.  In this case the CodeableConcept is not populated.  Or you can express \"as needed\" with a reason by including the CodeableConcept.  In this case the Boolean is assumed to be True.  If you set the Boolean to False, then the dose is given according to the schedule and is not \"prn\" or \"as needed\".",
+        "min": 0,
+        "max": "0",
+        "type": [
+          {
+            "code": "boolean"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MedicationAsNeededReason"
+            }
+          ],
+          "strength": "example",
+          "description": "A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose.  For example \"pain\", \"30 minutes prior to sexual intercourse\", \"on flare-up\" etc.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/medication-as-needed-reason"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code=\"as needed\"].value=boolean or codable concept"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.dosage.site",
+        "path": "MedicationStatement.dosage.site",
+        "short": "Body site to administer to",
+        "definition": "Body site to administer to.",
+        "comment": "If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [body-site-instance](extension-body-site-instance.html).  May be a summary code, or a reference to a very precise definition of the location, or both.",
+        "requirements": "A coded specification of the anatomic site where the medication first enters the body.",
+        "min": 0,
+        "max": "0",
+        "type": [
+          {
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "strength": "required",
+          "valueSetReference": {
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".approachSiteCode"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.dosage.route",
+        "path": "MedicationStatement.dosage.route",
+        "short": "How drug should enter body",
+        "definition": "How drug should enter body.",
+        "requirements": "A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.",
+        "min": 0,
+        "max": "0",
+        "type": [
+          {
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "RouteOfAdministration"
+            }
+          ],
+          "strength": "example",
+          "description": "A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/route-codes"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".routeCode"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.dosage.method",
+        "path": "MedicationStatement.dosage.method",
+        "short": "Technique for administering medication",
+        "definition": "Technique for administering medication.",
+        "comment": "Terminologies used often pre-coordinate this term with the route and or form of administration.",
+        "requirements": "A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections.  For examples, Slow Push; Deep IV.",
+        "min": 0,
+        "max": "0",
+        "type": [
+          {
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MedicationAdministrationMethod"
+            }
+          ],
+          "strength": "example",
+          "description": "A coded concept describing the technique by which the medicine is administered.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/administration-method-codes"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".doseQuantity"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.dosage.dose[x]",
+        "path": "MedicationStatement.dosage.dose[x]",
+        "short": "Amount of medication per dose",
+        "definition": "Amount of medication per dose.",
+        "comment": "Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.",
+        "requirements": "The amount of therapeutic or other substance given at one administration event.",
+        "min": 0,
+        "max": "0",
+        "type": [
+          {
+            "code": "Quantity",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-Quantity"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".doseQuantity"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.dosage.maxDosePerPeriod",
+        "path": "MedicationStatement.dosage.maxDosePerPeriod",
+        "short": "Upper limit on medication per unit of time",
+        "definition": "Upper limit on medication per unit of time.",
+        "comment": "This is intended for use as an adjunct to the dosage when there is an upper cap.  For example \"2 tablets every 4 hours to a maximum of 8/day\".",
+        "requirements": "The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time.  For example, 1000mg in 24 hours.",
+        "min": 0,
+        "max": "0",
+        "type": [
+          {
+            "code": "Ratio",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-medication-MaximumDosePerTimePeriod"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".maxDoseQuantity"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.dosage.maxDosePerAdministration",
+        "path": "MedicationStatement.dosage.maxDosePerAdministration",
+        "short": "Upper limit on medication per administration",
+        "definition": "Upper limit on medication per administration.",
+        "comment": "This is intended for use as an adjunct to the dosage when there is an upper cap.  For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg.",
+        "requirements": "The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Quantity",
+            "profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "not supported"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.dosage.maxDosePerLifetime",
+        "path": "MedicationStatement.dosage.maxDosePerLifetime",
+        "short": "Upper limit on medication per lifetime of the patient",
+        "definition": "Upper limit on medication per lifetime of the patient.",
+        "requirements": "The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Quantity",
+            "profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "not supported"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.dosage.rate[x]",
+        "path": "MedicationStatement.dosage.rate[x]",
+        "short": "Amount of medication per unit of time",
+        "definition": "Amount of medication per unit of time.",
+        "comment": "It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.",
+        "requirements": "Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr.  May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours.   Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours.  Sometimes, a rate can imply duration when expressed as total volume / duration (e.g.  500mL/2 hours implies a duration of 2 hours).  However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Ratio"
+          },
+          {
+            "code": "Range"
+          },
+          {
+            "code": "Quantity",
+            "profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".rateQuantity"
           }
         ]
       }
@@ -758,12 +1409,6 @@
           }
         ]
       },
-      {
-        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.notTaken",
-        "path": "MedicationStatement.notTaken",
-        "min": 1,
-        "max": "1"
-      },
       {
         "id": "MedicationStatement:shr-medication-MedicationNotAdministered.reasonNotTaken",
         "path": "MedicationStatement.reasonNotTaken",
@@ -778,13 +1423,13 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-medication-ReasonMedicationNotUsedVS"
+            "reference": "http://standardhealthrecord.org/shr/medication/vs/ReasonMedicationNotUsedVS"
           }
         }
       },
       {
-        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.reasonForUseCodeableConcept",
-        "path": "MedicationStatement.reasonForUseCodeableConcept",
+        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.reasonCode",
+        "path": "MedicationStatement.reasonCode",
         "min": 1,
         "max": "1",
         "type": [
@@ -793,6 +1438,119 @@
             "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
           }
         ]
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.dosage",
+        "path": "MedicationStatement.dosage",
+        "min": 0,
+        "max": "1"
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.dosage.text",
+        "path": "MedicationStatement.dosage.text",
+        "min": 0,
+        "max": "0"
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.dosage.additionalInstruction",
+        "path": "MedicationStatement.dosage.additionalInstruction",
+        "min": 0,
+        "max": "0",
+        "type": [
+          {
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+          }
+        ],
+        "binding": {
+          "strength": "required",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/additional-instructions-codes"
+          }
+        }
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.dosage.timing",
+        "path": "MedicationStatement.dosage.timing",
+        "min": 0,
+        "max": "0"
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.dosage.asNeeded[x]",
+        "path": "MedicationStatement.dosage.asNeeded[x]",
+        "min": 0,
+        "max": "0",
+        "type": [
+          {
+            "code": "boolean"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.dosage.site",
+        "path": "MedicationStatement.dosage.site",
+        "min": 0,
+        "max": "0",
+        "type": [
+          {
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+          }
+        ],
+        "binding": {
+          "strength": "required",
+          "valueSetReference": {
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
+          }
+        }
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.dosage.route",
+        "path": "MedicationStatement.dosage.route",
+        "min": 0,
+        "max": "0",
+        "type": [
+          {
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.dosage.method",
+        "path": "MedicationStatement.dosage.method",
+        "min": 0,
+        "max": "0",
+        "type": [
+          {
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.dosage.dose[x]",
+        "path": "MedicationStatement.dosage.dose[x]",
+        "min": 0,
+        "max": "0",
+        "type": [
+          {
+            "code": "Quantity",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-Quantity"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationNotAdministered.dosage.maxDosePerPeriod",
+        "path": "MedicationStatement.dosage.maxDosePerPeriod",
+        "min": 0,
+        "max": "0",
+        "type": [
+          {
+            "code": "Ratio",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-medication-MaximumDosePerTimePeriod"
+          }
+        ]
       }
     ]
   }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-medication-MedicationNotPrescribed.json b/lib/resources/standard_health_record/StructureDefinition-shr-medication-MedicationNotPrescribed.json
old mode 100755
new mode 100644
index 6a795ed..64dcf89
--- a/lib/resources/standard_health_record/StructureDefinition-shr-medication-MedicationNotPrescribed.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-medication-MedicationNotPrescribed.json
@@ -3,7 +3,7 @@
   "id": "shr-medication-MedicationNotPrescribed",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR MedicationNotPrescribed Profile</b></p>\n  <p>A record of a medication NOT prescribed. Recorded only when deviating from the normal expectation, care plan, or standard of care.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.medication.MedicationNotPrescribed maps to MedicationRequest:\n  Medication maps to medication[x].Reference\n  Reason maps to reasonCode\n  RequestStatus maps to status\n  RequestedPerformanceTime maps to dispenseRequest.validityPeriod\n  RequestedPerformer.Organization maps to dispenseRequest.performer\n  PerformerInstructions maps to note.text\n  NumberOfRepeatsAllowed maps to dispenseRequest.numberOfRepeatsAllowed\n  QuantityPerDispense maps to dispenseRequest.quantity\n  SupplyDuration maps to dispenseRequest.expectedSupplyDuration\n  Dosage.AmountPerDose.Quantity maps to dosageInstruction.dose[x].SimpleQuantity\n  Dosage.AmountPerDose.TBD &quot;Range&quot; maps to dosageInstruction.dose[x].Range\n  Dosage.TimingOfDoses maps to dosageInstruction.timing\n  Dosage.DoseAsNeededIndicator maps to dosageInstruction.asNeeded[x].boolean\n  Dosage.DoseInstructionsText maps to dosageInstruction.text\n  Dosage.AdditionalDoseInstruction maps to dosageInstruction.additionalInstructions\n  Dosage.RouteIntoBody maps to dosageInstruction.route\n  Dosage.AdministrationMethod maps to dosageInstruction.method\n  Dosage.AdministrationBodySite maps to dosageInstruction.site\n  Dosage.MaximumDosePerTimePeriod maps to dosageInstruction.maxDosePerPeriod\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR MedicationNotPrescribed Profile</b></p>\n  <p>A record of a medication NOT prescribed. Recorded only when deviating from the normal expectation, care plan, or standard of care.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.medication.MedicationNotPrescribed maps to MedicationRequest:\n  Medication maps to medication[x].Reference\n  Reason maps to reasonCode\n  RequestStatus maps to status\n  RequestedPerformanceTime maps to dispenseRequest.validityPeriod\n  PriorityOfRequest maps to priority\n  RequestedPerformer.Organization maps to dispenseRequest.performer\n  constrain note to 0..1\n  PerformerInstructions maps to note.text\n  NumberOfRepeatsAllowed maps to dispenseRequest.numberOfRepeatsAllowed\n  QuantityPerDispense maps to dispenseRequest.quantity\n  SupplyDuration maps to dispenseRequest.expectedSupplyDuration\n  constrain dosageInstruction to 0..1\n  Dosage.AmountPerDose.Quantity maps to dosageInstruction.dose[x].SimpleQuantity\n  Dosage.AmountPerDose.&lt;TBD &quot;Range&quot;&gt; maps to dosageInstruction.dose[x].Range\n  Dosage.TimingOfDoses maps to dosageInstruction.timing\n  Dosage.DoseAsNeededIndicator maps to dosageInstruction.asNeeded[x].boolean\n  Dosage.DoseInstructionsText maps to dosageInstruction.text\n  Dosage.AdditionalDoseInstruction maps to dosageInstruction.additionalInstruction\n  Dosage.RouteIntoBody maps to dosageInstruction.route\n  Dosage.AdministrationMethod maps to dosageInstruction.method\n  Dosage.AdministrationBodySite maps to dosageInstruction.site\n  Dosage.MaximumDosePerTimePeriod maps to dosageInstruction.maxDosePerPeriod\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-medication-MedicationNotPrescribed",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.medication.MedicationNotPrescribed"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR MedicationNotPrescribed Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.380Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,10 +27,14 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.286Z",
   "description": "A record of a medication NOT prescribed. Recorded only when deviating from the normal expectation, care plan, or standard of care.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
     {
       "identity": "script10.6",
       "uri": "http://ncpdp.org/SCRIPT10_6",
@@ -107,6 +113,10 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "..Request"
+          },
           {
             "identity": "script10.6",
             "map": "Message/Body/NewRx"
@@ -126,7 +136,7 @@
         "path": "MedicationRequest.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -165,7 +175,7 @@
         "path": "MedicationRequest.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -186,7 +196,7 @@
         "path": "MedicationRequest.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -206,6 +216,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -220,7 +238,7 @@
         "path": "MedicationRequest.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -254,7 +272,7 @@
         "path": "MedicationRequest.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -283,16 +301,19 @@
         "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.extension",
         "path": "MedicationRequest.extension",
         "slicing": {
-          "id": "187",
+          "id": "184",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -321,6 +342,7 @@
         "path": "MedicationRequest.extension",
         "sliceName": "actioncode",
         "definition": "The code for the action, such as an intervention or test, to be carried out.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -353,6 +375,7 @@
         "path": "MedicationRequest.extension",
         "sliceName": "occurrencetime",
         "definition": "The point in time or span of time in which something happens.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -385,6 +408,7 @@
         "path": "MedicationRequest.extension",
         "sliceName": "participant",
         "definition": "A statement about an actor who did (or did not) participate in a certain task or activity. Unlike a HealthcareInvolvement which continues over period of time, the participant is associated with doing or not doing a specific task, such admitting a patient, performing a procedure, or taking a measurement.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -412,43 +436,12 @@
           }
         ]
       },
-      {
-        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.extension:priorityofrequest",
-        "path": "MedicationRequest.extension",
-        "sliceName": "priorityofrequest",
-        "definition": "Urgency level for which results must be reported to the requestor or responsible individual.",
-        "alias": [
-          "extensions",
-          "user content"
-        ],
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "DomainResource.extension",
-          "min": 0,
-          "max": "*"
-        },
-        "type": [
-          {
-            "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-PriorityOfRequest-extension"
-          }
-        ],
-        "mustSupport": false,
-        "isModifier": false,
-        "isSummary": false,
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "N/A"
-          }
-        ]
-      },
       {
         "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.extension:patientinstructions",
         "path": "MedicationRequest.extension",
         "sliceName": "patientinstructions",
         "definition": "Information for the patient, such as, where to get the test, how to prepare for the test, etc.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -480,16 +473,19 @@
         "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.modifierExtension",
         "path": "MedicationRequest.modifierExtension",
         "slicing": {
-          "id": "188",
+          "id": "185",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -519,6 +515,7 @@
         "path": "MedicationRequest.modifierExtension",
         "sliceName": "nonoccurrencemodifier",
         "definition": "When true, indicates either that the event or action documented in the entry did not occur, or the the thing documented is absent or does not exist.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -551,6 +548,7 @@
         "path": "MedicationRequest.modifierExtension",
         "sliceName": "medicationnotprescribedmodifier",
         "definition": "True, if the medication should not, or was not prescribed for a particular reason.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -609,9 +607,12 @@
         "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.modifierExtension:medicationnotprescribedmodifier.extension",
         "path": "MedicationRequest.modifierExtension.extension",
         "slicing": {
-          "id": "184",
+          "id": "181",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -711,7 +712,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -837,7 +837,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -882,7 +881,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-medication-ReasonMedicationNotUsedVS"
+            "reference": "http://standardhealthrecord.org/shr/medication/vs/ReasonMedicationNotUsedVS"
           }
         },
         "mapping": [
@@ -900,7 +899,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -1059,8 +1057,8 @@
       {
         "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.identifier",
         "path": "MedicationRequest.identifier",
-        "short": "External identifier",
-        "definition": "External identifier - one that would be used by another non-FHIR system - for example a re-imbursement system might issue its own id for each prescription that is created.  This is particularly important where FHIR only provides part of an entire workflow process where records have to be tracked through an entire system.",
+        "short": "External ids for this request",
+        "definition": "This records identifiers associated with this medication request that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. For example a re-imbursement system might issue its own id for each prescription that is created.  This is particularly important where FHIR only provides part of an entire workflow process where records must be tracked through an entire system.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1069,6 +1067,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…identifer"
+          },
           {
             "identity": "script10.6",
             "map": "Message/Header/PrescriberOrderNumber"
@@ -1079,7 +1081,7 @@
           },
           {
             "identity": "rim",
-            "map": "id"
+            "map": ".id"
           },
           {
             "identity": "w5",
@@ -1104,13 +1106,23 @@
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/PlanDefinition"
           }
         ],
-        "isSummary": true
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…definition"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=DEFN].target[classCode=unspecified]"
+          }
+        ]
       },
       {
         "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.basedOn",
         "path": "MedicationRequest.basedOn",
         "short": "What request fulfills",
-        "definition": "Plan/proposal/order fulfilled by this request.",
+        "definition": "A plan or request that is fulfilled in whole or in part by this medication request.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1118,10 +1130,6 @@
             "code": "Reference",
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
           },
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DiagnosticRequest"
-          },
           {
             "code": "Reference",
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
@@ -1135,13 +1143,24 @@
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
           }
         ],
-        "isSummary": true
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…basedOn"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target[classCode=SBADM or PROC or PCPR or OBS, moodCode=RQO orPLAN or PRP]"
+          }
+        ]
       },
       {
-        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.requisition",
-        "path": "MedicationRequest.requisition",
-        "short": "Identifier of composite",
-        "definition": "Composite request this is part of.",
+        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.groupIdentifier",
+        "path": "MedicationRequest.groupIdentifier",
+        "short": "Composite request this is part of",
+        "definition": "A shared identifier common to all requests that were authorized more or less simultaneously by a single author, representing the identifier of the requisition or prescription.",
+        "requirements": "Requests are linked either by a \"basedOn\" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1149,13 +1168,24 @@
             "code": "Identifier"
           }
         ],
-        "isSummary": true
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…groupIdentifier"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship(typeCode=COMP].target[classCode=SBADM, moodCode=INT].id"
+          }
+        ]
       },
       {
         "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.status",
         "path": "MedicationRequest.status",
-        "short": "active | on-hold | cancelled | completed | entered-in-error | stopped | draft",
-        "definition": "A code specifying the state of the order.  Generally this will be active or completed state.",
+        "short": "active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown",
+        "definition": "A code specifying the current state of the order.  Generally this will be active or completed state.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "min": 1,
         "max": "1",
         "type": [
@@ -1166,6 +1196,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MedicationRequestStatus"
+            }
+          ],
           "strength": "required",
           "description": "A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription",
           "valueSetReference": {
@@ -1173,13 +1209,17 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…status"
+          },
           {
             "identity": "script10.6",
             "map": "no mapping"
           },
           {
             "identity": "rim",
-            "map": "statusCode"
+            "map": ".statusCode"
           },
           {
             "identity": "w5",
@@ -1188,40 +1228,135 @@
         ]
       },
       {
-        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.stage",
-        "path": "MedicationRequest.stage",
-        "short": "proposal | plan | original-order",
+        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.intent",
+        "path": "MedicationRequest.intent",
+        "short": "proposal | plan | order | instance-order",
         "definition": "Whether the request is a proposal, plan, or an original order.",
-        "comments": "It is expected that the type of requester will be restricted for different stages of a MedicationRequest.  For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device.  Plans can be created by Practitioners, Patients, RelatedPersons and Devices.  Original orders can be created by a Practitioner only.",
+        "comment": "It is expected that the type of requester will be restricted for different stages of a MedicationRequest.  For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device.  Plans can be created by Practitioners, Patients, RelatedPersons and Devices.  Original orders can be created by a Practitioner only.\r\rAn instance-order is an instantiation of a request or order and may be used to populate Medication Administration Record.\n\nThis element is labeled as a modifier because the intent alters when and how the resource is actually applicable.",
         "min": 1,
         "max": "1",
         "type": [
           {
-            "code": "CodeableConcept"
+            "code": "code"
           }
         ],
         "isModifier": true,
         "isSummary": true,
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MedicationRequestIntent"
+            }
+          ],
+          "strength": "required",
           "description": "The kind of medication order",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/medication-request-stage"
+            "reference": "http://hl7.org/fhir/ValueSet/medication-request-intent"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…intent"
+          },
+          {
+            "identity": "rim",
+            "map": ".moodCode (nuances beyond PRP/PLAN/RQO would need to be elsewhere)"
+          },
+          {
+            "identity": "w5",
+            "map": "class"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.category",
+        "path": "MedicationRequest.category",
+        "short": "Type of medication usage",
+        "definition": "Indicates the type of medication order and where the medication is expected to be consumed or administered.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MedicationRequestCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "A coded concept identifying where the medication ordered is expected to be consumed or administered",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/medication-request-category"
           }
         },
         "mapping": [
+          {
+            "identity": "script10.6",
+            "map": "Message/Body/NewRx/MedicationPrescribed/Directions\r\ror \r\rMessage/Body/NewRx/MedicationPrescribed/StructuredSIG"
+          },
+          {
+            "identity": "rim",
+            "map": ".inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code=\"type of medication usage\"].value"
+          },
           {
             "identity": "w5",
             "map": "class"
           }
         ]
       },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.priority",
+        "path": "MedicationRequest.priority",
+        "short": "routine | urgent | stat | asap",
+        "definition": "Indicates how quickly the Medication Request should be addressed with respect to other requests.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "code"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MedicationRequestPriority"
+            }
+          ],
+          "strength": "required",
+          "description": "Identifies the level of importance to be assigned to actioning the request",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/medication-request-priority"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…priority"
+          },
+          {
+            "identity": "rim",
+            "map": ".priorityCode"
+          },
+          {
+            "identity": "w5",
+            "map": "grade"
+          }
+        ]
+      },
       {
         "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.medication[x]",
         "path": "MedicationRequest.medication[x]",
         "short": "Medication to be taken",
-        "definition": "Identifies the medication being administered. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications.",
-        "comments": "If only a code is specified, then it needs to be a code for a specific product.  If more information is required, then the use of the medication resource is recommended.  Note: do not use Medication.name to describe the prescribed medication. When the only available information is a text description of the medication, Medication.code.text should be used.",
+        "definition": "Identifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications.",
+        "comment": "If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended.  For example, if you require form or lot number or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource. .",
         "min": 1,
         "max": "1",
         "type": [
@@ -1232,6 +1367,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MedicationCode"
+            }
+          ],
           "strength": "example",
           "description": "A coded concept identifying substance or product that can be ordered.",
           "valueSetReference": {
@@ -1239,6 +1380,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…code"
+          },
           {
             "identity": "script10.6",
             "map": "Message/Body/NewRx/MedicationPrescribed\r\rMedication.code.coding.code = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCode\r\rMedication.code.coding.system = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCodeQualifier\r\rMedication.code.coding.display = Message/Body/NewRx/MedicationPrescribed/DrugDescription"
@@ -1258,21 +1403,29 @@
         ]
       },
       {
-        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.patient",
-        "path": "MedicationRequest.patient",
-        "short": "Who prescription is for",
-        "definition": "A link to a resource representing the person to whom the medication will be given.",
-        "comments": "The patient on a medicationRequest is mandatory.  For the secondary use case where the actual patient is not provided, there still must be an anonymyzed patient specified.",
+        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.subject",
+        "path": "MedicationRequest.subject",
+        "short": "Who or group medication request is for",
+        "definition": "A link to a resource representing the person or set of individuals to whom the medication will be given.",
+        "comment": "The subject on a medication request is mandatory.  For the secondary use case where the actual subject is not provided, there still must be an anonymized subject specified.",
         "min": 1,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Group"
           }
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…subject"
+          },
           {
             "identity": "script10.6",
             "map": "Message/Body/NewRx/Patient\r\r(need detail to link to specific patient … Patient.Identification in SCRIPT)"
@@ -1283,7 +1436,7 @@
           },
           {
             "identity": "rim",
-            "map": "subject.role"
+            "map": ".participation[typeCode=AUT].role"
           },
           {
             "identity": "w5",
@@ -1295,8 +1448,8 @@
         "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.context",
         "path": "MedicationRequest.context",
         "short": "Created during encounter/admission/stay",
-        "definition": "A link to a resource that identifies the particular occurrence or set oc occurences of contact between patient and health care provider.",
-        "comments": "SubstanceAdministration->component->EncounterEvent.",
+        "definition": "A link to an encounter, or episode of care, that identifies the particular occurrence or set occurrences of contact between patient and health care provider.",
+        "comment": "SubstanceAdministration->component->EncounterEvent.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1310,6 +1463,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…context"
+          },
           {
             "identity": "script10.6",
             "map": "no mapping"
@@ -1320,7 +1477,7 @@
           },
           {
             "identity": "rim",
-            "map": "componentOf.patientEncounter"
+            "map": ".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code=\"type of encounter or episode\"]"
           },
           {
             "identity": "w5",
@@ -1342,6 +1499,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS, RQO, PRP, APT, ARQ, GOL)]"
+          },
           {
             "identity": "w5",
             "map": "context"
@@ -1349,10 +1510,10 @@
         ]
       },
       {
-        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.dateWritten",
-        "path": "MedicationRequest.dateWritten",
-        "short": "When prescription was initially authorized",
-        "definition": "The date (and perhaps time) when the prescription was initially written.",
+        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.authoredOn",
+        "path": "MedicationRequest.authoredOn",
+        "short": "When request was initially authored",
+        "definition": "The date (and perhaps time) when the prescription was initially written or authored on.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1362,6 +1523,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…authoredOn"
+          },
           {
             "identity": "script10.6",
             "map": "Message/Body/NewRx/MedicationPrescribed/WrittenDate"
@@ -1383,99 +1548,295 @@
       {
         "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.requester",
         "path": "MedicationRequest.requester",
-        "short": "Who ordered the initial medication(s)",
-        "definition": "The healthcare professional responsible for authorizing the initial prescription.",
-        "comments": "It is expected that the type of requester will be restricted for different stages of a MedicationRequest.  For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device.  Plans can be created by Practitioners, Patients, RelatedPersons and Devices.  Original orders can be created by a Practitioner only.",
+        "short": "Who/What requested the Request",
+        "definition": "The individual, organization or device that initiated the request and has responsibility for its activation.",
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
-          },
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
-          },
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient"
-          },
+            "code": "BackboneElement"
+          }
+        ],
+        "constraint": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
+            "key": "ele-1",
+            "severity": "error",
+            "human": "All FHIR elements must have a @value or children",
+            "expression": "children().count() > id.count()",
+            "xpath": "@value|f:*|h:div",
+            "source": "Element"
           },
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Device"
+            "key": "mps-1",
+            "severity": "error",
+            "human": "onBehalfOf can only be specified if agent is practitioner or device",
+            "expression": "(agent.resolve().empty()) or (agent.resolve() is Device) or (agent.resolve() is Practitioner) or onBehalfOf.exists().not()",
+            "xpath": "contains(f:agent, '/Practitioner') or contains(f:agent, '/Device') or not(exists(f:onBehalfOf))"
           }
         ],
         "isSummary": true,
         "mapping": [
           {
-            "identity": "script10.6",
-            "map": "Message/Body/NewRx/Prescriber\r\r(need detail to link to specific prescriber … Prescriber.Identification in SCRIPT)"
-          },
-          {
-            "identity": "v2",
-            "map": "RXE-13-Ordering Provider's DEA Number / RXO-14-Ordering Provider's DEA Number / RXE-14-Pharmacist/Treatment Supplier's Verifier ID / RXO-15-Pharmacist/Treatment Supplier's Verifier ID / ORC-12-Ordering Provider / PRT-5-Participation Person: PRT-4-Participation='OP' (all but last deprecated)"
+            "identity": "workflow",
+            "map": "…requester"
           },
           {
             "identity": "rim",
-            "map": "author.role"
+            "map": ".participation[typeCode=AUT].role"
           },
           {
             "identity": "w5",
-            "map": "who.actor"
+            "map": "who.author"
           }
         ]
       },
       {
-        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.reasonCode",
-        "path": "MedicationRequest.reasonCode",
-        "short": "Reason or indication for writing the prescription",
-        "definition": "Can be the reason or the indication for writing the prescription.",
-        "comments": "This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonReference.",
+        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.requester.id",
+        "path": "MedicationRequest.requester.id",
+        "representation": [
+          "xmlAttr"
+        ],
+        "short": "xml:id (or equivalent in JSON)",
+        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
         "min": 0,
         "max": "1",
+        "base": {
+          "path": "Element.id",
+          "min": 0,
+          "max": "1"
+        },
         "type": [
           {
-            "code": "CodeableConcept",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+            "code": "string"
           }
         ],
-        "binding": {
-          "strength": "example",
-          "description": "A coded concept indicating why the medication was ordered.",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/condition-code"
-          }
-        },
         "mapping": [
-          {
-            "identity": "script10.6",
-            "map": "Message/Body/NewRx/MedicationPrescribed/Diagnosis/Primary/Value"
-          },
-          {
-            "identity": "v2",
-            "map": "ORC-16-Order Control Code Reason /RXE-27-Give Indication/RXO-20-Indication / RXD-21-Indication / RXG-22-Indication / RXA-19-Indication"
-          },
           {
             "identity": "rim",
-            "map": "reason.observation.reasonCode"
-          },
-          {
-            "identity": "w5",
-            "map": "why"
+            "map": "n/a"
           }
         ]
       },
       {
-        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.reasonReference",
-        "path": "MedicationRequest.reasonReference",
-        "short": "Condition or Observation that supports why the prescription is being written",
-        "definition": "Condition or observation that supports why the prescription is being written.",
-        "comments": "This is a reference to a condition that is the reason for the medication order.  If only a code exists, use reasonCode.",
+        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.requester.extension",
+        "path": "MedicationRequest.requester.extension",
+        "short": "Additional Content defined by implementations",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "Element.extension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.requester.modifierExtension",
+        "path": "MedicationRequest.requester.modifierExtension",
+        "short": "Extensions that cannot be ignored",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content",
+          "modifiers"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "BackboneElement.modifierExtension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "isModifier": true,
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "N/A"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.requester.agent",
+        "path": "MedicationRequest.requester.agent",
+        "short": "Who ordered the initial medication(s)",
+        "definition": "The healthcare professional responsible for authorizing the initial prescription.",
+        "comment": "It is expected that the type of requester will be restricted for different stages of a MedicationRequest.  For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device.  Plans can be created by Practitioners, Patients, RelatedPersons and Devices.  Original orders can be created by a Practitioner only.",
+        "min": 1,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Device"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "….agent"
+          },
+          {
+            "identity": "script10.6",
+            "map": "Message/Body/NewRx/Prescriber\r\r(need detail to link to specific prescriber … Prescriber.Identification in SCRIPT)"
+          },
+          {
+            "identity": "v2",
+            "map": "RXE-13-Ordering Provider's DEA Number / RXO-14-Ordering Provider's DEA Number / RXE-14-Pharmacist/Treatment Supplier's Verifier ID / RXO-15-Pharmacist/Treatment Supplier's Verifier ID / ORC-12-Ordering Provider / PRT-5-Participation Person: PRT-4-Participation='OP' (all but last deprecated)"
+          },
+          {
+            "identity": "rim",
+            "map": ".player"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.requester.onBehalfOf",
+        "path": "MedicationRequest.requester.onBehalfOf",
+        "short": "Organization agent is acting for",
+        "definition": "The organization the device or practitioner was acting on behalf of.",
+        "requirements": "Practitioners and Devices can be associated with multiple organizations. This element indicates which organization they were acting on behalf of when authoring the request.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
+          }
+        ],
+        "condition": [
+          "mps-1"
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "….onBehalfOf"
+          },
+          {
+            "identity": "rim",
+            "map": ".scoper"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.recorder",
+        "path": "MedicationRequest.recorder",
+        "short": "Person who entered the request",
+        "definition": "The person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".participation[typeCode=TRANS].role[classCode=ASSIGNED].code (HealthcareProviderType)"
+          },
+          {
+            "identity": "w5",
+            "map": "who"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.reasonCode",
+        "path": "MedicationRequest.reasonCode",
+        "short": "Reason or indication for writing the prescription",
+        "definition": "The reason or the indication for ordering the medication.",
+        "comment": "This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonReference.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MedicationRequestReason"
+            }
+          ],
+          "strength": "example",
+          "description": "A coded concept indicating why the medication was ordered.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/condition-code"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…reasonCode"
+          },
+          {
+            "identity": "script10.6",
+            "map": "Message/Body/NewRx/MedicationPrescribed/Diagnosis/Primary/Value"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC-16-Order Control Code Reason /RXE-27-Give Indication/RXO-20-Indication / RXD-21-Indication / RXG-22-Indication / RXA-19-Indication"
+          },
+          {
+            "identity": "rim",
+            "map": "reason.observation.reasonCode"
+          },
+          {
+            "identity": "w5",
+            "map": "why"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.reasonReference",
+        "path": "MedicationRequest.reasonReference",
+        "short": "Condition or Observation that supports why the prescription is being written",
+        "definition": "Condition or observation that supports why the medication was ordered.",
+        "comment": "This is a reference to a condition or observation that is the reason for the medication order.  If only a code exists, use reasonCode.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1489,83 +1850,653 @@
           }
         ],
         "mapping": [
-          {
-            "identity": "script10.6",
-            "map": "no mapping"
-          },
+          {
+            "identity": "workflow",
+            "map": "…reasonReference"
+          },
+          {
+            "identity": "script10.6",
+            "map": "no mapping"
+          },
+          {
+            "identity": "rim",
+            "map": "reason.observation[code=ASSERTION].value"
+          },
+          {
+            "identity": "w5",
+            "map": "why"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.note",
+        "path": "MedicationRequest.note",
+        "short": "Information about the prescription",
+        "definition": "Extra information about the prescription that could not be conveyed by the other attributes.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Annotation"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…note"
+          },
+          {
+            "identity": "script10.6",
+            "map": "Message/Body/NewRx/MedicationPrescribed/Note"
+          },
+          {
+            "identity": "rim",
+            "map": ".inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code=\"annotation\"].value"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.note.id",
+        "path": "MedicationRequest.note.id",
+        "representation": [
+          "xmlAttr"
+        ],
+        "short": "xml:id (or equivalent in JSON)",
+        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Element.id",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.note.extension",
+        "path": "MedicationRequest.note.extension",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
+        "short": "Additional Content defined by implementations",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "Element.extension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.note.author[x]",
+        "path": "MedicationRequest.note.author[x]",
+        "short": "Individual responsible for the annotation",
+        "definition": "The individual responsible for making the annotation.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
+          },
+          {
+            "code": "string"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "v2",
+            "map": "N/A"
+          },
+          {
+            "identity": "rim",
+            "map": "Act.participant[typeCode=AUT].role"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.note.time",
+        "path": "MedicationRequest.note.time",
+        "short": "When the annotation was made",
+        "definition": "Indicates when this particular annotation was made.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "dateTime"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "v2",
+            "map": "N/A"
+          },
+          {
+            "identity": "rim",
+            "map": "Act.effectiveTime"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.note.text",
+        "path": "MedicationRequest.note.text",
+        "short": "The annotation  - text content",
+        "definition": "The text of the annotation.",
+        "min": 1,
+        "max": "1",
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "v2",
+            "map": "N/A"
+          },
+          {
+            "identity": "rim",
+            "map": "Act.text"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.dosageInstruction",
+        "path": "MedicationRequest.dosageInstruction",
+        "short": "How the medication should be taken",
+        "definition": "Indicates how the medication is to be used by the patient.",
+        "comment": "There are examples where a medication request may include the option of an oral dose or an Intravenous or Intramuscular dose.  For example, \"Ondansetron 8mg orally or IV twice a day as needed for nausea\" or \"Compazine® (prochlorperazine) 5-10mg PO or 25mg PR bid prn nausea or vomiting\".  In these cases, two medication requests would be created that could be grouped together.  The decision on which dose and route of administration to use is based on the patient's condition at the time the dose is needed.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Dosage"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…occurrence[x]"
+          },
+          {
+            "identity": "rim",
+            "map": "see dosageInstruction mapping"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.dosageInstruction.id",
+        "path": "MedicationRequest.dosageInstruction.id",
+        "representation": [
+          "xmlAttr"
+        ],
+        "short": "xml:id (or equivalent in JSON)",
+        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Element.id",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.dosageInstruction.extension",
+        "path": "MedicationRequest.dosageInstruction.extension",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
+        "short": "Additional Content defined by implementations",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "Element.extension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.dosageInstruction.sequence",
+        "path": "MedicationRequest.dosageInstruction.sequence",
+        "short": "The order of the dosage instructions",
+        "definition": "Indicates the order in which the dosage instructions should be applied or interpreted.",
+        "requirements": "If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent.  If the sequence number is different, then the Dosages are intended to be sequential.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "integer"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".text"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.dosageInstruction.text",
+        "path": "MedicationRequest.dosageInstruction.text",
+        "short": "Free text dosage instructions e.g. SIG",
+        "definition": "Free text dosage instructions e.g. SIG.",
+        "requirements": "Free text dosage instructions can be used for cases where the instructions are too complex to code.  The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated.  If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".text"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.dosageInstruction.additionalInstruction",
+        "path": "MedicationRequest.dosageInstruction.additionalInstruction",
+        "short": "Supplemental instruction - e.g. \"with meals\"",
+        "definition": "Supplemental instruction - e.g. \"with meals\".",
+        "requirements": "Additional instruction such as \"Swallow with plenty of water\" which may or may not be coded.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "strength": "required",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/additional-instructions-codes"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".text"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.dosageInstruction.patientInstruction",
+        "path": "MedicationRequest.dosageInstruction.patientInstruction",
+        "short": "Patient or consumer oriented instructions",
+        "definition": "Instructions in terms that are understood by the patient or consumer.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".text"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.dosageInstruction.timing",
+        "path": "MedicationRequest.dosageInstruction.timing",
+        "short": "When medication should be administered",
+        "definition": "When medication should be administered.",
+        "comment": "This attribute may not always be populated while the Dosage.text is expected to be populated.  If both are populated, then the Dosage.text should reflect the content of the Dosage.timing.",
+        "requirements": "The timing schedule for giving the medication to the patient. The Schedule data type allows many different expressions. For example: \"Every 8 hours\"; \"Three times a day\"; \"1/2 an hour before breakfast for 10 days from 23-Dec 2011:\"; \"15 Oct 2013, 17 Oct 2013 and 1 Nov 2013\".  Sometimes, a rate can imply duration when expressed as total volume / duration (e.g.  500mL/2 hours implies a duration of 2 hours).  However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Timing"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".effectiveTime"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.dosageInstruction.asNeeded[x]",
+        "path": "MedicationRequest.dosageInstruction.asNeeded[x]",
+        "short": "Take \"as needed\" (for x)",
+        "definition": "Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).",
+        "comment": "Can express \"as needed\" without a reason by setting the Boolean = True.  In this case the CodeableConcept is not populated.  Or you can express \"as needed\" with a reason by including the CodeableConcept.  In this case the Boolean is assumed to be True.  If you set the Boolean to False, then the dose is given according to the schedule and is not \"prn\" or \"as needed\".",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "boolean"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MedicationAsNeededReason"
+            }
+          ],
+          "strength": "example",
+          "description": "A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose.  For example \"pain\", \"30 minutes prior to sexual intercourse\", \"on flare-up\" etc.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/medication-as-needed-reason"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code=\"as needed\"].value=boolean or codable concept"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.dosageInstruction.site",
+        "path": "MedicationRequest.dosageInstruction.site",
+        "short": "Body site to administer to",
+        "definition": "Body site to administer to.",
+        "comment": "If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [body-site-instance](extension-body-site-instance.html).  May be a summary code, or a reference to a very precise definition of the location, or both.",
+        "requirements": "A coded specification of the anatomic site where the medication first enters the body.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "strength": "required",
+          "valueSetReference": {
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
+          }
+        },
+        "mapping": [
           {
             "identity": "rim",
-            "map": "reason.observation[code=ASSERTION].value"
-          },
-          {
-            "identity": "w5",
-            "map": "why"
+            "map": ".approachSiteCode"
           }
         ]
       },
       {
-        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.note",
-        "path": "MedicationRequest.note",
-        "short": "Information about the prescription",
-        "definition": "Extra information about the prescription that could not be conveyed by the other attributes.",
+        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.dosageInstruction.route",
+        "path": "MedicationRequest.dosageInstruction.route",
+        "short": "How drug should enter body",
+        "definition": "How drug should enter body.",
+        "requirements": "A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
-            "code": "Annotation"
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
           }
         ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "RouteOfAdministration"
+            }
+          ],
+          "strength": "example",
+          "description": "A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/route-codes"
+          }
+        },
         "mapping": [
-          {
-            "identity": "script10.6",
-            "map": "Message/Body/NewRx/MedicationPrescribed/Note"
-          },
           {
             "identity": "rim",
-            "map": ".inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code=\"annotation\"].value"
+            "map": ".routeCode"
           }
         ]
       },
       {
-        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.category",
-        "path": "MedicationRequest.category",
-        "short": "Type of medication usage",
-        "definition": "Indicates where type of medication order and where the medication is expected to be consumed or administered.",
+        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.dosageInstruction.method",
+        "path": "MedicationRequest.dosageInstruction.method",
+        "short": "Technique for administering medication",
+        "definition": "Technique for administering medication.",
+        "comment": "Terminologies used often pre-coordinate this term with the route and or form of administration.",
+        "requirements": "A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections.  For examples, Slow Push; Deep IV.",
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "CodeableConcept"
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
           }
         ],
+        "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MedicationAdministrationMethod"
+            }
+          ],
           "strength": "example",
-          "description": "A coded concept identifying where the medication ordered is expected to be consumed or administered",
+          "description": "A coded concept describing the technique by which the medicine is administered.",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/medication-request-category"
+            "reference": "http://hl7.org/fhir/ValueSet/administration-method-codes"
           }
         },
         "mapping": [
           {
-            "identity": "script10.6",
-            "map": "Message/Body/NewRx/MedicationPrescribed/Directions\r\ror \r\rMessage/Body/NewRx/MedicationPrescribed/StructuredSIG"
-          },
+            "identity": "rim",
+            "map": ".doseQuantity"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.dosageInstruction.dose[x]",
+        "path": "MedicationRequest.dosageInstruction.dose[x]",
+        "short": "Amount of medication per dose",
+        "definition": "Amount of medication per dose.",
+        "comment": "Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.",
+        "requirements": "The amount of therapeutic or other substance given at one administration event.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Quantity",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-Quantity"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
           {
             "identity": "rim",
-            "map": "not mapped"
+            "map": ".doseQuantity"
           }
         ]
       },
       {
-        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.dosageInstruction",
-        "path": "MedicationRequest.dosageInstruction",
-        "short": "How the medication should be taken",
-        "definition": "Indicates how the medication is to be used by the patient.",
+        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.dosageInstruction.maxDosePerPeriod",
+        "path": "MedicationRequest.dosageInstruction.maxDosePerPeriod",
+        "short": "Upper limit on medication per unit of time",
+        "definition": "Upper limit on medication per unit of time.",
+        "comment": "This is intended for use as an adjunct to the dosage when there is an upper cap.  For example \"2 tablets every 4 hours to a maximum of 8/day\".",
+        "requirements": "The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time.  For example, 1000mg in 24 hours.",
         "min": 0,
-        "max": "*",
+        "max": "1",
+        "type": [
+          {
+            "code": "Ratio",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-medication-MaximumDosePerTimePeriod"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".maxDoseQuantity"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.dosageInstruction.maxDosePerAdministration",
+        "path": "MedicationRequest.dosageInstruction.maxDosePerAdministration",
+        "short": "Upper limit on medication per administration",
+        "definition": "Upper limit on medication per administration.",
+        "comment": "This is intended for use as an adjunct to the dosage when there is an upper cap.  For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg.",
+        "requirements": "The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Quantity",
+            "profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "not supported"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.dosageInstruction.maxDosePerLifetime",
+        "path": "MedicationRequest.dosageInstruction.maxDosePerLifetime",
+        "short": "Upper limit on medication per lifetime of the patient",
+        "definition": "Upper limit on medication per lifetime of the patient.",
+        "requirements": "The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Quantity",
+            "profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "not supported"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.dosageInstruction.rate[x]",
+        "path": "MedicationRequest.dosageInstruction.rate[x]",
+        "short": "Amount of medication per unit of time",
+        "definition": "Amount of medication per unit of time.",
+        "comment": "It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.",
+        "requirements": "Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr.  May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours.   Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours.  Sometimes, a rate can imply duration when expressed as total volume / duration (e.g.  500mL/2 hours implies a duration of 2 hours).  However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.",
+        "min": 0,
+        "max": "1",
         "type": [
           {
-            "code": "DosageInstruction"
+            "code": "Ratio"
+          },
+          {
+            "code": "Range"
+          },
+          {
+            "code": "Quantity",
+            "profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".rateQuantity"
           }
         ]
       },
@@ -1573,7 +2504,7 @@
         "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.dispenseRequest",
         "path": "MedicationRequest.dispenseRequest",
         "short": "Medication supply authorization",
-        "definition": "Indicates the specific details for the dispense or medication supply part of a medication order (also known as a Medication Prescription).  Note that this information is NOT always sent with the order.  There may be in some settings (e.g. hospitals) institutional or system support for completing the dispense details in the pharmacy department.",
+        "definition": "Indicates the specific details for the dispense or medication supply part of a medication request (also known as a Medication Prescription or Medication Order).  Note that this information is not always sent with the order.  There may be in some settings (e.g. hospitals) institutional or system support for completing the dispense details in the pharmacy department.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1634,7 +2565,7 @@
         "path": "MedicationRequest.dispenseRequest.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1663,7 +2594,7 @@
         "path": "MedicationRequest.dispenseRequest.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1695,7 +2626,7 @@
         "path": "MedicationRequest.dispenseRequest.validityPeriod",
         "short": "Time period supply is authorized for",
         "definition": "This indicates the validity period of a prescription (stale dating the Prescription).",
-        "comments": "It reflects the prescriber perspective for the validity of the prescription. Dispenses must not be made against the prescription outside of this period. The lower-bound of the Dispensing Window signifies the earliest date that the prescription can be filled for the first time. If an upper-bound is not specified then the Prescription is open-ended or will default to a stale-date based on regulations.",
+        "comment": "It reflects the prescribers' perspective for the validity of the prescription. Dispenses must not be made against the prescription outside of this period. The lower-bound of the Dispensing Window signifies the earliest date that the prescription can be filled for the first time. If an upper-bound is not specified then the Prescription is open-ended or will default to a stale-date based on regulations.",
         "requirements": "Indicates when the Prescription becomes valid, and when it ceases to be a dispensable Prescription.",
         "min": 0,
         "max": "1",
@@ -1720,8 +2651,8 @@
         "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.dispenseRequest.numberOfRepeatsAllowed",
         "path": "MedicationRequest.dispenseRequest.numberOfRepeatsAllowed",
         "short": "Number of refills authorized",
-        "definition": "An integer indicating the number of times, in addition to the original dispense, (aka refills or repeats) that the patient can receive the prescribed medication. Usage Notes: This integer does NOT include the original order dispense. This means that if an order indicates dispense 30 tablets plus \"3 repeats\", then the order can be dispensed a total of 4 times and the patient can receive a total of 120 tablets.",
-        "comments": "If displaying \"number of authorized fills\", add 1 to this number.",
+        "definition": "An integer indicating the number of times, in addition to the original dispense, (aka refills or repeats) that the patient can receive the prescribed medication. Usage Notes: This integer does not include the original order dispense. This means that if an order indicates dispense 30 tablets plus \"3 repeats\", then the order can be dispensed a total of 4 times and the patient can receive a total of 120 tablets.",
+        "comment": "If displaying \"number of authorized fills\", add 1 to this number.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1777,7 +2708,7 @@
         "path": "MedicationRequest.dispenseRequest.expectedSupplyDuration",
         "short": "Number of days supply per dispense",
         "definition": "Identifies the period time over which the supplied product is expected to be used, or the length of time the dispense is expected to last.",
-        "comments": "In some situations, this attribute may be used instead of quantity to identify the amount supplied by how long it is expected to last, rather than the physical quantity issued, e.g. 90 days supply of medication (based on an ordered dosage) When possible, it is always better to specify quantity, as this tends to be more precise. expectedSupplyDuration will always be an estimate that can be influenced by external factors.",
+        "comment": "In some situations, this attribute may be used instead of quantity to identify the amount supplied by how long it is expected to last, rather than the physical quantity issued, e.g. 90 days supply of medication (based on an ordered dosage) When possible, it is always better to specify quantity, as this tends to be more precise. expectedSupplyDuration will always be an estimate that can be influenced by external factors.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1811,6 +2742,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=COMP].target[classCode=SPLY, moodCode=RQO] .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]"
+          },
           {
             "identity": "w5",
             "map": "who"
@@ -1821,7 +2756,7 @@
         "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.substitution",
         "path": "MedicationRequest.substitution",
         "short": "Any restrictions on medication substitution",
-        "definition": "Indicates whether or not substitution can or should be part of the dispense. In some cases substitution must happen, in other cases substitution must not happen, and in others it does not matter. This block explains the prescriber's intent. If nothing is specified substitution may be done.",
+        "definition": "Indicates whether or not substitution can or should be part of the dispense. In some cases substitution must happen, in other cases substitution must not happen. This block explains the prescriber's intent. If nothing is specified substitution may be done.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1882,7 +2817,7 @@
         "path": "MedicationRequest.substitution.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1911,7 +2846,7 @@
         "path": "MedicationRequest.substitution.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1943,6 +2878,7 @@
         "path": "MedicationRequest.substitution.allowed",
         "short": "Whether substitution is allowed or not",
         "definition": "True if the prescriber allows a different drug to be dispensed from what was prescribed.",
+        "comment": "This element is labeled as a modifer because whether substitution is allow or not cannot be ignored.",
         "min": 1,
         "max": "1",
         "type": [
@@ -1979,6 +2915,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MedicationIntendedSubstitutionReason"
+            }
+          ],
           "strength": "example",
           "description": "A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.",
           "valueSetReference": {
@@ -2003,7 +2945,7 @@
       {
         "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.priorPrescription",
         "path": "MedicationRequest.priorPrescription",
-        "short": "An order/prescription that this supersedes",
+        "short": "An order/prescription that is being replaced",
         "definition": "A link to a resource representing an earlier order related order or prescription.",
         "min": 0,
         "max": "1",
@@ -2014,6 +2956,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…replaces"
+          },
           {
             "identity": "script10.6",
             "map": "not mapped"
@@ -2024,12 +2970,37 @@
           }
         ]
       },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.detectedIssue",
+        "path": "MedicationRequest.detectedIssue",
+        "short": "Clinical Issue with action",
+        "definition": "Indicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. Drug-drug interaction, duplicate therapy, dosage alert etc.",
+        "alias": [
+          "Contraindication",
+          "Drug Utilization Review (DUR)",
+          "Alert"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DetectedIssue"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".inboundRelationship[typeCode=SUBJ]/source[classCode=ALRT,moodCode=EVN].value"
+          }
+        ]
+      },
       {
         "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.eventHistory",
         "path": "MedicationRequest.eventHistory",
         "short": "A list of events of interest in the lifecycle",
-        "definition": "A summary of the events of interest that have occurred as the request is processed; e.g. when the order was verified or when it was completed.",
-        "comments": "See usage notes in Request pattern in request history.",
+        "definition": "Links to Provenance records for past versions of this resource or fulfilling request or event resources that identify key state transitions or updates that are likely to be relevant to a user looking at the current version of the resource.",
+        "comment": "This may not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.).",
         "min": 0,
         "max": "*",
         "type": [
@@ -2037,6 +3008,16 @@
             "code": "Reference",
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/Provenance"
           }
+        ],
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…relevantHistory"
+          },
+          {
+            "identity": "rim",
+            "map": ".inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]"
+          }
         ]
       }
     ]
@@ -2097,22 +3078,6 @@
         "isModifier": false,
         "isSummary": false
       },
-      {
-        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.extension:priorityofrequest",
-        "path": "MedicationRequest.extension",
-        "sliceName": "priorityofrequest",
-        "min": 0,
-        "max": "1",
-        "type": [
-          {
-            "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-PriorityOfRequest-extension"
-          }
-        ],
-        "mustSupport": false,
-        "isModifier": false,
-        "isSummary": false
-      },
       {
         "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.extension:patientinstructions",
         "path": "MedicationRequest.extension",
@@ -2190,6 +3155,99 @@
           }
         ]
       },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.note",
+        "path": "MedicationRequest.note",
+        "min": 0,
+        "max": "1"
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.dosageInstruction",
+        "path": "MedicationRequest.dosageInstruction",
+        "min": 0,
+        "max": "1"
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.dosageInstruction.additionalInstruction",
+        "path": "MedicationRequest.dosageInstruction.additionalInstruction",
+        "type": [
+          {
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+          }
+        ],
+        "binding": {
+          "strength": "required",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/additional-instructions-codes"
+          }
+        }
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.dosageInstruction.asNeeded[x]",
+        "path": "MedicationRequest.dosageInstruction.asNeeded[x]",
+        "type": [
+          {
+            "code": "boolean"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.dosageInstruction.site",
+        "path": "MedicationRequest.dosageInstruction.site",
+        "type": [
+          {
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+          }
+        ],
+        "binding": {
+          "strength": "required",
+          "valueSetReference": {
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
+          }
+        }
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.dosageInstruction.route",
+        "path": "MedicationRequest.dosageInstruction.route",
+        "type": [
+          {
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.dosageInstruction.method",
+        "path": "MedicationRequest.dosageInstruction.method",
+        "type": [
+          {
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.dosageInstruction.dose[x]",
+        "path": "MedicationRequest.dosageInstruction.dose[x]",
+        "type": [
+          {
+            "code": "Quantity",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-Quantity"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.dosageInstruction.maxDosePerPeriod",
+        "path": "MedicationRequest.dosageInstruction.maxDosePerPeriod",
+        "type": [
+          {
+            "code": "Ratio",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-medication-MaximumDosePerTimePeriod"
+          }
+        ]
+      },
       {
         "id": "MedicationRequest:shr-medication-MedicationNotPrescribed.dispenseRequest",
         "path": "MedicationRequest.dispenseRequest"
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-medication-MedicationNotPrescribedModifier-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-medication-MedicationNotPrescribedModifier-extension.json
old mode 100755
new mode 100644
index 835e556..2aff832
--- a/lib/resources/standard_health_record/StructureDefinition-shr-medication-MedicationNotPrescribedModifier-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-medication-MedicationNotPrescribedModifier-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.medication.MedicationNotPrescribedModifier"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR MedicationNotPrescribedModifier Extension",
   "title": "SHR MedicationNotPrescribedModifier Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.351Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.282Z",
   "description": "True, if the medication should not, or was not prescribed for a particular reason.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -105,9 +106,12 @@
         "id": "Extension:medicationnotprescribedmodifier.extension",
         "path": "Extension.extension",
         "slicing": {
-          "id": "184",
+          "id": "181",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -233,7 +237,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -278,7 +281,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-medication-ReasonMedicationNotUsedVS"
+            "reference": "http://standardhealthrecord.org/shr/medication/vs/ReasonMedicationNotUsedVS"
           }
         },
         "mapping": [
@@ -296,7 +299,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -494,7 +496,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-medication-ReasonMedicationNotUsedVS"
+            "reference": "http://standardhealthrecord.org/shr/medication/vs/ReasonMedicationNotUsedVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-medication-MedicationPrescription.json b/lib/resources/standard_health_record/StructureDefinition-shr-medication-MedicationPrescription.json
old mode 100755
new mode 100644
index 59991d0..6233773
--- a/lib/resources/standard_health_record/StructureDefinition-shr-medication-MedicationPrescription.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-medication-MedicationPrescription.json
@@ -3,7 +3,7 @@
   "id": "shr-medication-MedicationPrescription",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR MedicationPrescription Profile</b></p>\n  <p>Report of a medication prescription.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.medication.MedicationPrescription maps to MedicationRequest:\n  Medication maps to medication[x].Reference\n  Reason maps to reasonCode\n  RequestStatus maps to status\n  RequestedPerformanceTime maps to dispenseRequest.validityPeriod\n  RequestedPerformer.Organization maps to dispenseRequest.performer\n  PerformerInstructions maps to note.text\n  NumberOfRepeatsAllowed maps to dispenseRequest.numberOfRepeatsAllowed\n  QuantityPerDispense maps to dispenseRequest.quantity\n  SupplyDuration maps to dispenseRequest.expectedSupplyDuration\n  Dosage.AmountPerDose.Quantity maps to dosageInstruction.dose[x].SimpleQuantity\n  Dosage.AmountPerDose.TBD &quot;Range&quot; maps to dosageInstruction.dose[x].Range\n  Dosage.TimingOfDoses maps to dosageInstruction.timing\n  Dosage.DoseAsNeededIndicator maps to dosageInstruction.asNeeded[x].boolean\n  Dosage.DoseInstructionsText maps to dosageInstruction.text\n  Dosage.AdditionalDoseInstruction maps to dosageInstruction.additionalInstructions\n  Dosage.RouteIntoBody maps to dosageInstruction.route\n  Dosage.AdministrationMethod maps to dosageInstruction.method\n  Dosage.AdministrationBodySite maps to dosageInstruction.site\n  Dosage.MaximumDosePerTimePeriod maps to dosageInstruction.maxDosePerPeriod\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR MedicationPrescription Profile</b></p>\n  <p>Report of a medication prescription.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.medication.MedicationPrescription maps to MedicationRequest:\n  Medication maps to medication[x].Reference\n  Reason maps to reasonCode\n  RequestStatus maps to status\n  RequestedPerformanceTime maps to dispenseRequest.validityPeriod\n  PriorityOfRequest maps to priority\n  RequestedPerformer.Organization maps to dispenseRequest.performer\n  constrain note to 0..1\n  PerformerInstructions maps to note.text\n  NumberOfRepeatsAllowed maps to dispenseRequest.numberOfRepeatsAllowed\n  QuantityPerDispense maps to dispenseRequest.quantity\n  SupplyDuration maps to dispenseRequest.expectedSupplyDuration\n  constrain dosageInstruction to 0..1\n  Dosage.AmountPerDose.Quantity maps to dosageInstruction.dose[x].SimpleQuantity\n  Dosage.AmountPerDose.&lt;TBD &quot;Range&quot;&gt; maps to dosageInstruction.dose[x].Range\n  Dosage.TimingOfDoses maps to dosageInstruction.timing\n  Dosage.DoseAsNeededIndicator maps to dosageInstruction.asNeeded[x].boolean\n  Dosage.DoseInstructionsText maps to dosageInstruction.text\n  Dosage.AdditionalDoseInstruction maps to dosageInstruction.additionalInstruction\n  Dosage.RouteIntoBody maps to dosageInstruction.route\n  Dosage.AdministrationMethod maps to dosageInstruction.method\n  Dosage.AdministrationBodySite maps to dosageInstruction.site\n  Dosage.MaximumDosePerTimePeriod maps to dosageInstruction.maxDosePerPeriod\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-medication-MedicationPrescription",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.medication.MedicationPrescription"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR MedicationPrescription Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.321Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,10 +27,14 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.279Z",
   "description": "Report of a medication prescription.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
     {
       "identity": "script10.6",
       "uri": "http://ncpdp.org/SCRIPT10_6",
@@ -107,6 +113,10 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "..Request"
+          },
           {
             "identity": "script10.6",
             "map": "Message/Body/NewRx"
@@ -126,7 +136,7 @@
         "path": "MedicationRequest.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -165,7 +175,7 @@
         "path": "MedicationRequest.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -186,7 +196,7 @@
         "path": "MedicationRequest.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -206,6 +216,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -220,7 +238,7 @@
         "path": "MedicationRequest.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -254,7 +272,7 @@
         "path": "MedicationRequest.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -283,16 +301,19 @@
         "id": "MedicationRequest:shr-medication-MedicationPrescription.extension",
         "path": "MedicationRequest.extension",
         "slicing": {
-          "id": "185",
+          "id": "182",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -321,6 +342,7 @@
         "path": "MedicationRequest.extension",
         "sliceName": "actioncode",
         "definition": "The code for the action, such as an intervention or test, to be carried out.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -353,6 +375,7 @@
         "path": "MedicationRequest.extension",
         "sliceName": "occurrencetime",
         "definition": "The point in time or span of time in which something happens.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -385,6 +408,7 @@
         "path": "MedicationRequest.extension",
         "sliceName": "participant",
         "definition": "A statement about an actor who did (or did not) participate in a certain task or activity. Unlike a HealthcareInvolvement which continues over period of time, the participant is associated with doing or not doing a specific task, such admitting a patient, performing a procedure, or taking a measurement.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -412,43 +436,12 @@
           }
         ]
       },
-      {
-        "id": "MedicationRequest:shr-medication-MedicationPrescription.extension:priorityofrequest",
-        "path": "MedicationRequest.extension",
-        "sliceName": "priorityofrequest",
-        "definition": "Urgency level for which results must be reported to the requestor or responsible individual.",
-        "alias": [
-          "extensions",
-          "user content"
-        ],
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "DomainResource.extension",
-          "min": 0,
-          "max": "*"
-        },
-        "type": [
-          {
-            "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-PriorityOfRequest-extension"
-          }
-        ],
-        "mustSupport": false,
-        "isModifier": false,
-        "isSummary": false,
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "N/A"
-          }
-        ]
-      },
       {
         "id": "MedicationRequest:shr-medication-MedicationPrescription.extension:patientinstructions",
         "path": "MedicationRequest.extension",
         "sliceName": "patientinstructions",
         "definition": "Information for the patient, such as, where to get the test, how to prepare for the test, etc.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -480,16 +473,19 @@
         "id": "MedicationRequest:shr-medication-MedicationPrescription.modifierExtension",
         "path": "MedicationRequest.modifierExtension",
         "slicing": {
-          "id": "186",
+          "id": "183",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -519,6 +515,7 @@
         "path": "MedicationRequest.modifierExtension",
         "sliceName": "nonoccurrencemodifier",
         "definition": "When true, indicates either that the event or action documented in the entry did not occur, or the the thing documented is absent or does not exist.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -551,6 +548,7 @@
         "path": "MedicationRequest.modifierExtension",
         "sliceName": "medicationnotprescribedmodifier",
         "definition": "True, if the medication should not, or was not prescribed for a particular reason.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -581,8 +579,8 @@
       {
         "id": "MedicationRequest:shr-medication-MedicationPrescription.identifier",
         "path": "MedicationRequest.identifier",
-        "short": "External identifier",
-        "definition": "External identifier - one that would be used by another non-FHIR system - for example a re-imbursement system might issue its own id for each prescription that is created.  This is particularly important where FHIR only provides part of an entire workflow process where records have to be tracked through an entire system.",
+        "short": "External ids for this request",
+        "definition": "This records identifiers associated with this medication request that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. For example a re-imbursement system might issue its own id for each prescription that is created.  This is particularly important where FHIR only provides part of an entire workflow process where records must be tracked through an entire system.",
         "min": 0,
         "max": "*",
         "type": [
@@ -591,6 +589,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…identifer"
+          },
           {
             "identity": "script10.6",
             "map": "Message/Header/PrescriberOrderNumber"
@@ -601,7 +603,7 @@
           },
           {
             "identity": "rim",
-            "map": "id"
+            "map": ".id"
           },
           {
             "identity": "w5",
@@ -626,13 +628,23 @@
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/PlanDefinition"
           }
         ],
-        "isSummary": true
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…definition"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=DEFN].target[classCode=unspecified]"
+          }
+        ]
       },
       {
         "id": "MedicationRequest:shr-medication-MedicationPrescription.basedOn",
         "path": "MedicationRequest.basedOn",
         "short": "What request fulfills",
-        "definition": "Plan/proposal/order fulfilled by this request.",
+        "definition": "A plan or request that is fulfilled in whole or in part by this medication request.",
         "min": 0,
         "max": "*",
         "type": [
@@ -640,10 +652,6 @@
             "code": "Reference",
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
           },
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DiagnosticRequest"
-          },
           {
             "code": "Reference",
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
@@ -657,13 +665,24 @@
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
           }
         ],
-        "isSummary": true
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…basedOn"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target[classCode=SBADM or PROC or PCPR or OBS, moodCode=RQO orPLAN or PRP]"
+          }
+        ]
       },
       {
-        "id": "MedicationRequest:shr-medication-MedicationPrescription.requisition",
-        "path": "MedicationRequest.requisition",
-        "short": "Identifier of composite",
-        "definition": "Composite request this is part of.",
+        "id": "MedicationRequest:shr-medication-MedicationPrescription.groupIdentifier",
+        "path": "MedicationRequest.groupIdentifier",
+        "short": "Composite request this is part of",
+        "definition": "A shared identifier common to all requests that were authorized more or less simultaneously by a single author, representing the identifier of the requisition or prescription.",
+        "requirements": "Requests are linked either by a \"basedOn\" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation.",
         "min": 0,
         "max": "1",
         "type": [
@@ -671,13 +690,24 @@
             "code": "Identifier"
           }
         ],
-        "isSummary": true
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…groupIdentifier"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship(typeCode=COMP].target[classCode=SBADM, moodCode=INT].id"
+          }
+        ]
       },
       {
         "id": "MedicationRequest:shr-medication-MedicationPrescription.status",
         "path": "MedicationRequest.status",
-        "short": "active | on-hold | cancelled | completed | entered-in-error | stopped | draft",
-        "definition": "A code specifying the state of the order.  Generally this will be active or completed state.",
+        "short": "active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown",
+        "definition": "A code specifying the current state of the order.  Generally this will be active or completed state.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "min": 1,
         "max": "1",
         "type": [
@@ -688,6 +718,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MedicationRequestStatus"
+            }
+          ],
           "strength": "required",
           "description": "A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription",
           "valueSetReference": {
@@ -695,13 +731,17 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…status"
+          },
           {
             "identity": "script10.6",
             "map": "no mapping"
           },
           {
             "identity": "rim",
-            "map": "statusCode"
+            "map": ".statusCode"
           },
           {
             "identity": "w5",
@@ -710,40 +750,135 @@
         ]
       },
       {
-        "id": "MedicationRequest:shr-medication-MedicationPrescription.stage",
-        "path": "MedicationRequest.stage",
-        "short": "proposal | plan | original-order",
+        "id": "MedicationRequest:shr-medication-MedicationPrescription.intent",
+        "path": "MedicationRequest.intent",
+        "short": "proposal | plan | order | instance-order",
         "definition": "Whether the request is a proposal, plan, or an original order.",
-        "comments": "It is expected that the type of requester will be restricted for different stages of a MedicationRequest.  For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device.  Plans can be created by Practitioners, Patients, RelatedPersons and Devices.  Original orders can be created by a Practitioner only.",
+        "comment": "It is expected that the type of requester will be restricted for different stages of a MedicationRequest.  For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device.  Plans can be created by Practitioners, Patients, RelatedPersons and Devices.  Original orders can be created by a Practitioner only.\r\rAn instance-order is an instantiation of a request or order and may be used to populate Medication Administration Record.\n\nThis element is labeled as a modifier because the intent alters when and how the resource is actually applicable.",
         "min": 1,
         "max": "1",
         "type": [
           {
-            "code": "CodeableConcept"
+            "code": "code"
           }
         ],
         "isModifier": true,
         "isSummary": true,
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MedicationRequestIntent"
+            }
+          ],
+          "strength": "required",
           "description": "The kind of medication order",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/medication-request-stage"
+            "reference": "http://hl7.org/fhir/ValueSet/medication-request-intent"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…intent"
+          },
+          {
+            "identity": "rim",
+            "map": ".moodCode (nuances beyond PRP/PLAN/RQO would need to be elsewhere)"
+          },
+          {
+            "identity": "w5",
+            "map": "class"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationPrescription.category",
+        "path": "MedicationRequest.category",
+        "short": "Type of medication usage",
+        "definition": "Indicates the type of medication order and where the medication is expected to be consumed or administered.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MedicationRequestCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "A coded concept identifying where the medication ordered is expected to be consumed or administered",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/medication-request-category"
           }
         },
         "mapping": [
+          {
+            "identity": "script10.6",
+            "map": "Message/Body/NewRx/MedicationPrescribed/Directions\r\ror \r\rMessage/Body/NewRx/MedicationPrescribed/StructuredSIG"
+          },
+          {
+            "identity": "rim",
+            "map": ".inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code=\"type of medication usage\"].value"
+          },
           {
             "identity": "w5",
             "map": "class"
           }
         ]
       },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationPrescription.priority",
+        "path": "MedicationRequest.priority",
+        "short": "routine | urgent | stat | asap",
+        "definition": "Indicates how quickly the Medication Request should be addressed with respect to other requests.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "code"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MedicationRequestPriority"
+            }
+          ],
+          "strength": "required",
+          "description": "Identifies the level of importance to be assigned to actioning the request",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/medication-request-priority"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…priority"
+          },
+          {
+            "identity": "rim",
+            "map": ".priorityCode"
+          },
+          {
+            "identity": "w5",
+            "map": "grade"
+          }
+        ]
+      },
       {
         "id": "MedicationRequest:shr-medication-MedicationPrescription.medication[x]",
         "path": "MedicationRequest.medication[x]",
         "short": "Medication to be taken",
-        "definition": "Identifies the medication being administered. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications.",
-        "comments": "If only a code is specified, then it needs to be a code for a specific product.  If more information is required, then the use of the medication resource is recommended.  Note: do not use Medication.name to describe the prescribed medication. When the only available information is a text description of the medication, Medication.code.text should be used.",
+        "definition": "Identifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications.",
+        "comment": "If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended.  For example, if you require form or lot number or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource. .",
         "min": 1,
         "max": "1",
         "type": [
@@ -754,6 +889,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MedicationCode"
+            }
+          ],
           "strength": "example",
           "description": "A coded concept identifying substance or product that can be ordered.",
           "valueSetReference": {
@@ -761,6 +902,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…code"
+          },
           {
             "identity": "script10.6",
             "map": "Message/Body/NewRx/MedicationPrescribed\r\rMedication.code.coding.code = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCode\r\rMedication.code.coding.system = Message/Body/NewRx/MedicationPrescribed/DrugCoded/ProductCodeQualifier\r\rMedication.code.coding.display = Message/Body/NewRx/MedicationPrescribed/DrugDescription"
@@ -780,21 +925,29 @@
         ]
       },
       {
-        "id": "MedicationRequest:shr-medication-MedicationPrescription.patient",
-        "path": "MedicationRequest.patient",
-        "short": "Who prescription is for",
-        "definition": "A link to a resource representing the person to whom the medication will be given.",
-        "comments": "The patient on a medicationRequest is mandatory.  For the secondary use case where the actual patient is not provided, there still must be an anonymyzed patient specified.",
+        "id": "MedicationRequest:shr-medication-MedicationPrescription.subject",
+        "path": "MedicationRequest.subject",
+        "short": "Who or group medication request is for",
+        "definition": "A link to a resource representing the person or set of individuals to whom the medication will be given.",
+        "comment": "The subject on a medication request is mandatory.  For the secondary use case where the actual subject is not provided, there still must be an anonymized subject specified.",
         "min": 1,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Group"
           }
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…subject"
+          },
           {
             "identity": "script10.6",
             "map": "Message/Body/NewRx/Patient\r\r(need detail to link to specific patient … Patient.Identification in SCRIPT)"
@@ -805,7 +958,7 @@
           },
           {
             "identity": "rim",
-            "map": "subject.role"
+            "map": ".participation[typeCode=AUT].role"
           },
           {
             "identity": "w5",
@@ -817,8 +970,8 @@
         "id": "MedicationRequest:shr-medication-MedicationPrescription.context",
         "path": "MedicationRequest.context",
         "short": "Created during encounter/admission/stay",
-        "definition": "A link to a resource that identifies the particular occurrence or set oc occurences of contact between patient and health care provider.",
-        "comments": "SubstanceAdministration->component->EncounterEvent.",
+        "definition": "A link to an encounter, or episode of care, that identifies the particular occurrence or set occurrences of contact between patient and health care provider.",
+        "comment": "SubstanceAdministration->component->EncounterEvent.",
         "min": 0,
         "max": "1",
         "type": [
@@ -832,6 +985,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…context"
+          },
           {
             "identity": "script10.6",
             "map": "no mapping"
@@ -842,7 +999,7 @@
           },
           {
             "identity": "rim",
-            "map": "componentOf.patientEncounter"
+            "map": ".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code=\"type of encounter or episode\"]"
           },
           {
             "identity": "w5",
@@ -864,6 +1021,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS, RQO, PRP, APT, ARQ, GOL)]"
+          },
           {
             "identity": "w5",
             "map": "context"
@@ -871,10 +1032,10 @@
         ]
       },
       {
-        "id": "MedicationRequest:shr-medication-MedicationPrescription.dateWritten",
-        "path": "MedicationRequest.dateWritten",
-        "short": "When prescription was initially authorized",
-        "definition": "The date (and perhaps time) when the prescription was initially written.",
+        "id": "MedicationRequest:shr-medication-MedicationPrescription.authoredOn",
+        "path": "MedicationRequest.authoredOn",
+        "short": "When request was initially authored",
+        "definition": "The date (and perhaps time) when the prescription was initially written or authored on.",
         "min": 0,
         "max": "1",
         "type": [
@@ -884,6 +1045,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…authoredOn"
+          },
           {
             "identity": "script10.6",
             "map": "Message/Body/NewRx/MedicationPrescribed/WrittenDate"
@@ -905,189 +1070,955 @@
       {
         "id": "MedicationRequest:shr-medication-MedicationPrescription.requester",
         "path": "MedicationRequest.requester",
-        "short": "Who ordered the initial medication(s)",
-        "definition": "The healthcare professional responsible for authorizing the initial prescription.",
-        "comments": "It is expected that the type of requester will be restricted for different stages of a MedicationRequest.  For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device.  Plans can be created by Practitioners, Patients, RelatedPersons and Devices.  Original orders can be created by a Practitioner only.",
+        "short": "Who/What requested the Request",
+        "definition": "The individual, organization or device that initiated the request and has responsibility for its activation.",
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
-          },
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
-          },
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient"
-          },
+            "code": "BackboneElement"
+          }
+        ],
+        "constraint": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
+            "key": "ele-1",
+            "severity": "error",
+            "human": "All FHIR elements must have a @value or children",
+            "expression": "children().count() > id.count()",
+            "xpath": "@value|f:*|h:div",
+            "source": "Element"
           },
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Device"
+            "key": "mps-1",
+            "severity": "error",
+            "human": "onBehalfOf can only be specified if agent is practitioner or device",
+            "expression": "(agent.resolve().empty()) or (agent.resolve() is Device) or (agent.resolve() is Practitioner) or onBehalfOf.exists().not()",
+            "xpath": "contains(f:agent, '/Practitioner') or contains(f:agent, '/Device') or not(exists(f:onBehalfOf))"
           }
         ],
         "isSummary": true,
         "mapping": [
           {
-            "identity": "script10.6",
-            "map": "Message/Body/NewRx/Prescriber\r\r(need detail to link to specific prescriber … Prescriber.Identification in SCRIPT)"
-          },
-          {
-            "identity": "v2",
-            "map": "RXE-13-Ordering Provider's DEA Number / RXO-14-Ordering Provider's DEA Number / RXE-14-Pharmacist/Treatment Supplier's Verifier ID / RXO-15-Pharmacist/Treatment Supplier's Verifier ID / ORC-12-Ordering Provider / PRT-5-Participation Person: PRT-4-Participation='OP' (all but last deprecated)"
+            "identity": "workflow",
+            "map": "…requester"
           },
           {
             "identity": "rim",
-            "map": "author.role"
+            "map": ".participation[typeCode=AUT].role"
           },
           {
             "identity": "w5",
-            "map": "who.actor"
+            "map": "who.author"
           }
         ]
       },
       {
-        "id": "MedicationRequest:shr-medication-MedicationPrescription.reasonCode",
-        "path": "MedicationRequest.reasonCode",
-        "short": "Reason or indication for writing the prescription",
-        "definition": "Can be the reason or the indication for writing the prescription.",
-        "comments": "This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonReference.",
+        "id": "MedicationRequest:shr-medication-MedicationPrescription.requester.id",
+        "path": "MedicationRequest.requester.id",
+        "representation": [
+          "xmlAttr"
+        ],
+        "short": "xml:id (or equivalent in JSON)",
+        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
         "min": 0,
         "max": "1",
+        "base": {
+          "path": "Element.id",
+          "min": 0,
+          "max": "1"
+        },
         "type": [
           {
-            "code": "CodeableConcept",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+            "code": "string"
           }
         ],
-        "binding": {
-          "strength": "example",
-          "description": "A coded concept indicating why the medication was ordered.",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/condition-code"
-          }
-        },
         "mapping": [
-          {
-            "identity": "script10.6",
-            "map": "Message/Body/NewRx/MedicationPrescribed/Diagnosis/Primary/Value"
-          },
-          {
-            "identity": "v2",
-            "map": "ORC-16-Order Control Code Reason /RXE-27-Give Indication/RXO-20-Indication / RXD-21-Indication / RXG-22-Indication / RXA-19-Indication"
-          },
           {
             "identity": "rim",
-            "map": "reason.observation.reasonCode"
-          },
-          {
-            "identity": "w5",
-            "map": "why"
+            "map": "n/a"
           }
         ]
       },
       {
-        "id": "MedicationRequest:shr-medication-MedicationPrescription.reasonReference",
-        "path": "MedicationRequest.reasonReference",
-        "short": "Condition or Observation that supports why the prescription is being written",
-        "definition": "Condition or observation that supports why the prescription is being written.",
-        "comments": "This is a reference to a condition that is the reason for the medication order.  If only a code exists, use reasonCode.",
+        "id": "MedicationRequest:shr-medication-MedicationPrescription.requester.extension",
+        "path": "MedicationRequest.requester.extension",
+        "short": "Additional Content defined by implementations",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content"
+        ],
         "min": 0,
         "max": "*",
-        "type": [
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Condition"
+        "base": {
+          "path": "Element.extension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationPrescription.requester.modifierExtension",
+        "path": "MedicationRequest.requester.modifierExtension",
+        "short": "Extensions that cannot be ignored",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content",
+          "modifiers"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "BackboneElement.modifierExtension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "isModifier": true,
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "N/A"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationPrescription.requester.agent",
+        "path": "MedicationRequest.requester.agent",
+        "short": "Who ordered the initial medication(s)",
+        "definition": "The healthcare professional responsible for authorizing the initial prescription.",
+        "comment": "It is expected that the type of requester will be restricted for different stages of a MedicationRequest.  For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device.  Plans can be created by Practitioners, Patients, RelatedPersons and Devices.  Original orders can be created by a Practitioner only.",
+        "min": 1,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Device"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "….agent"
+          },
+          {
+            "identity": "script10.6",
+            "map": "Message/Body/NewRx/Prescriber\r\r(need detail to link to specific prescriber … Prescriber.Identification in SCRIPT)"
+          },
+          {
+            "identity": "v2",
+            "map": "RXE-13-Ordering Provider's DEA Number / RXO-14-Ordering Provider's DEA Number / RXE-14-Pharmacist/Treatment Supplier's Verifier ID / RXO-15-Pharmacist/Treatment Supplier's Verifier ID / ORC-12-Ordering Provider / PRT-5-Participation Person: PRT-4-Participation='OP' (all but last deprecated)"
+          },
+          {
+            "identity": "rim",
+            "map": ".player"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationPrescription.requester.onBehalfOf",
+        "path": "MedicationRequest.requester.onBehalfOf",
+        "short": "Organization agent is acting for",
+        "definition": "The organization the device or practitioner was acting on behalf of.",
+        "requirements": "Practitioners and Devices can be associated with multiple organizations. This element indicates which organization they were acting on behalf of when authoring the request.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
+          }
+        ],
+        "condition": [
+          "mps-1"
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "….onBehalfOf"
+          },
+          {
+            "identity": "rim",
+            "map": ".scoper"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationPrescription.recorder",
+        "path": "MedicationRequest.recorder",
+        "short": "Person who entered the request",
+        "definition": "The person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".participation[typeCode=TRANS].role[classCode=ASSIGNED].code (HealthcareProviderType)"
+          },
+          {
+            "identity": "w5",
+            "map": "who"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationPrescription.reasonCode",
+        "path": "MedicationRequest.reasonCode",
+        "short": "Reason or indication for writing the prescription",
+        "definition": "The reason or the indication for ordering the medication.",
+        "comment": "This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonReference.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MedicationRequestReason"
+            }
+          ],
+          "strength": "example",
+          "description": "A coded concept indicating why the medication was ordered.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/condition-code"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…reasonCode"
+          },
+          {
+            "identity": "script10.6",
+            "map": "Message/Body/NewRx/MedicationPrescribed/Diagnosis/Primary/Value"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC-16-Order Control Code Reason /RXE-27-Give Indication/RXO-20-Indication / RXD-21-Indication / RXG-22-Indication / RXA-19-Indication"
+          },
+          {
+            "identity": "rim",
+            "map": "reason.observation.reasonCode"
+          },
+          {
+            "identity": "w5",
+            "map": "why"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationPrescription.reasonReference",
+        "path": "MedicationRequest.reasonReference",
+        "short": "Condition or Observation that supports why the prescription is being written",
+        "definition": "Condition or observation that supports why the medication was ordered.",
+        "comment": "This is a reference to a condition or observation that is the reason for the medication order.  If only a code exists, use reasonCode.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Condition"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Observation"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…reasonReference"
+          },
+          {
+            "identity": "script10.6",
+            "map": "no mapping"
+          },
+          {
+            "identity": "rim",
+            "map": "reason.observation[code=ASSERTION].value"
+          },
+          {
+            "identity": "w5",
+            "map": "why"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationPrescription.note",
+        "path": "MedicationRequest.note",
+        "short": "Information about the prescription",
+        "definition": "Extra information about the prescription that could not be conveyed by the other attributes.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Annotation"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…note"
+          },
+          {
+            "identity": "script10.6",
+            "map": "Message/Body/NewRx/MedicationPrescribed/Note"
+          },
+          {
+            "identity": "rim",
+            "map": ".inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code=\"annotation\"].value"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationPrescription.note.id",
+        "path": "MedicationRequest.note.id",
+        "representation": [
+          "xmlAttr"
+        ],
+        "short": "xml:id (or equivalent in JSON)",
+        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Element.id",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationPrescription.note.extension",
+        "path": "MedicationRequest.note.extension",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
+        "short": "Additional Content defined by implementations",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "Element.extension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationPrescription.note.author[x]",
+        "path": "MedicationRequest.note.author[x]",
+        "short": "Individual responsible for the annotation",
+        "definition": "The individual responsible for making the annotation.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
+          },
+          {
+            "code": "string"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "v2",
+            "map": "N/A"
+          },
+          {
+            "identity": "rim",
+            "map": "Act.participant[typeCode=AUT].role"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationPrescription.note.time",
+        "path": "MedicationRequest.note.time",
+        "short": "When the annotation was made",
+        "definition": "Indicates when this particular annotation was made.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "dateTime"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "v2",
+            "map": "N/A"
+          },
+          {
+            "identity": "rim",
+            "map": "Act.effectiveTime"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationPrescription.note.text",
+        "path": "MedicationRequest.note.text",
+        "short": "The annotation  - text content",
+        "definition": "The text of the annotation.",
+        "min": 1,
+        "max": "1",
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "v2",
+            "map": "N/A"
+          },
+          {
+            "identity": "rim",
+            "map": "Act.text"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationPrescription.dosageInstruction",
+        "path": "MedicationRequest.dosageInstruction",
+        "short": "How the medication should be taken",
+        "definition": "Indicates how the medication is to be used by the patient.",
+        "comment": "There are examples where a medication request may include the option of an oral dose or an Intravenous or Intramuscular dose.  For example, \"Ondansetron 8mg orally or IV twice a day as needed for nausea\" or \"Compazine® (prochlorperazine) 5-10mg PO or 25mg PR bid prn nausea or vomiting\".  In these cases, two medication requests would be created that could be grouped together.  The decision on which dose and route of administration to use is based on the patient's condition at the time the dose is needed.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Dosage"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…occurrence[x]"
           },
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Observation"
+            "identity": "rim",
+            "map": "see dosageInstruction mapping"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationPrescription.dosageInstruction.id",
+        "path": "MedicationRequest.dosageInstruction.id",
+        "representation": [
+          "xmlAttr"
+        ],
+        "short": "xml:id (or equivalent in JSON)",
+        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Element.id",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationPrescription.dosageInstruction.extension",
+        "path": "MedicationRequest.dosageInstruction.extension",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
+        "short": "Additional Content defined by implementations",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "Element.extension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationPrescription.dosageInstruction.sequence",
+        "path": "MedicationRequest.dosageInstruction.sequence",
+        "short": "The order of the dosage instructions",
+        "definition": "Indicates the order in which the dosage instructions should be applied or interpreted.",
+        "requirements": "If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent.  If the sequence number is different, then the Dosages are intended to be sequential.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "integer"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".text"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationPrescription.dosageInstruction.text",
+        "path": "MedicationRequest.dosageInstruction.text",
+        "short": "Free text dosage instructions e.g. SIG",
+        "definition": "Free text dosage instructions e.g. SIG.",
+        "requirements": "Free text dosage instructions can be used for cases where the instructions are too complex to code.  The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated.  If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".text"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationPrescription.dosageInstruction.additionalInstruction",
+        "path": "MedicationRequest.dosageInstruction.additionalInstruction",
+        "short": "Supplemental instruction - e.g. \"with meals\"",
+        "definition": "Supplemental instruction - e.g. \"with meals\".",
+        "requirements": "Additional instruction such as \"Swallow with plenty of water\" which may or may not be coded.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "strength": "required",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/additional-instructions-codes"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".text"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationPrescription.dosageInstruction.patientInstruction",
+        "path": "MedicationRequest.dosageInstruction.patientInstruction",
+        "short": "Patient or consumer oriented instructions",
+        "definition": "Instructions in terms that are understood by the patient or consumer.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".text"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationPrescription.dosageInstruction.timing",
+        "path": "MedicationRequest.dosageInstruction.timing",
+        "short": "When medication should be administered",
+        "definition": "When medication should be administered.",
+        "comment": "This attribute may not always be populated while the Dosage.text is expected to be populated.  If both are populated, then the Dosage.text should reflect the content of the Dosage.timing.",
+        "requirements": "The timing schedule for giving the medication to the patient. The Schedule data type allows many different expressions. For example: \"Every 8 hours\"; \"Three times a day\"; \"1/2 an hour before breakfast for 10 days from 23-Dec 2011:\"; \"15 Oct 2013, 17 Oct 2013 and 1 Nov 2013\".  Sometimes, a rate can imply duration when expressed as total volume / duration (e.g.  500mL/2 hours implies a duration of 2 hours).  However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Timing"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".effectiveTime"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationPrescription.dosageInstruction.asNeeded[x]",
+        "path": "MedicationRequest.dosageInstruction.asNeeded[x]",
+        "short": "Take \"as needed\" (for x)",
+        "definition": "Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).",
+        "comment": "Can express \"as needed\" without a reason by setting the Boolean = True.  In this case the CodeableConcept is not populated.  Or you can express \"as needed\" with a reason by including the CodeableConcept.  In this case the Boolean is assumed to be True.  If you set the Boolean to False, then the dose is given according to the schedule and is not \"prn\" or \"as needed\".",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "boolean"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MedicationAsNeededReason"
+            }
+          ],
+          "strength": "example",
+          "description": "A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose.  For example \"pain\", \"30 minutes prior to sexual intercourse\", \"on flare-up\" etc.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/medication-as-needed-reason"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code=\"as needed\"].value=boolean or codable concept"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationPrescription.dosageInstruction.site",
+        "path": "MedicationRequest.dosageInstruction.site",
+        "short": "Body site to administer to",
+        "definition": "Body site to administer to.",
+        "comment": "If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [body-site-instance](extension-body-site-instance.html).  May be a summary code, or a reference to a very precise definition of the location, or both.",
+        "requirements": "A coded specification of the anatomic site where the medication first enters the body.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
           }
         ],
+        "isSummary": true,
+        "binding": {
+          "strength": "required",
+          "valueSetReference": {
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
+          }
+        },
         "mapping": [
-          {
-            "identity": "script10.6",
-            "map": "no mapping"
-          },
           {
             "identity": "rim",
-            "map": "reason.observation[code=ASSERTION].value"
-          },
-          {
-            "identity": "w5",
-            "map": "why"
+            "map": ".approachSiteCode"
           }
         ]
       },
       {
-        "id": "MedicationRequest:shr-medication-MedicationPrescription.note",
-        "path": "MedicationRequest.note",
-        "short": "Information about the prescription",
-        "definition": "Extra information about the prescription that could not be conveyed by the other attributes.",
+        "id": "MedicationRequest:shr-medication-MedicationPrescription.dosageInstruction.route",
+        "path": "MedicationRequest.dosageInstruction.route",
+        "short": "How drug should enter body",
+        "definition": "How drug should enter body.",
+        "requirements": "A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
-            "code": "Annotation"
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
           }
         ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "RouteOfAdministration"
+            }
+          ],
+          "strength": "example",
+          "description": "A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/route-codes"
+          }
+        },
         "mapping": [
-          {
-            "identity": "script10.6",
-            "map": "Message/Body/NewRx/MedicationPrescribed/Note"
-          },
           {
             "identity": "rim",
-            "map": ".inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code=\"annotation\"].value"
+            "map": ".routeCode"
           }
         ]
       },
       {
-        "id": "MedicationRequest:shr-medication-MedicationPrescription.category",
-        "path": "MedicationRequest.category",
-        "short": "Type of medication usage",
-        "definition": "Indicates where type of medication order and where the medication is expected to be consumed or administered.",
+        "id": "MedicationRequest:shr-medication-MedicationPrescription.dosageInstruction.method",
+        "path": "MedicationRequest.dosageInstruction.method",
+        "short": "Technique for administering medication",
+        "definition": "Technique for administering medication.",
+        "comment": "Terminologies used often pre-coordinate this term with the route and or form of administration.",
+        "requirements": "A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections.  For examples, Slow Push; Deep IV.",
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "CodeableConcept"
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
           }
         ],
+        "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MedicationAdministrationMethod"
+            }
+          ],
           "strength": "example",
-          "description": "A coded concept identifying where the medication ordered is expected to be consumed or administered",
+          "description": "A coded concept describing the technique by which the medicine is administered.",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/medication-request-category"
+            "reference": "http://hl7.org/fhir/ValueSet/administration-method-codes"
           }
         },
         "mapping": [
           {
-            "identity": "script10.6",
-            "map": "Message/Body/NewRx/MedicationPrescribed/Directions\r\ror \r\rMessage/Body/NewRx/MedicationPrescribed/StructuredSIG"
-          },
+            "identity": "rim",
+            "map": ".doseQuantity"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationPrescription.dosageInstruction.dose[x]",
+        "path": "MedicationRequest.dosageInstruction.dose[x]",
+        "short": "Amount of medication per dose",
+        "definition": "Amount of medication per dose.",
+        "comment": "Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.",
+        "requirements": "The amount of therapeutic or other substance given at one administration event.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Quantity",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-Quantity"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
           {
             "identity": "rim",
-            "map": "not mapped"
+            "map": ".doseQuantity"
           }
         ]
       },
       {
-        "id": "MedicationRequest:shr-medication-MedicationPrescription.dosageInstruction",
-        "path": "MedicationRequest.dosageInstruction",
-        "short": "How the medication should be taken",
-        "definition": "Indicates how the medication is to be used by the patient.",
+        "id": "MedicationRequest:shr-medication-MedicationPrescription.dosageInstruction.maxDosePerPeriod",
+        "path": "MedicationRequest.dosageInstruction.maxDosePerPeriod",
+        "short": "Upper limit on medication per unit of time",
+        "definition": "Upper limit on medication per unit of time.",
+        "comment": "This is intended for use as an adjunct to the dosage when there is an upper cap.  For example \"2 tablets every 4 hours to a maximum of 8/day\".",
+        "requirements": "The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time.  For example, 1000mg in 24 hours.",
         "min": 0,
-        "max": "*",
+        "max": "1",
+        "type": [
+          {
+            "code": "Ratio",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-medication-MaximumDosePerTimePeriod"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".maxDoseQuantity"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationPrescription.dosageInstruction.maxDosePerAdministration",
+        "path": "MedicationRequest.dosageInstruction.maxDosePerAdministration",
+        "short": "Upper limit on medication per administration",
+        "definition": "Upper limit on medication per administration.",
+        "comment": "This is intended for use as an adjunct to the dosage when there is an upper cap.  For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg.",
+        "requirements": "The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Quantity",
+            "profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "not supported"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationPrescription.dosageInstruction.maxDosePerLifetime",
+        "path": "MedicationRequest.dosageInstruction.maxDosePerLifetime",
+        "short": "Upper limit on medication per lifetime of the patient",
+        "definition": "Upper limit on medication per lifetime of the patient.",
+        "requirements": "The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Quantity",
+            "profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "not supported"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationPrescription.dosageInstruction.rate[x]",
+        "path": "MedicationRequest.dosageInstruction.rate[x]",
+        "short": "Amount of medication per unit of time",
+        "definition": "Amount of medication per unit of time.",
+        "comment": "It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.",
+        "requirements": "Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr.  May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours.   Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours.  Sometimes, a rate can imply duration when expressed as total volume / duration (e.g.  500mL/2 hours implies a duration of 2 hours).  However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.",
+        "min": 0,
+        "max": "1",
         "type": [
           {
-            "code": "DosageInstruction"
+            "code": "Ratio"
+          },
+          {
+            "code": "Range"
+          },
+          {
+            "code": "Quantity",
+            "profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".rateQuantity"
           }
         ]
       },
@@ -1095,7 +2026,7 @@
         "id": "MedicationRequest:shr-medication-MedicationPrescription.dispenseRequest",
         "path": "MedicationRequest.dispenseRequest",
         "short": "Medication supply authorization",
-        "definition": "Indicates the specific details for the dispense or medication supply part of a medication order (also known as a Medication Prescription).  Note that this information is NOT always sent with the order.  There may be in some settings (e.g. hospitals) institutional or system support for completing the dispense details in the pharmacy department.",
+        "definition": "Indicates the specific details for the dispense or medication supply part of a medication request (also known as a Medication Prescription or Medication Order).  Note that this information is not always sent with the order.  There may be in some settings (e.g. hospitals) institutional or system support for completing the dispense details in the pharmacy department.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1156,7 +2087,7 @@
         "path": "MedicationRequest.dispenseRequest.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1185,7 +2116,7 @@
         "path": "MedicationRequest.dispenseRequest.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1217,7 +2148,7 @@
         "path": "MedicationRequest.dispenseRequest.validityPeriod",
         "short": "Time period supply is authorized for",
         "definition": "This indicates the validity period of a prescription (stale dating the Prescription).",
-        "comments": "It reflects the prescriber perspective for the validity of the prescription. Dispenses must not be made against the prescription outside of this period. The lower-bound of the Dispensing Window signifies the earliest date that the prescription can be filled for the first time. If an upper-bound is not specified then the Prescription is open-ended or will default to a stale-date based on regulations.",
+        "comment": "It reflects the prescribers' perspective for the validity of the prescription. Dispenses must not be made against the prescription outside of this period. The lower-bound of the Dispensing Window signifies the earliest date that the prescription can be filled for the first time. If an upper-bound is not specified then the Prescription is open-ended or will default to a stale-date based on regulations.",
         "requirements": "Indicates when the Prescription becomes valid, and when it ceases to be a dispensable Prescription.",
         "min": 0,
         "max": "1",
@@ -1242,8 +2173,8 @@
         "id": "MedicationRequest:shr-medication-MedicationPrescription.dispenseRequest.numberOfRepeatsAllowed",
         "path": "MedicationRequest.dispenseRequest.numberOfRepeatsAllowed",
         "short": "Number of refills authorized",
-        "definition": "An integer indicating the number of times, in addition to the original dispense, (aka refills or repeats) that the patient can receive the prescribed medication. Usage Notes: This integer does NOT include the original order dispense. This means that if an order indicates dispense 30 tablets plus \"3 repeats\", then the order can be dispensed a total of 4 times and the patient can receive a total of 120 tablets.",
-        "comments": "If displaying \"number of authorized fills\", add 1 to this number.",
+        "definition": "An integer indicating the number of times, in addition to the original dispense, (aka refills or repeats) that the patient can receive the prescribed medication. Usage Notes: This integer does not include the original order dispense. This means that if an order indicates dispense 30 tablets plus \"3 repeats\", then the order can be dispensed a total of 4 times and the patient can receive a total of 120 tablets.",
+        "comment": "If displaying \"number of authorized fills\", add 1 to this number.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1299,7 +2230,7 @@
         "path": "MedicationRequest.dispenseRequest.expectedSupplyDuration",
         "short": "Number of days supply per dispense",
         "definition": "Identifies the period time over which the supplied product is expected to be used, or the length of time the dispense is expected to last.",
-        "comments": "In some situations, this attribute may be used instead of quantity to identify the amount supplied by how long it is expected to last, rather than the physical quantity issued, e.g. 90 days supply of medication (based on an ordered dosage) When possible, it is always better to specify quantity, as this tends to be more precise. expectedSupplyDuration will always be an estimate that can be influenced by external factors.",
+        "comment": "In some situations, this attribute may be used instead of quantity to identify the amount supplied by how long it is expected to last, rather than the physical quantity issued, e.g. 90 days supply of medication (based on an ordered dosage) When possible, it is always better to specify quantity, as this tends to be more precise. expectedSupplyDuration will always be an estimate that can be influenced by external factors.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1333,6 +2264,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=COMP].target[classCode=SPLY, moodCode=RQO] .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]"
+          },
           {
             "identity": "w5",
             "map": "who"
@@ -1343,7 +2278,7 @@
         "id": "MedicationRequest:shr-medication-MedicationPrescription.substitution",
         "path": "MedicationRequest.substitution",
         "short": "Any restrictions on medication substitution",
-        "definition": "Indicates whether or not substitution can or should be part of the dispense. In some cases substitution must happen, in other cases substitution must not happen, and in others it does not matter. This block explains the prescriber's intent. If nothing is specified substitution may be done.",
+        "definition": "Indicates whether or not substitution can or should be part of the dispense. In some cases substitution must happen, in other cases substitution must not happen. This block explains the prescriber's intent. If nothing is specified substitution may be done.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1404,7 +2339,7 @@
         "path": "MedicationRequest.substitution.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1433,7 +2368,7 @@
         "path": "MedicationRequest.substitution.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1465,6 +2400,7 @@
         "path": "MedicationRequest.substitution.allowed",
         "short": "Whether substitution is allowed or not",
         "definition": "True if the prescriber allows a different drug to be dispensed from what was prescribed.",
+        "comment": "This element is labeled as a modifer because whether substitution is allow or not cannot be ignored.",
         "min": 1,
         "max": "1",
         "type": [
@@ -1501,6 +2437,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MedicationIntendedSubstitutionReason"
+            }
+          ],
           "strength": "example",
           "description": "A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.",
           "valueSetReference": {
@@ -1525,7 +2467,7 @@
       {
         "id": "MedicationRequest:shr-medication-MedicationPrescription.priorPrescription",
         "path": "MedicationRequest.priorPrescription",
-        "short": "An order/prescription that this supersedes",
+        "short": "An order/prescription that is being replaced",
         "definition": "A link to a resource representing an earlier order related order or prescription.",
         "min": 0,
         "max": "1",
@@ -1536,6 +2478,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…replaces"
+          },
           {
             "identity": "script10.6",
             "map": "not mapped"
@@ -1546,12 +2492,37 @@
           }
         ]
       },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationPrescription.detectedIssue",
+        "path": "MedicationRequest.detectedIssue",
+        "short": "Clinical Issue with action",
+        "definition": "Indicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. Drug-drug interaction, duplicate therapy, dosage alert etc.",
+        "alias": [
+          "Contraindication",
+          "Drug Utilization Review (DUR)",
+          "Alert"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DetectedIssue"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".inboundRelationship[typeCode=SUBJ]/source[classCode=ALRT,moodCode=EVN].value"
+          }
+        ]
+      },
       {
         "id": "MedicationRequest:shr-medication-MedicationPrescription.eventHistory",
         "path": "MedicationRequest.eventHistory",
         "short": "A list of events of interest in the lifecycle",
-        "definition": "A summary of the events of interest that have occurred as the request is processed; e.g. when the order was verified or when it was completed.",
-        "comments": "See usage notes in Request pattern in request history.",
+        "definition": "Links to Provenance records for past versions of this resource or fulfilling request or event resources that identify key state transitions or updates that are likely to be relevant to a user looking at the current version of the resource.",
+        "comment": "This may not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.).",
         "min": 0,
         "max": "*",
         "type": [
@@ -1559,6 +2530,16 @@
             "code": "Reference",
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/Provenance"
           }
+        ],
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…relevantHistory"
+          },
+          {
+            "identity": "rim",
+            "map": ".inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]"
+          }
         ]
       }
     ]
@@ -1619,22 +2600,6 @@
         "isModifier": false,
         "isSummary": false
       },
-      {
-        "id": "MedicationRequest:shr-medication-MedicationPrescription.extension:priorityofrequest",
-        "path": "MedicationRequest.extension",
-        "sliceName": "priorityofrequest",
-        "min": 0,
-        "max": "1",
-        "type": [
-          {
-            "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-PriorityOfRequest-extension"
-          }
-        ],
-        "mustSupport": false,
-        "isModifier": false,
-        "isSummary": false
-      },
       {
         "id": "MedicationRequest:shr-medication-MedicationPrescription.extension:patientinstructions",
         "path": "MedicationRequest.extension",
@@ -1711,6 +2676,99 @@
           }
         ]
       },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationPrescription.note",
+        "path": "MedicationRequest.note",
+        "min": 0,
+        "max": "1"
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationPrescription.dosageInstruction",
+        "path": "MedicationRequest.dosageInstruction",
+        "min": 0,
+        "max": "1"
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationPrescription.dosageInstruction.additionalInstruction",
+        "path": "MedicationRequest.dosageInstruction.additionalInstruction",
+        "type": [
+          {
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+          }
+        ],
+        "binding": {
+          "strength": "required",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/additional-instructions-codes"
+          }
+        }
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationPrescription.dosageInstruction.asNeeded[x]",
+        "path": "MedicationRequest.dosageInstruction.asNeeded[x]",
+        "type": [
+          {
+            "code": "boolean"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationPrescription.dosageInstruction.site",
+        "path": "MedicationRequest.dosageInstruction.site",
+        "type": [
+          {
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+          }
+        ],
+        "binding": {
+          "strength": "required",
+          "valueSetReference": {
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
+          }
+        }
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationPrescription.dosageInstruction.route",
+        "path": "MedicationRequest.dosageInstruction.route",
+        "type": [
+          {
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationPrescription.dosageInstruction.method",
+        "path": "MedicationRequest.dosageInstruction.method",
+        "type": [
+          {
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationPrescription.dosageInstruction.dose[x]",
+        "path": "MedicationRequest.dosageInstruction.dose[x]",
+        "type": [
+          {
+            "code": "Quantity",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-Quantity"
+          }
+        ]
+      },
+      {
+        "id": "MedicationRequest:shr-medication-MedicationPrescription.dosageInstruction.maxDosePerPeriod",
+        "path": "MedicationRequest.dosageInstruction.maxDosePerPeriod",
+        "type": [
+          {
+            "code": "Ratio",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-medication-MaximumDosePerTimePeriod"
+          }
+        ]
+      },
       {
         "id": "MedicationRequest:shr-medication-MedicationPrescription.dispenseRequest",
         "path": "MedicationRequest.dispenseRequest"
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-medication-MedicationUse.json b/lib/resources/standard_health_record/StructureDefinition-shr-medication-MedicationUse.json
old mode 100755
new mode 100644
index f0feed0..e7d54bb
--- a/lib/resources/standard_health_record/StructureDefinition-shr-medication-MedicationUse.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-medication-MedicationUse.json
@@ -3,7 +3,7 @@
   "id": "shr-medication-MedicationUse",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR MedicationUse Profile</b></p>\n  <p>Report of a medication used (or not used). Medication use is either reported, directly observed, or inferred from clinical events associated with orders, prescriptions written, pharmacy dispensings, procedural administrations, and other patient-reported information.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.medication.MedicationUse maps to MedicationStatement:\n  Medication maps to medication[x].Reference\n  PeriodOfUse maps to effective[x].Period\n  Reason maps to reasonForUseCodeableConcept\n  MedicationNotUsedModifier maps to notTaken\n  MedicationNotUsedModifier.Reason maps to reasonNotTaken\n  Dosage.AmountPerDose.Quantity maps to dosage.dose[x].SimpleQuantity\n  Dosage.AmountPerDose.TBD &quot;Range&quot; maps to dosage.dose[x].Range\n  Dosage.TimingOfDoses maps to dosage.timing\n  Dosage.DoseAsNeededIndicator maps to dosage.asNeeded[x].boolean\n  Dosage.DoseInstructionsText maps to dosage.text\n  Dosage.AdditionalDoseInstruction maps to dosage.additionalInstructions\n  Dosage.RouteIntoBody maps to dosage.route\n  Dosage.AdministrationMethod maps to dosage.method\n  Dosage.AdministrationBodySite maps to dosage.site\n  Dosage.MaximumDosePerTimePeriod maps to dosage.maxDosePerPeriod\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR MedicationUse Profile</b></p>\n  <p>Report of a medication used (or not used). Medication use is either reported, directly observed, or inferred from clinical events associated with orders, prescriptions written, pharmacy dispensings, procedural administrations, and other patient-reported information.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.medication.MedicationUse maps to MedicationStatement:\n  Medication maps to medication[x].Reference\n  PeriodOfUse maps to effective[x].Period\n  Reason maps to reasonCode\n  MedicationNotUsedModifier maps to taken\n  MedicationNotUsedModifier.Reason maps to reasonNotTaken\n  constrain dosage to 0..1\n  Dosage.AmountPerDose.Quantity maps to dosage.dose[x].SimpleQuantity\n  Dosage.AmountPerDose.&lt;TBD &quot;Range&quot;&gt; maps to dosage.dose[x].Range\n  Dosage.TimingOfDoses maps to dosage.timing\n  Dosage.DoseAsNeededIndicator maps to dosage.asNeeded[x].boolean\n  Dosage.DoseInstructionsText maps to dosage.text\n  Dosage.AdditionalDoseInstruction maps to dosage.additionalInstruction\n  Dosage.RouteIntoBody maps to dosage.route\n  Dosage.AdministrationMethod maps to dosage.method\n  Dosage.AdministrationBodySite maps to dosage.site\n  Dosage.MaximumDosePerTimePeriod maps to dosage.maxDosePerPeriod\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-medication-MedicationUse",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.medication.MedicationUse"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR MedicationUse Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.248Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,10 +27,14 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.270Z",
   "description": "Report of a medication used (or not used). Medication use is either reported, directly observed, or inferred from clinical events associated with orders, prescriptions written, pharmacy dispensings, procedural administrations, and other patient-reported information.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
     {
       "identity": "rim",
       "uri": "http://hl7.org/v3",
@@ -57,7 +63,7 @@
         "path": "MedicationStatement",
         "short": "SHR MedicationUse Profile",
         "definition": "Report of a medication used (or not used). Medication use is either reported, directly observed, or inferred from clinical events associated with orders, prescriptions written, pharmacy dispensings, procedural administrations, and other patient-reported information.",
-        "comments": "When interpreting a medicationStatement, the value of the status and NotTaken needed to be considered:\rMedicationStatement.status + MedicationStatement.wasNotTaken\rStatus=Active + NotTaken=T = Not currently taking\rStatus=Completed + NotTaken=T = Not taken in the past\rStatus=Intended + NotTaken=T = No intention of taking\rStatus=Active + NotTaken=F = Taking, but not as prescribed\rStatus=Active + NotTaken=F = Taking\rStatus=Intended +NotTaken= F = Will be taking (not started)\rStatus=Completed + NotTaken=F = Taken in past\rStatus=In Error + NotTaken=N/A = In Error.",
+        "comment": "When interpreting a medicationStatement, the value of the status and NotTaken needed to be considered:\rMedicationStatement.status + MedicationStatement.wasNotTaken\rStatus=Active + NotTaken=T = Not currently taking\rStatus=Completed + NotTaken=T = Not taken in the past\rStatus=Intended + NotTaken=T = No intention of taking\rStatus=Active + NotTaken=F = Taking, but not as prescribed\rStatus=Active + NotTaken=F = Taking\rStatus=Intended +NotTaken= F = Will be taking (not started)\rStatus=Completed + NotTaken=F = Taken in past\rStatus=In Error + NotTaken=N/A = In Error.",
         "min": 0,
         "max": "*",
         "constraint": [
@@ -96,9 +102,9 @@
           {
             "key": "mst-1",
             "severity": "error",
-            "human": "Reason not taken is only permitted if notTaken is Yes",
-            "expression": "reasonNotTaken.empty() or notTaken='y'",
-            "xpath": "not(exists(f:reasonNotTaken) and (f:notTaken/@value='n' or f:notTaken/@value='unk'))"
+            "human": "Reason not taken is only permitted if Taken is No",
+            "expression": "reasonNotTaken.exists().not() or (taken = 'n')",
+            "xpath": "not(exists(f:reasonNotTaken)) or f:taken/@value='n'"
           }
         ],
         "mapping": [
@@ -106,6 +112,10 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "..Event"
+          },
           {
             "identity": "rim",
             "map": "SubstanceAdministration"
@@ -121,7 +131,7 @@
         "path": "MedicationStatement.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -160,7 +170,7 @@
         "path": "MedicationStatement.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -181,7 +191,7 @@
         "path": "MedicationStatement.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -201,6 +211,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -215,7 +233,7 @@
         "path": "MedicationStatement.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -249,7 +267,7 @@
         "path": "MedicationStatement.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -278,16 +296,19 @@
         "id": "MedicationStatement:shr-medication-MedicationUse.extension",
         "path": "MedicationStatement.extension",
         "slicing": {
-          "id": "182",
+          "id": "179",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -316,6 +337,7 @@
         "path": "MedicationStatement.extension",
         "sliceName": "adherence",
         "definition": "A statement of the ability and cooperation of the patient in taking medicine or supplement as recommended or prescribed. This includes correct timing, dosage, and frequency.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -348,7 +370,7 @@
         "path": "MedicationStatement.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -385,10 +407,15 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…identifer"
+          },
           {
             "identity": "rim",
-            "map": "SubstanceAdministration.id"
+            "map": ".id"
           },
           {
             "identity": "w5",
@@ -396,12 +423,121 @@
           }
         ]
       },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationUse.basedOn",
+        "path": "MedicationStatement.basedOn",
+        "short": "Fulfils plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…basedOn"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target[classCode=SBADM or PROC or PCPR or OBS, moodCode=RQO orPLAN or PRP]"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationUse.partOf",
+        "path": "MedicationStatement.partOf",
+        "short": "Part of referenced event",
+        "definition": "A larger event of which this particular event is a component or step.",
+        "requirements": "This should not be used when indicating which resource a MedicationStatement has been derived from.  If that is the use case, then MedicationStatement.derivedFrom should be used.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationAdministration"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationDispense"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationStatement"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Procedure"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Observation"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…part of"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=COMP]/target[classCode=SPLY or SBADM or PROC or OBS,moodCode=EVN]"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationUse.context",
+        "path": "MedicationStatement.context",
+        "short": "Encounter / Episode associated with MedicationStatement",
+        "definition": "The encounter or episode of care that establishes the context for this MedicationStatement.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…context"
+          },
+          {
+            "identity": "rim",
+            "map": ".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code=\"type of encounter or episode\"]"
+          }
+        ]
+      },
       {
         "id": "MedicationStatement:shr-medication-MedicationUse.status",
         "path": "MedicationStatement.status",
         "short": "active | completed | entered-in-error | intended | stopped | on-hold",
         "definition": "A code representing the patient or other source's judgment about the state of the medication used that this statement is about.  Generally this will be active or completed.",
-        "comments": "MedicationStatement is a statement at a point in time.  The status is only representative at the point when it was asserted.  The value set for MedicationStatement.status contains codes that assert the status of the use of the medication by the patient (for example, stopped or on hold) as well as codes that assert the status of the medication statement itself (for example, entered in error).",
+        "comment": "MedicationStatement is a statement at a point in time.  The status is only representative at the point when it was asserted.  The value set for MedicationStatement.status contains codes that assert the status of the use of the medication by the patient (for example, stopped or on hold) as well as codes that assert the status of the medication statement itself (for example, entered in error).\n\nThis element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "min": 1,
         "max": "1",
         "type": [
@@ -412,6 +548,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MedicationStatementStatus"
+            }
+          ],
           "strength": "required",
           "description": "A coded concept indicating the current status of a MedicationStatement.",
           "valueSetReference": {
@@ -419,6 +561,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…status"
+          },
           {
             "identity": "rim",
             "map": ".statusCode"
@@ -429,12 +575,49 @@
           }
         ]
       },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationUse.category",
+        "path": "MedicationStatement.category",
+        "short": "Type of medication usage",
+        "definition": "Indicates where type of medication statement and where the medication is expected to be consumed or administered.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MedicationStatementCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "A coded concept identifying where the medication included in the medicationstatement is expected to be consumed or administered",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/medication-statement-category"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code=\"type of medication usage\"].value"
+          },
+          {
+            "identity": "w5",
+            "map": "class"
+          }
+        ]
+      },
       {
         "id": "MedicationStatement:shr-medication-MedicationUse.medication[x]",
         "path": "MedicationStatement.medication[x]",
         "short": "What medication was taken",
         "definition": "Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.",
-        "comments": "If only a code is specified, then it needs to be a code for a specific product.  If more information is required, then the use of the medication resource is recommended.  Note: do not use Medication.name to describe the medication this statement concerns. When the only available information is a text description of the medication, Medication.code.text should be used.",
+        "comment": "If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended.  For example if you require form or lot number, then you must reference the Medication resource. .",
         "min": 1,
         "max": "1",
         "type": [
@@ -445,6 +628,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MedicationCode"
+            }
+          ],
           "strength": "example",
           "description": "A coded concept identifying the substance or product being taken.",
           "valueSetReference": {
@@ -452,9 +641,13 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…code"
+          },
           {
             "identity": "rim",
-            "map": "SubstanceAdministration>Component>SubstanceAdministrationRequest.consumable"
+            "map": ".participation[typeCode=CSM].role[classCode=ADMM or MANU]"
           },
           {
             "identity": "w5",
@@ -463,61 +656,56 @@
         ]
       },
       {
-        "id": "MedicationStatement:shr-medication-MedicationUse.subject",
-        "path": "MedicationStatement.subject",
-        "short": "Who is/was taking  the medication",
-        "definition": "The person, animal or group who is/was taking the medication.",
+        "id": "MedicationStatement:shr-medication-MedicationUse.effective[x]",
+        "path": "MedicationStatement.effective[x]",
+        "short": "The date/time or interval when the medication was taken",
+        "definition": "The interval of time during which it is being asserted that the patient was taking the medication (or was not taking, when the wasNotGiven element is true).",
+        "comment": "This attribute reflects the period over which the patient consumed the medication and is expected to be populated on the majority of Medication Statements. If the medication is still being taken at the time the statement is recorded, the \"end\" date will be omitted.",
         "min": 1,
         "max": "1",
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient"
-          },
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Group"
+            "code": "Period",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-PeriodOfUse"
           }
         ],
         "isSummary": true,
         "mapping": [
           {
-            "identity": "v2",
-            "map": "PID-3-Patient ID List"
+            "identity": "workflow",
+            "map": "…occurrence[x]"
           },
           {
             "identity": "rim",
-            "map": "SubstanceAdministration->subject->Patient"
+            "map": ".effectiveTime"
           },
           {
             "identity": "w5",
-            "map": "who.focus"
+            "map": "when.done"
           }
         ]
       },
       {
-        "id": "MedicationStatement:shr-medication-MedicationUse.effective[x]",
-        "path": "MedicationStatement.effective[x]",
-        "short": "Over what period was medication consumed?",
-        "definition": "The interval of time during which it is being asserted that the patient was taking the medication (or was not taking, when the wasNotGiven element is true).",
-        "comments": "If the medication is still being taken at the time the statement is recorded, the \"end\" date will be omitted.",
-        "min": 1,
+        "id": "MedicationStatement:shr-medication-MedicationUse.dateAsserted",
+        "path": "MedicationStatement.dateAsserted",
+        "short": "When the statement was asserted?",
+        "definition": "The date when the medication statement was asserted by the information source.",
+        "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "Period",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-PeriodOfUse"
+            "code": "dateTime"
           }
         ],
         "isSummary": true,
         "mapping": [
           {
             "identity": "rim",
-            "map": "SubstanceAdministration.effectiveTime"
+            "map": ".participation[typeCode=AUT].time"
           },
           {
             "identity": "w5",
-            "map": "when.done"
+            "map": "when.recorded"
           }
         ]
       },
@@ -549,7 +737,7 @@
         "mapping": [
           {
             "identity": "rim",
-            "map": ".participation[typeCode=INF].role[classCode=PAT, or  codes for Practioner or Related Person (if PAT is the informer, then syntax for self-reported =true)"
+            "map": ".participation[typeCode=INF].role[classCode=PAT, or codes for Practioner or Related Person (if PAT is the informer, then syntax for self-reported =true)"
           },
           {
             "identity": "w5",
@@ -558,52 +746,70 @@
         ]
       },
       {
-        "id": "MedicationStatement:shr-medication-MedicationUse.derivedFrom",
-        "path": "MedicationStatement.derivedFrom",
-        "short": "Additional supporting information",
-        "definition": "Allows linking the MedicationStatement to the underlying MedicationRequest, or to other information that supports or is used to derive the MedicationStatement.",
-        "comments": "Likely references would be to MedicationRequest, MedicationDispense, Claim, Observation or QuestionnaireAnswers.",
-        "min": 0,
-        "max": "*",
+        "id": "MedicationStatement:shr-medication-MedicationUse.subject",
+        "path": "MedicationStatement.subject",
+        "short": "Who is/was taking  the medication",
+        "definition": "The person, animal or group who is/was taking the medication.",
+        "min": 1,
+        "max": "1",
         "type": [
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Resource"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Group"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…subject"
+          },
+          {
+            "identity": "v2",
+            "map": "PID-3-Patient ID List"
+          },
           {
             "identity": "rim",
-            "map": ".outboundRelationship[typeCode=SPRT]/target[classCode=ACT,moodCode=EVN]"
+            "map": ".participation[typeCode=SBJ].role[classCode=PAT]"
+          },
+          {
+            "identity": "w5",
+            "map": "who"
           }
         ]
       },
       {
-        "id": "MedicationStatement:shr-medication-MedicationUse.dateAsserted",
-        "path": "MedicationStatement.dateAsserted",
-        "short": "When the statement was asserted?",
-        "definition": "The date when the medication statement was asserted by the information source.",
+        "id": "MedicationStatement:shr-medication-MedicationUse.derivedFrom",
+        "path": "MedicationStatement.derivedFrom",
+        "short": "Additional supporting information",
+        "definition": "Allows linking the MedicationStatement to the underlying MedicationRequest, or to other information that supports or is used to derive the MedicationStatement.",
+        "comment": "Likely references would be to MedicationRequest, MedicationDispense, Claim, Observation or QuestionnaireAnswers.  The most common use cases for deriving a MedicationStatement comes from creating a MedicationStatement from a MedicationRequest or from a lab observation or a claim.  it should be noted that the amount of information that is available varies from the type resource that you derive the MedicationStatement from.",
         "min": 0,
-        "max": "1",
+        "max": "*",
         "type": [
           {
-            "code": "dateTime"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Resource"
           }
         ],
-        "isSummary": true,
         "mapping": [
           {
             "identity": "rim",
-            "map": ".participation[typeCode=AUT].time"
+            "map": ".outboundRelationship[typeCode=SPRT]/target[classCode=ACT,moodCode=EVN]"
           }
         ]
       },
       {
-        "id": "MedicationStatement:shr-medication-MedicationUse.notTaken",
-        "path": "MedicationStatement.notTaken",
-        "short": "y | n | unk",
+        "id": "MedicationStatement:shr-medication-MedicationUse.taken",
+        "path": "MedicationStatement.taken",
+        "short": "y | n | unk | na",
         "definition": "Indicator of the certainty of whether the medication was taken by the patient.",
-        "min": 0,
+        "comment": "This element is labeled as a modifier because it indicates that the medication was not taken.",
+        "min": 1,
         "max": "1",
         "type": [
           {
@@ -613,12 +819,28 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MedicationStatementTaken"
+            }
+          ],
           "strength": "required",
           "description": "A coded concept identifying level of certainty if patient has taken or has not taken the medication",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/medication-statement-nottaken"
+            "reference": "http://hl7.org/fhir/ValueSet/medication-statement-taken"
           }
-        }
+        },
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…notDone"
+          },
+          {
+            "identity": "rim",
+            "map": ".actionNegationInd"
+          }
+        ]
       },
       {
         "id": "MedicationStatement:shr-medication-MedicationUse.reasonNotTaken",
@@ -639,22 +861,22 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-medication-ReasonMedicationNotUsedVS"
+            "reference": "http://standardhealthrecord.org/shr/medication/vs/ReasonMedicationNotUsedVS"
           }
         },
         "mapping": [
           {
             "identity": "rim",
-            "map": "SubstanceAdministration->Reason->Observation->Value"
+            "map": ".outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code=\"reason not taken\"].value"
           }
         ]
       },
       {
-        "id": "MedicationStatement:shr-medication-MedicationUse.reasonForUseCodeableConcept",
-        "path": "MedicationStatement.reasonForUseCodeableConcept",
+        "id": "MedicationStatement:shr-medication-MedicationUse.reasonCode",
+        "path": "MedicationStatement.reasonCode",
         "short": "Reason for why the medication is being/was taken",
         "definition": "A reason for why the medication is being/was taken.",
-        "comments": "This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonForUseReference.",
+        "comment": "This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonForUseReference.",
         "min": 1,
         "max": "1",
         "type": [
@@ -664,6 +886,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MedicationReason"
+            }
+          ],
           "strength": "example",
           "description": "A coded concept identifying why the medication is being taken.",
           "valueSetReference": {
@@ -671,18 +899,26 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…reasoneCodeableConcept"
+          },
           {
             "identity": "rim",
             "map": ".reasonCode"
+          },
+          {
+            "identity": "w5",
+            "map": "why"
           }
         ]
       },
       {
-        "id": "MedicationStatement:shr-medication-MedicationUse.reasonForUseReference",
-        "path": "MedicationStatement.reasonForUseReference",
+        "id": "MedicationStatement:shr-medication-MedicationUse.reasonReference",
+        "path": "MedicationStatement.reasonReference",
         "short": "Condition or observation that supports why the medication is being/was taken",
         "definition": "Condition or observation that supports why the medication is being/was taken.",
-        "comments": "This is a reference to a condition that is the reason why the medication is being/was taken.  If only a code exists, use reasonForUseCode.",
+        "comment": "This is a reference to a condition that is the reason why the medication is being/was taken.  If only a code exists, use reasonForUseCode.",
         "min": 0,
         "max": "*",
         "type": [
@@ -696,9 +932,17 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…reasonReference"
+          },
           {
             "identity": "rim",
-            "map": "not mapped"
+            "map": ".outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code=\"reason for use\"].value"
+          },
+          {
+            "identity": "w5",
+            "map": "why"
           }
         ]
       },
@@ -715,6 +959,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "…note"
+          },
           {
             "identity": "rim",
             "map": ".inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code=\"annotation\"].value"
@@ -722,47 +970,454 @@
         ]
       },
       {
-        "id": "MedicationStatement:shr-medication-MedicationUse.category",
-        "path": "MedicationStatement.category",
-        "short": "Type of medication usage",
-        "definition": "Indicates where type of medication statement and where the medication is expected to be consumed or administered.",
+        "id": "MedicationStatement:shr-medication-MedicationUse.dosage",
+        "path": "MedicationStatement.dosage",
+        "short": "Details of how medication is/was taken or should be taken",
+        "definition": "Indicates how the medication is/was or should be taken by the patient.",
+        "comment": "The dates included in the dosage on a Medication Statement reflect the dates for a given dose.  For example, \"from November 1, 2016 to November 3, 2016, take one tablet daily and from November 4, 2016 to November 7, 2016, take two tablets daily.\"  It is expected that this specificity may only be populated where the patient brings in their labeled container or where the Medication Statement is derived from a MedicationRequest.",
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "code"
+            "code": "Dosage"
           }
         ],
-        "binding": {
-          "strength": "example",
-          "description": "A coded concept identifying where the medication included in the medicationstatement is expected to be consumed or administered",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/medication-statement-category"
-          }
-        },
         "mapping": [
           {
             "identity": "rim",
-            "map": "not mapped"
+            "map": "refer dosageInstruction mapping"
           }
         ]
       },
       {
-        "id": "MedicationStatement:shr-medication-MedicationUse.dosage",
-        "path": "MedicationStatement.dosage",
-        "short": "Details of how medication was taken",
-        "definition": "Indicates how the medication is/was used by the patient.",
+        "id": "MedicationStatement:shr-medication-MedicationUse.dosage.id",
+        "path": "MedicationStatement.dosage.id",
+        "representation": [
+          "xmlAttr"
+        ],
+        "short": "xml:id (or equivalent in JSON)",
+        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
         "min": 0,
-        "max": "*",
+        "max": "1",
+        "base": {
+          "path": "Element.id",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationUse.dosage.extension",
+        "path": "MedicationStatement.dosage.extension",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "value",
+              "path": "url"
+            }
+          ],
+          "description": "Extensions are always sliced by (at least) url",
+          "rules": "open"
+        },
+        "short": "Additional Content defined by implementations",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "Element.extension",
+          "min": 0,
+          "max": "*"
+        },
         "type": [
           {
-            "code": "DosageInstruction"
+            "code": "Extension"
           }
         ],
         "mapping": [
           {
             "identity": "rim",
-            "map": "SubstanceAdministration>Component>SubstanceAdministrationRequest"
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationUse.dosage.sequence",
+        "path": "MedicationStatement.dosage.sequence",
+        "short": "The order of the dosage instructions",
+        "definition": "Indicates the order in which the dosage instructions should be applied or interpreted.",
+        "requirements": "If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent.  If the sequence number is different, then the Dosages are intended to be sequential.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "integer"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".text"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationUse.dosage.text",
+        "path": "MedicationStatement.dosage.text",
+        "short": "Free text dosage instructions e.g. SIG",
+        "definition": "Free text dosage instructions e.g. SIG.",
+        "requirements": "Free text dosage instructions can be used for cases where the instructions are too complex to code.  The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated.  If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".text"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationUse.dosage.additionalInstruction",
+        "path": "MedicationStatement.dosage.additionalInstruction",
+        "short": "Supplemental instruction - e.g. \"with meals\"",
+        "definition": "Supplemental instruction - e.g. \"with meals\".",
+        "requirements": "Additional instruction such as \"Swallow with plenty of water\" which may or may not be coded.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "strength": "required",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/additional-instructions-codes"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".text"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationUse.dosage.patientInstruction",
+        "path": "MedicationStatement.dosage.patientInstruction",
+        "short": "Patient or consumer oriented instructions",
+        "definition": "Instructions in terms that are understood by the patient or consumer.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".text"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationUse.dosage.timing",
+        "path": "MedicationStatement.dosage.timing",
+        "short": "When medication should be administered",
+        "definition": "When medication should be administered.",
+        "comment": "This attribute may not always be populated while the Dosage.text is expected to be populated.  If both are populated, then the Dosage.text should reflect the content of the Dosage.timing.",
+        "requirements": "The timing schedule for giving the medication to the patient. The Schedule data type allows many different expressions. For example: \"Every 8 hours\"; \"Three times a day\"; \"1/2 an hour before breakfast for 10 days from 23-Dec 2011:\"; \"15 Oct 2013, 17 Oct 2013 and 1 Nov 2013\".  Sometimes, a rate can imply duration when expressed as total volume / duration (e.g.  500mL/2 hours implies a duration of 2 hours).  However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Timing"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".effectiveTime"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationUse.dosage.asNeeded[x]",
+        "path": "MedicationStatement.dosage.asNeeded[x]",
+        "short": "Take \"as needed\" (for x)",
+        "definition": "Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).",
+        "comment": "Can express \"as needed\" without a reason by setting the Boolean = True.  In this case the CodeableConcept is not populated.  Or you can express \"as needed\" with a reason by including the CodeableConcept.  In this case the Boolean is assumed to be True.  If you set the Boolean to False, then the dose is given according to the schedule and is not \"prn\" or \"as needed\".",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "boolean"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MedicationAsNeededReason"
+            }
+          ],
+          "strength": "example",
+          "description": "A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose.  For example \"pain\", \"30 minutes prior to sexual intercourse\", \"on flare-up\" etc.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/medication-as-needed-reason"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code=\"as needed\"].value=boolean or codable concept"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationUse.dosage.site",
+        "path": "MedicationStatement.dosage.site",
+        "short": "Body site to administer to",
+        "definition": "Body site to administer to.",
+        "comment": "If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [body-site-instance](extension-body-site-instance.html).  May be a summary code, or a reference to a very precise definition of the location, or both.",
+        "requirements": "A coded specification of the anatomic site where the medication first enters the body.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "strength": "required",
+          "valueSetReference": {
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".approachSiteCode"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationUse.dosage.route",
+        "path": "MedicationStatement.dosage.route",
+        "short": "How drug should enter body",
+        "definition": "How drug should enter body.",
+        "requirements": "A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "RouteOfAdministration"
+            }
+          ],
+          "strength": "example",
+          "description": "A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/route-codes"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".routeCode"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationUse.dosage.method",
+        "path": "MedicationStatement.dosage.method",
+        "short": "Technique for administering medication",
+        "definition": "Technique for administering medication.",
+        "comment": "Terminologies used often pre-coordinate this term with the route and or form of administration.",
+        "requirements": "A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections.  For examples, Slow Push; Deep IV.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "MedicationAdministrationMethod"
+            }
+          ],
+          "strength": "example",
+          "description": "A coded concept describing the technique by which the medicine is administered.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/administration-method-codes"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".doseQuantity"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationUse.dosage.dose[x]",
+        "path": "MedicationStatement.dosage.dose[x]",
+        "short": "Amount of medication per dose",
+        "definition": "Amount of medication per dose.",
+        "comment": "Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.",
+        "requirements": "The amount of therapeutic or other substance given at one administration event.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Quantity",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-Quantity"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".doseQuantity"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationUse.dosage.maxDosePerPeriod",
+        "path": "MedicationStatement.dosage.maxDosePerPeriod",
+        "short": "Upper limit on medication per unit of time",
+        "definition": "Upper limit on medication per unit of time.",
+        "comment": "This is intended for use as an adjunct to the dosage when there is an upper cap.  For example \"2 tablets every 4 hours to a maximum of 8/day\".",
+        "requirements": "The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time.  For example, 1000mg in 24 hours.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Ratio",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-medication-MaximumDosePerTimePeriod"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".maxDoseQuantity"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationUse.dosage.maxDosePerAdministration",
+        "path": "MedicationStatement.dosage.maxDosePerAdministration",
+        "short": "Upper limit on medication per administration",
+        "definition": "Upper limit on medication per administration.",
+        "comment": "This is intended for use as an adjunct to the dosage when there is an upper cap.  For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg.",
+        "requirements": "The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Quantity",
+            "profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "not supported"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationUse.dosage.maxDosePerLifetime",
+        "path": "MedicationStatement.dosage.maxDosePerLifetime",
+        "short": "Upper limit on medication per lifetime of the patient",
+        "definition": "Upper limit on medication per lifetime of the patient.",
+        "requirements": "The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Quantity",
+            "profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "not supported"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationUse.dosage.rate[x]",
+        "path": "MedicationStatement.dosage.rate[x]",
+        "short": "Amount of medication per unit of time",
+        "definition": "Amount of medication per unit of time.",
+        "comment": "It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.",
+        "requirements": "Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr.  May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours.   Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours.  Sometimes, a rate can imply duration when expressed as total volume / duration (e.g.  500mL/2 hours implies a duration of 2 hours).  However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Ratio"
+          },
+          {
+            "code": "Range"
+          },
+          {
+            "code": "Quantity",
+            "profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".rateQuantity"
           }
         ]
       }
@@ -828,13 +1483,13 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-medication-ReasonMedicationNotUsedVS"
+            "reference": "http://standardhealthrecord.org/shr/medication/vs/ReasonMedicationNotUsedVS"
           }
         }
       },
       {
-        "id": "MedicationStatement:shr-medication-MedicationUse.reasonForUseCodeableConcept",
-        "path": "MedicationStatement.reasonForUseCodeableConcept",
+        "id": "MedicationStatement:shr-medication-MedicationUse.reasonCode",
+        "path": "MedicationStatement.reasonCode",
         "min": 1,
         "max": "1",
         "type": [
@@ -843,6 +1498,93 @@
             "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
           }
         ]
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationUse.dosage",
+        "path": "MedicationStatement.dosage",
+        "min": 0,
+        "max": "1"
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationUse.dosage.additionalInstruction",
+        "path": "MedicationStatement.dosage.additionalInstruction",
+        "type": [
+          {
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+          }
+        ],
+        "binding": {
+          "strength": "required",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/additional-instructions-codes"
+          }
+        }
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationUse.dosage.asNeeded[x]",
+        "path": "MedicationStatement.dosage.asNeeded[x]",
+        "type": [
+          {
+            "code": "boolean"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationUse.dosage.site",
+        "path": "MedicationStatement.dosage.site",
+        "type": [
+          {
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+          }
+        ],
+        "binding": {
+          "strength": "required",
+          "valueSetReference": {
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
+          }
+        }
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationUse.dosage.route",
+        "path": "MedicationStatement.dosage.route",
+        "type": [
+          {
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationUse.dosage.method",
+        "path": "MedicationStatement.dosage.method",
+        "type": [
+          {
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationUse.dosage.dose[x]",
+        "path": "MedicationStatement.dosage.dose[x]",
+        "type": [
+          {
+            "code": "Quantity",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-Quantity"
+          }
+        ]
+      },
+      {
+        "id": "MedicationStatement:shr-medication-MedicationUse.dosage.maxDosePerPeriod",
+        "path": "MedicationStatement.dosage.maxDosePerPeriod",
+        "type": [
+          {
+            "code": "Ratio",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-medication-MaximumDosePerTimePeriod"
+          }
+        ]
       }
     ]
   }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-medication-NonAdherenceReason-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-medication-NonAdherenceReason-extension.json
old mode 100755
new mode 100644
index 60bd955..a04a598
--- a/lib/resources/standard_health_record/StructureDefinition-shr-medication-NonAdherenceReason-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-medication-NonAdherenceReason-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.medication.NonAdherenceReason"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR NonAdherenceReason Extension",
   "title": "SHR NonAdherenceReason Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.269Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.271Z",
   "description": "Reason for not following the stated treatment plan, prescription, or protocol.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -170,7 +170,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-medication-MedicationNonAdherenceReasonVS"
+            "reference": "http://standardhealthrecord.org/shr/medication/vs/MedicationNonAdherenceReasonVS"
           }
         },
         "mapping": [
@@ -221,7 +221,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-medication-MedicationNonAdherenceReasonVS"
+            "reference": "http://standardhealthrecord.org/shr/medication/vs/MedicationNonAdherenceReasonVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-medication-OverTheCounter-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-medication-OverTheCounter-extension.json
deleted file mode 100755
index 875f6b7..0000000
--- a/lib/resources/standard_health_record/StructureDefinition-shr-medication-OverTheCounter-extension.json
+++ /dev/null
@@ -1,216 +0,0 @@
-{
-  "resourceType": "StructureDefinition",
-  "id": "shr-medication-OverTheCounter-extension",
-  "text": {
-    "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR OverTheCounter Extension</b></p>\n  <p>True if the medication is available to consumers without a prescription.</p>\n</div>"
-  },
-  "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-medication-OverTheCounter-extension",
-  "identifier": [
-    {
-      "system": "http://standardhealthrecord.org",
-      "value": "shr.medication.OverTheCounter"
-    }
-  ],
-  "name": "SHR OverTheCounter Extension",
-  "title": "SHR OverTheCounter Extension",
-  "status": "draft",
-  "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
-  "contact": [
-    {
-      "telecom": [
-        {
-          "system": "url",
-          "value": "http://www.standardhealthrecord.org"
-        }
-      ]
-    }
-  ],
-  "date": "2017-03-21T00:21:36.268Z",
-  "description": "True if the medication is available to consumers without a prescription.",
-  "fhirVersion": "1.8.0",
-  "kind": "complex-type",
-  "abstract": false,
-  "contextType": "resource",
-  "context": [
-    "*"
-  ],
-  "type": "Extension",
-  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Extension",
-  "derivation": "constraint",
-  "snapshot": {
-    "element": [
-      {
-        "id": "Extension:overthecounter",
-        "path": "Extension",
-        "short": "SHR OverTheCounter Extension",
-        "definition": "True if the medication is available to consumers without a prescription.",
-        "min": 0,
-        "max": "*",
-        "base": {
-          "path": "Extension",
-          "min": 0,
-          "max": "1"
-        },
-        "condition": [
-          "ele-1"
-        ],
-        "constraint": [
-          {
-            "key": "ele-1",
-            "severity": "error",
-            "human": "All FHIR elements must have a @value or children",
-            "expression": "children().count() > id.count()",
-            "xpath": "@value|f:*|h:div",
-            "source": "Element"
-          },
-          {
-            "key": "ext-1",
-            "severity": "error",
-            "human": "Must have either extensions or value[x], not both",
-            "expression": "extension.exists() != value.exists()",
-            "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
-            "source": "Extension"
-          }
-        ]
-      },
-      {
-        "id": "Extension:overthecounter.id",
-        "path": "Extension.id",
-        "representation": [
-          "xmlAttr"
-        ],
-        "short": "xml:id (or equivalent in JSON)",
-        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "Element.id",
-          "min": 0,
-          "max": "1"
-        },
-        "type": [
-          {
-            "code": "string"
-          }
-        ],
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "N/A"
-          }
-        ]
-      },
-      {
-        "id": "Extension:overthecounter.extension:extension",
-        "path": "Extension.extension",
-        "sliceName": "extension",
-        "short": "Extension",
-        "definition": "An Extension",
-        "min": 0,
-        "max": "0",
-        "base": {
-          "path": "Element.extension",
-          "min": 0,
-          "max": "*"
-        },
-        "type": [
-          {
-            "code": "Extension"
-          }
-        ]
-      },
-      {
-        "id": "Extension:overthecounter.url",
-        "path": "Extension.url",
-        "representation": [
-          "xmlAttr"
-        ],
-        "short": "identifies the meaning of the extension",
-        "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
-        "min": 1,
-        "max": "1",
-        "base": {
-          "path": "Extension.url",
-          "min": 1,
-          "max": "1"
-        },
-        "type": [
-          {
-            "code": "uri"
-          }
-        ],
-        "fixedUri": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-medication-OverTheCounter-extension",
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "N/A"
-          }
-        ]
-      },
-      {
-        "id": "Extension:overthecounter.valueBoolean",
-        "path": "Extension.valueBoolean",
-        "short": "Value of extension",
-        "definition": "Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).",
-        "min": 1,
-        "max": "1",
-        "base": {
-          "path": "Extension.value[x]",
-          "min": 0,
-          "max": "1"
-        },
-        "type": [
-          {
-            "code": "boolean"
-          }
-        ],
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "N/A"
-          }
-        ]
-      }
-    ]
-  },
-  "differential": {
-    "element": [
-      {
-        "id": "Extension:overthecounter",
-        "path": "Extension",
-        "short": "SHR OverTheCounter Extension",
-        "definition": "True if the medication is available to consumers without a prescription.",
-        "min": 0,
-        "max": "*"
-      },
-      {
-        "id": "Extension:overthecounter.extension:extension",
-        "path": "Extension.extension",
-        "sliceName": "extension",
-        "max": "0"
-      },
-      {
-        "id": "Extension:overthecounter.url",
-        "path": "Extension.url",
-        "type": [
-          {
-            "code": "uri"
-          }
-        ],
-        "fixedUri": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-medication-OverTheCounter-extension"
-      },
-      {
-        "id": "Extension:overthecounter.valueBoolean",
-        "path": "Extension.valueBoolean",
-        "min": 1,
-        "type": [
-          {
-            "code": "boolean"
-          }
-        ]
-      }
-    ]
-  }
-}
\ No newline at end of file
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-medication-RouteIntoBody-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-medication-RouteIntoBody-extension.json
old mode 100755
new mode 100644
index ee519f5..2514bef
--- a/lib/resources/standard_health_record/StructureDefinition-shr-medication-RouteIntoBody-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-medication-RouteIntoBody-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.medication.RouteIntoBody"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR RouteIntoBody Extension",
   "title": "SHR RouteIntoBody Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.040Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.006Z",
   "description": "The way a substance enters an organism after contact, particularly, the route of drug administration.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-medication-TypeOfChange-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-medication-TypeOfChange-extension.json
old mode 100755
new mode 100644
index b7eb67c..ecfa070
--- a/lib/resources/standard_health_record/StructureDefinition-shr-medication-TypeOfChange-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-medication-TypeOfChange-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.medication.TypeOfChange"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR TypeOfChange Extension",
   "title": "SHR TypeOfChange Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.403Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.291Z",
   "description": "Whether the change is a dose change, switch to a new medication, or discontinuation.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -170,7 +170,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-medication-MedicationChangeTypeVS"
+            "reference": "http://standardhealthrecord.org/shr/medication/vs/MedicationChangeTypeVS"
           }
         },
         "mapping": [
@@ -221,7 +221,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-medication-MedicationChangeTypeVS"
+            "reference": "http://standardhealthrecord.org/shr/medication/vs/MedicationChangeTypeVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-observation-CodeableConceptObservation.json b/lib/resources/standard_health_record/StructureDefinition-shr-observation-CodeableConceptObservation.json
old mode 100755
new mode 100644
index 43ff924..b86306a
--- a/lib/resources/standard_health_record/StructureDefinition-shr-observation-CodeableConceptObservation.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-observation-CodeableConceptObservation.json
@@ -3,7 +3,7 @@
   "id": "shr-observation-CodeableConceptObservation",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR CodeableConceptObservation Profile</b></p>\n  <p>An observation whose value is a codeable concept</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.observation.CodeableConceptObservation maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR CodeableConceptObservation Profile</b></p>\n  <p>An observation whose value is a codeable concept</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.observation.CodeableConceptObservation maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  CodeableConcept maps to value[x].CodeableConcept\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-observation-CodeableConceptObservation",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.observation.CodeableConceptObservation"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR CodeableConceptObservation Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.872Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.968Z",
   "description": "An observation whose value is a codeable concept",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR CodeableConceptObservation Profile",
         "definition": "An observation whose value is a codeable concept",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-observation-CodeableConceptObservation.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "59",
+          "id": "57",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -397,16 +434,19 @@
         "id": "Observation:shr-observation-CodeableConceptObservation.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "60",
+          "id": "58",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -436,6 +476,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -466,8 +507,8 @@
       {
         "id": "Observation:shr-observation-CodeableConceptObservation.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -476,7 +517,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -491,6 +537,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-observation-CodeableConceptObservation.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-observation-CodeableConceptObservation.status",
         "extension": [
@@ -502,6 +605,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -513,6 +617,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -520,6 +630,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -539,8 +657,8 @@
         "path": "Observation.category",
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 0,
         "max": "*",
         "type": [
@@ -550,8 +668,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -573,6 +697,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -583,6 +710,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -590,6 +723,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -598,6 +739,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -609,7 +754,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -633,6 +778,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -648,20 +797,32 @@
         ]
       },
       {
-        "id": "Observation:shr-observation-CodeableConceptObservation.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-observation-CodeableConceptObservation.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -681,8 +842,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -696,6 +860,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -715,7 +883,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -767,6 +935,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -786,8 +958,8 @@
         "path": "Observation.value[x]",
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 1,
         "max": "1",
         "type": [
@@ -801,6 +973,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -808,6 +988,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -816,7 +1000,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -829,6 +1013,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -836,6 +1026,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -863,6 +1057,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -870,6 +1070,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -877,6 +1081,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -894,6 +1102,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -909,8 +1121,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -919,6 +1130,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -926,6 +1143,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -933,6 +1154,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -941,7 +1166,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -952,6 +1177,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -974,7 +1205,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -984,6 +1215,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -991,6 +1226,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -999,7 +1238,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1013,6 +1252,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1020,6 +1263,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1028,7 +1275,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1097,7 +1344,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1126,7 +1373,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1208,30 +1455,82 @@
         ]
       },
       {
-        "id": "Observation:shr-observation-CodeableConceptObservation.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-observation-CodeableConceptObservation.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-observation-CodeableConceptObservation.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1287,8 +1586,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1350,7 +1649,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1379,7 +1678,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1411,7 +1710,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1421,6 +1720,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1471,7 +1776,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1534,7 +1839,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1563,7 +1868,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1605,6 +1910,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1612,6 +1923,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1631,8 +1946,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1669,6 +1984,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1676,6 +1995,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1684,7 +2007,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1697,6 +2020,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1719,7 +2048,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1732,6 +2061,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1739,6 +2074,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1746,6 +2085,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1754,7 +2097,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1873,12 +2216,16 @@
         ]
       },
       {
-        "id": "Observation:shr-observation-CodeableConceptObservation.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-observation-CodeableConceptObservation.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-observation-HistoryObservation.json b/lib/resources/standard_health_record/StructureDefinition-shr-observation-HistoryObservation.json
old mode 100755
new mode 100644
index dbd5b23..c9fb96f
--- a/lib/resources/standard_health_record/StructureDefinition-shr-observation-HistoryObservation.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-observation-HistoryObservation.json
@@ -3,7 +3,7 @@
   "id": "shr-observation-HistoryObservation",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR HistoryObservation Profile</b></p>\n  <p>Captures some aspect of the life, health, or medical history of a subject.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.observation.HistoryObservation maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR HistoryObservation Profile</b></p>\n  <p>Captures some aspect of the life, health, or medical history of a subject.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.observation.HistoryObservation maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-observation-HistoryObservation",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.observation.HistoryObservation"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR HistoryObservation Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.907Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.974Z",
   "description": "Captures some aspect of the life, health, or medical history of a subject.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR HistoryObservation Profile",
         "definition": "Captures some aspect of the life, health, or medical history of a subject.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-observation-HistoryObservation.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "63",
+          "id": "61",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -398,6 +435,7 @@
         "path": "Observation.extension",
         "sliceName": "setting",
         "definition": "Description of the place or type of surroundings where something is positioned or where an event takes place.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -430,6 +468,7 @@
         "path": "Observation.extension",
         "sliceName": "location",
         "definition": "A position, site, or point in space where something can be found.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -462,6 +501,7 @@
         "path": "Observation.extension",
         "sliceName": "frequency",
         "definition": "How many occurrences of an event per unit of time.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -493,16 +533,19 @@
         "id": "Observation:shr-observation-HistoryObservation.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "64",
+          "id": "62",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -532,6 +575,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -562,8 +606,8 @@
       {
         "id": "Observation:shr-observation-HistoryObservation.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -572,7 +616,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -587,6 +636,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-observation-HistoryObservation.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-observation-HistoryObservation.status",
         "extension": [
@@ -598,6 +704,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -609,6 +716,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -616,6 +729,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -634,17 +755,20 @@
         "id": "Observation:shr-observation-HistoryObservation.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "61",
+          "id": "59",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 1,
         "max": "*",
         "type": [
@@ -654,8 +778,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -698,6 +828,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -708,6 +841,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -715,6 +854,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -723,6 +870,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -734,7 +885,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -758,6 +909,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -773,20 +928,32 @@
         ]
       },
       {
-        "id": "Observation:shr-observation-HistoryObservation.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-observation-HistoryObservation.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -806,8 +973,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -821,6 +991,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -840,7 +1014,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -892,6 +1066,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -911,8 +1089,8 @@
         "path": "Observation.value[x]",
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -925,6 +1103,9 @@
           {
             "code": "string"
           },
+          {
+            "code": "boolean"
+          },
           {
             "code": "Range"
           },
@@ -952,6 +1133,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -959,6 +1148,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -967,7 +1160,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -980,6 +1173,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -987,6 +1186,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -1014,6 +1217,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1021,6 +1230,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1028,6 +1241,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1045,6 +1262,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -1060,8 +1281,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1070,6 +1290,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -1077,6 +1303,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -1084,6 +1314,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1092,7 +1326,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1103,6 +1337,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1125,7 +1365,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1135,6 +1375,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1142,6 +1386,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1150,7 +1398,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1164,6 +1412,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1171,6 +1423,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1179,7 +1435,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1248,7 +1504,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1277,7 +1533,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1359,30 +1615,82 @@
         ]
       },
       {
-        "id": "Observation:shr-observation-HistoryObservation.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-observation-HistoryObservation.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-observation-HistoryObservation.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1438,8 +1746,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1501,7 +1809,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1530,7 +1838,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1562,7 +1870,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1572,6 +1880,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1622,7 +1936,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1685,7 +1999,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1714,7 +2028,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1756,6 +2070,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1763,6 +2083,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1782,8 +2106,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1820,6 +2144,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1827,6 +2155,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1835,7 +2167,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1848,6 +2180,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1870,7 +2208,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1883,6 +2221,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1890,6 +2234,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1897,6 +2245,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1905,7 +2257,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -2031,9 +2383,12 @@
         "id": "Observation:shr-observation-HistoryObservation.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "61",
+          "id": "59",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -2103,12 +2458,16 @@
         ]
       },
       {
-        "id": "Observation:shr-observation-HistoryObservation.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-observation-HistoryObservation.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-observation-Observation.json b/lib/resources/standard_health_record/StructureDefinition-shr-observation-Observation.json
old mode 100755
new mode 100644
index fcf35bb..29cf9ef
--- a/lib/resources/standard_health_record/StructureDefinition-shr-observation-Observation.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-observation-Observation.json
@@ -3,7 +3,7 @@
   "id": "shr-observation-Observation",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR Observation Profile</b></p>\n  <p>An act that is intended to result in new information about a subject. The focus of an observation can include the subject&#039;s behavior, physiological state, functional status, environment, exposures to substances, etc. The method of observing can be via direct questions, formal assessment vehicle, laboratory test, or imaging procedure.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.observation.Observation maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR Observation Profile</b></p>\n  <p>An act that is intended to result in new information about a subject. The focus of an observation can include the subject's behavior, physiological state, functional status, environment, exposures to substances, etc. The method of observing can be via direct questions, formal assessment vehicle, laboratory test, or imaging procedure.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.observation.Observation maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-observation-Observation",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.observation.Observation"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Observation Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.844Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.960Z",
   "description": "An act that is intended to result in new information about a subject. The focus of an observation can include the subject's behavior, physiological state, functional status, environment, exposures to substances, etc. The method of observing can be via direct questions, formal assessment vehicle, laboratory test, or imaging procedure.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR Observation Profile",
         "definition": "An act that is intended to result in new information about a subject. The focus of an observation can include the subject's behavior, physiological state, functional status, environment, exposures to substances, etc. The method of observing can be via direct questions, formal assessment vehicle, laboratory test, or imaging procedure.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-observation-Observation.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "57",
+          "id": "55",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -397,16 +434,19 @@
         "id": "Observation:shr-observation-Observation.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "58",
+          "id": "56",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -436,6 +476,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -466,8 +507,8 @@
       {
         "id": "Observation:shr-observation-Observation.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -476,7 +517,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -491,6 +537,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-observation-Observation.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-observation-Observation.status",
         "extension": [
@@ -502,6 +605,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -513,6 +617,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -520,6 +630,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -539,8 +657,8 @@
         "path": "Observation.category",
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 0,
         "max": "*",
         "type": [
@@ -550,8 +668,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -573,6 +697,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -583,6 +710,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -590,6 +723,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -598,6 +739,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -609,7 +754,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -633,6 +778,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -648,20 +797,32 @@
         ]
       },
       {
-        "id": "Observation:shr-observation-Observation.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-observation-Observation.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -681,8 +842,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -696,6 +860,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -715,7 +883,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -767,6 +935,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -786,8 +958,8 @@
         "path": "Observation.value[x]",
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -800,6 +972,9 @@
           {
             "code": "string"
           },
+          {
+            "code": "boolean"
+          },
           {
             "code": "Range"
           },
@@ -827,6 +1002,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -834,6 +1017,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -842,7 +1029,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -855,6 +1042,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -862,6 +1055,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -889,6 +1086,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -896,6 +1099,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -903,6 +1110,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -920,6 +1131,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -935,8 +1150,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -945,6 +1159,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -952,6 +1172,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -959,6 +1183,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -967,7 +1195,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -978,6 +1206,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1000,7 +1234,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1010,6 +1244,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1017,6 +1255,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1025,7 +1267,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1039,6 +1281,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1046,6 +1292,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1054,7 +1304,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1123,7 +1373,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1152,7 +1402,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1234,30 +1484,82 @@
         ]
       },
       {
-        "id": "Observation:shr-observation-Observation.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-observation-Observation.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-observation-Observation.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1313,8 +1615,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1376,7 +1678,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1405,7 +1707,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1437,7 +1739,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1447,6 +1749,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1497,7 +1805,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1560,7 +1868,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1589,7 +1897,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1631,6 +1939,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1638,6 +1952,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1657,8 +1975,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1695,6 +2013,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1702,6 +2024,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1710,7 +2036,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1723,6 +2049,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1745,7 +2077,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1758,6 +2090,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1765,6 +2103,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1772,6 +2114,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1780,7 +2126,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1899,12 +2245,16 @@
         ]
       },
       {
-        "id": "Observation:shr-observation-Observation.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-observation-Observation.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-observation-ObservationCode-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-observation-ObservationCode-extension.json
old mode 100755
new mode 100644
index b8b2364..c30b31d
--- a/lib/resources/standard_health_record/StructureDefinition-shr-observation-ObservationCode-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-observation-ObservationCode-extension.json
@@ -3,7 +3,7 @@
   "id": "shr-observation-ObservationCode-extension",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR ObservationCode Extension</b></p>\n  <p>A term from a controlled vocabulary that defines the data element (the question, not the answer) as specifically as possible. The specific code should always align with the concept of the element, but may be more specific. For example, the concept associated with medications is code for &#039;medication used&#039;, but the ObservationCode is the code for the particular medication used. For tests, ObservationCode identifies the specific test being performed, and for observations, the specific question being asked.</p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR ObservationCode Extension</b></p>\n  <p>A term from a controlled vocabulary that defines the data element (the question, not the answer) as specifically as possible. The specific code should always align with the concept of the element, but may be more specific. For example, the concept associated with medications is code for 'medication used', but the ObservationCode is the code for the particular medication used. For tests, ObservationCode identifies the specific test being performed, and for observations, the specific question being asked.</p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-observation-ObservationCode-extension",
   "identifier": [
@@ -12,9 +12,11 @@
       "value": "shr.observation.ObservationCode"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ObservationCode Extension",
   "title": "SHR ObservationCode Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:21.190Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.041Z",
   "description": "A term from a controlled vocabulary that defines the data element (the question, not the answer) as specifically as possible. The specific code should always align with the concept of the element, but may be more specific. For example, the concept associated with medications is code for 'medication used', but the ObservationCode is the code for the particular medication used. For tests, ObservationCode identifies the specific test being performed, and for observations, the specific question being asked.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-observation-ObservationNonOccurrenceModifier-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-observation-ObservationNonOccurrenceModifier-extension.json
old mode 100755
new mode 100644
index 5c49b33..d93a42d
--- a/lib/resources/standard_health_record/StructureDefinition-shr-observation-ObservationNonOccurrenceModifier-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-observation-ObservationNonOccurrenceModifier-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.observation.ObservationNonOccurrenceModifier"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ObservationNonOccurrenceModifier Extension",
   "title": "SHR ObservationNonOccurrenceModifier Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.623Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.883Z",
   "description": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -105,9 +106,12 @@
         "id": "Extension:observationnonoccurrencemodifier.extension",
         "path": "Extension.extension",
         "slicing": {
-          "id": "26",
+          "id": "24",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -233,7 +237,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -278,7 +281,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-observation-ObservationNotMadeReasonVS"
+            "reference": "http://standardhealthrecord.org/shr/observation/vs/ObservationNotMadeReasonVS"
           }
         },
         "mapping": [
@@ -296,7 +299,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -494,7 +496,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-observation-ObservationNotMadeReasonVS"
+            "reference": "http://standardhealthrecord.org/shr/observation/vs/ObservationNotMadeReasonVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-observation-ObservationQualifier-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-observation-ObservationQualifier-extension.json
old mode 100755
new mode 100644
index 90aa008..2b68f99
--- a/lib/resources/standard_health_record/StructureDefinition-shr-observation-ObservationQualifier-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-observation-ObservationQualifier-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.observation.ObservationQualifier"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ObservationQualifier Extension",
   "title": "SHR ObservationQualifier Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.623Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.884Z",
   "description": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-observation-ObservationReason-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-observation-ObservationReason-extension.json
old mode 100755
new mode 100644
index d5bc12b..6cba2af
--- a/lib/resources/standard_health_record/StructureDefinition-shr-observation-ObservationReason-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-observation-ObservationReason-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.observation.ObservationReason"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ObservationReason Extension",
   "title": "SHR ObservationReason Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.622Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.883Z",
   "description": "The reason for making the observation.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-observation-Panel.json b/lib/resources/standard_health_record/StructureDefinition-shr-observation-Panel.json
old mode 100755
new mode 100644
index d7b723b..975c747
--- a/lib/resources/standard_health_record/StructureDefinition-shr-observation-Panel.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-observation-Panel.json
@@ -3,7 +3,7 @@
   "id": "shr-observation-Panel",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR Panel Profile</b></p>\n  <p>A group of related observations, usually taken together. Typically the ObservationCategory and ObservationReason are not given for panel observations, but rather given at the level of the panel itself.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.observation.Panel maps to DiagnosticReport:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  CodeableConcept maps to codedDiagnosis\n  Observation maps to result\n  TBD &quot;Specimen&quot; maps to specimen\n  Interpretation maps to conclusion\n  ObservationCategory maps to category\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR Panel Profile</b></p>\n  <p>A group of related observations, usually taken together. Typically the ObservationCategory and ObservationReason are not given for panel observations, but rather given at the level of the panel itself.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.observation.Panel maps to DiagnosticReport:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  CodeableConcept maps to codedDiagnosis\n  Observation maps to result\n  &lt;TBD &quot;Specimen&quot;&gt; maps to specimen\n  Interpretation maps to conclusion\n  ObservationCategory maps to category\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-observation-Panel",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.observation.Panel"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Panel Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.934Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,15 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.980Z",
   "description": "A group of related observations, usually taken together. Typically the ObservationCategory and ObservationReason are not given for panel observations, but rather given at the level of the panel itself.",
   "purpose": "To support reporting for any diagnostic report into a clinical data repository.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -58,7 +64,7 @@
         "path": "DiagnosticReport",
         "short": "SHR Panel Profile",
         "definition": "A group of related observations, usually taken together. Typically the ObservationCategory and ObservationReason are not given for panel observations, but rather given at the level of the panel itself.",
-        "comments": "This is intended to capture a single report, and is not suitable for use in displaying summary information that covers multiple reports.  For example, this resource has not been designed for laboratory cumulative reporting formats nor detailed structured reports for sequencing.",
+        "comment": "This is intended to capture a single report, and is not suitable for use in displaying summary information that covers multiple reports.  For example, this resource has not been designed for laboratory cumulative reporting formats nor detailed structured reports for sequencing.",
         "alias": [
           "Report",
           "Test",
@@ -108,6 +114,10 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
           {
             "identity": "v2",
             "map": "ORU -> OBR"
@@ -127,7 +137,7 @@
         "path": "DiagnosticReport.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -166,7 +176,7 @@
         "path": "DiagnosticReport.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -187,7 +197,7 @@
         "path": "DiagnosticReport.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -207,6 +217,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -221,7 +239,7 @@
         "path": "DiagnosticReport.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -255,7 +273,7 @@
         "path": "DiagnosticReport.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -284,16 +302,19 @@
         "id": "DiagnosticReport:shr-observation-Panel.extension",
         "path": "DiagnosticReport.extension",
         "slicing": {
-          "id": "65",
+          "id": "63",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -322,6 +343,7 @@
         "path": "DiagnosticReport.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -354,7 +376,7 @@
         "path": "DiagnosticReport.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -382,11 +404,14 @@
       {
         "id": "DiagnosticReport:shr-observation-Panel.identifier",
         "path": "DiagnosticReport.identifier",
-        "short": "Id for external references to this report",
-        "definition": "The local ID assigned to the report by the order filler, usually by the Information System of the diagnostic service provider.",
+        "short": "Business identifier for report",
+        "definition": "Identifiers assigned to this report by the performer or other systems.",
+        "comment": "Usually assigned by the Information System of the diagnostic service provider (filler id).",
         "requirements": "Need to know what identifier to use when making queries about this report from the source laboratory, and for linking to the report outside FHIR context.",
         "alias": [
-          "ReportID"
+          "ReportID",
+          "Filler ID",
+          "Placer ID"
         ],
         "min": 0,
         "max": "*",
@@ -397,6 +422,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBR-51"
@@ -411,12 +440,65 @@
           }
         ]
       },
+      {
+        "id": "DiagnosticReport:shr-observation-Panel.basedOn",
+        "path": "DiagnosticReport.basedOn",
+        "short": "What was requested",
+        "definition": "Details concerning a test or procedure requested.",
+        "comment": "Note: Usually there is one test request for each result, however in some circumstances multiple test requests may be represented using a single test result resource. Note that there are also cases where one request leads to multiple reports.",
+        "requirements": "This allows tracing of authorization for the report and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Request"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC? OBR-2/3?"
+          },
+          {
+            "identity": "rim",
+            "map": "outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "DiagnosticReport:shr-observation-Panel.status",
         "path": "DiagnosticReport.status",
-        "short": "registered | partial | final | corrected | appended | cancelled | entered-in-error",
+        "short": "registered | partial | preliminary | final +",
         "definition": "The status of the diagnostic report as a whole.",
-        "comments": "This is labeled as \"Is Modifier\" because applications need to take appropriate action if a report is withdrawn.",
+        "comment": "This is labeled as \"Is Modifier\" because applications need to take appropriate action if a report is withdrawn.",
         "requirements": "Diagnostic services routinely issue provisional/incomplete reports, and sometimes withdraw previously released reports.",
         "min": 1,
         "max": "1",
@@ -428,6 +510,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "DiagnosticReportStatus"
+            }
+          ],
           "strength": "required",
           "description": "The status of the diagnostic report as a whole.",
           "valueSetReference": {
@@ -435,6 +523,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
           {
             "identity": "v2",
             "map": "OBR-25 (not 1:1 mapping)"
@@ -454,12 +546,12 @@
         "path": "DiagnosticReport.category",
         "short": "Service category",
         "definition": "A code that classifies the clinical discipline, department or diagnostic service that created the report (e.g. cardiology, biochemistry, hematology, MRI). This is used for searching, sorting and display purposes.",
-        "comments": "The level of granularity is defined by the category concepts in the value set. More fine-grained filtering can be performed using the metadata and/or terminology hierarchy in DiagnosticReport.code.",
+        "comment": "The level of granularity is defined by the category concepts in the value set. More fine-grained filtering can be performed using the metadata and/or terminology hierarchy in DiagnosticReport.code.",
         "alias": [
           "Department",
           "Sub-department",
-          "service",
-          "discipline"
+          "Service",
+          "Discipline"
         ],
         "min": 0,
         "max": "1",
@@ -496,6 +588,9 @@
         "path": "DiagnosticReport.code",
         "short": "Name/Code for this diagnostic report",
         "definition": "A code or name that describes this diagnostic report.",
+        "alias": [
+          "Type"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -505,6 +600,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "DiagnosticReportCodes"
+            }
+          ],
           "strength": "preferred",
           "description": "Codes that describe Diagnostic Reports.",
           "valueSetReference": {
@@ -512,6 +613,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
           {
             "identity": "v2",
             "map": "OBR-4 (HL7 v2 doesn't provide an easy way to indicate both the ordered test and the performed panel)"
@@ -529,7 +634,7 @@
       {
         "id": "DiagnosticReport:shr-observation-Panel.subject",
         "path": "DiagnosticReport.subject",
-        "short": "The subject of the report, usually, but not always, the patient",
+        "short": "The subject of the report - usually, but not always, the patient",
         "definition": "The subject of the report. Usually, but not always, this is a patient. However diagnostic services also perform analyses on specimens collected from a variety of other sources.",
         "requirements": "SHALL know the subject context.",
         "alias": [
@@ -557,6 +662,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3 (no HL7 v2 mapping for Group or Device)"
@@ -572,20 +681,33 @@
         ]
       },
       {
-        "id": "DiagnosticReport:shr-observation-Panel.encounter",
-        "path": "DiagnosticReport.encounter",
+        "id": "DiagnosticReport:shr-observation-Panel.context",
+        "path": "DiagnosticReport.context",
         "short": "Health care event when test ordered",
-        "definition": "The link to the health care event (encounter) when the order was made.",
+        "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) which this DiagnosticReport per is about.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
+        "requirements": "Links the request to the Encounter context.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1-19"
@@ -603,13 +725,14 @@
       {
         "id": "DiagnosticReport:shr-observation-Panel.effective[x]",
         "path": "DiagnosticReport.effective[x]",
-        "short": "Clinically Relevant time/time-period for report",
+        "short": "Clinically relevant time/time-period for report",
         "definition": "The time or time-period the observed values are related to. When the subject of the report is a patient, this is usually either the time of the procedure or of specimen collection(s), but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "If the diagnostic procedure was performed on the patient, this is the time it was performed. If there are specimens, the diagnostically relevant time can be derived from the specimen collection times, but the specimen information is not always available, and the exact relationship between the specimens and the diagnostically relevant time is not always automatic.",
+        "comment": "If the diagnostic procedure was performed on the patient, this is the time it was performed. If there are specimens, the diagnostically relevant time can be derived from the specimen collection times, but the specimen information is not always available, and the exact relationship between the specimens and the diagnostically relevant time is not always automatic.",
         "requirements": "Need to know where in the patient history to file/present this report.",
         "alias": [
           "Observation time",
-          "Effective Time"
+          "Effective Time",
+          "Occurrence"
         ],
         "min": 0,
         "max": "1",
@@ -623,6 +746,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBR-7"
@@ -642,7 +769,7 @@
         "path": "DiagnosticReport.issued",
         "short": "DateTime this version was released",
         "definition": "The date and time that this version of the report was released from the source diagnostic service.",
-        "comments": "May be different from the update time of the resource itself, because that is the status of the record (potentially a secondary copy), not the actual release time of the report.",
+        "comment": "May be different from the update time of the resource itself, because that is the status of the record (potentially a secondary copy), not the actual release time of the report.",
         "requirements": "Clinicians need to be able to check the date that the report was released.",
         "alias": [
           "Date Created",
@@ -675,10 +802,8 @@
       {
         "id": "DiagnosticReport:shr-observation-Panel.performer",
         "path": "DiagnosticReport.performer",
-        "short": "Responsible Diagnostic Service",
-        "definition": "The diagnostic service that is responsible for issuing the report.",
-        "comments": "This is not necessarily the source of the atomic data items. It is the entity that takes responsibility for the clinical report.",
-        "requirements": "Need to know whom to contact if there are queries about the results. Also may need to track the source of reports for secondary data analysis.",
+        "short": "Participants in producing the report",
+        "definition": "Indicates who or what participated in producing the report.",
         "alias": [
           "Laboratory",
           "Service",
@@ -690,23 +815,32 @@
         "max": "*",
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
-          },
+            "code": "BackboneElement"
+          }
+        ],
+        "constraint": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
+            "key": "ele-1",
+            "severity": "error",
+            "human": "All FHIR elements must have a @value or children",
+            "expression": "children().count() > id.count()",
+            "xpath": "@value|f:*|h:div",
+            "source": "Element"
           }
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "PRT-8 (where this PRT-4-Participation = \"PO\")"
           },
           {
             "identity": "rim",
-            "map": "participation[typeCode=AUT].role[classCode=ASSIGN].scoper"
+            "map": ".participation[typeCode=PRF]"
           },
           {
             "identity": "w5",
@@ -715,36 +849,166 @@
         ]
       },
       {
-        "id": "DiagnosticReport:shr-observation-Panel.request",
-        "path": "DiagnosticReport.request",
-        "short": "What was requested",
-        "definition": "Details concerning a test or procedure requested.",
-        "comments": "Note: Usually there is one test request for each result, however in some circumstances multiple test requests may be represented using a single test result resource. Note that there are also cases where one request leads to multiple reports.",
-        "requirements": "Need to be able to track completion of requests based on reports issued and also to report what diagnostic tests were requested (not always the same as what is delivered).",
+        "id": "DiagnosticReport:shr-observation-Panel.performer.id",
+        "path": "DiagnosticReport.performer.id",
+        "representation": [
+          "xmlAttr"
+        ],
+        "short": "xml:id (or equivalent in JSON)",
+        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Element.id",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "DiagnosticReport:shr-observation-Panel.performer.extension",
+        "path": "DiagnosticReport.performer.extension",
+        "short": "Additional Content defined by implementations",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content"
+        ],
         "min": 0,
         "max": "*",
+        "base": {
+          "path": "Element.extension",
+          "min": 0,
+          "max": "*"
+        },
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DiagnosticRequest"
+            "code": "Extension"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "DiagnosticReport:shr-observation-Panel.performer.modifierExtension",
+        "path": "DiagnosticReport.performer.modifierExtension",
+        "short": "Extensions that cannot be ignored",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content",
+          "modifiers"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "BackboneElement.modifierExtension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "isModifier": true,
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "N/A"
+          }
+        ]
+      },
+      {
+        "id": "DiagnosticReport:shr-observation-Panel.performer.role",
+        "path": "DiagnosticReport.performer.role",
+        "short": "Type of performer",
+        "definition": "Describes the type of participation (e.g.  a responsible party, author, or verifier).",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Role"
+            }
+          ],
+          "strength": "example",
+          "description": "Indicate a role of diagnostic report performer",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/performer-role"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer.role"
+          },
+          {
+            "identity": "v2",
+            "map": "PRT-8 (where this PRT-4-Participation = \"PO\")"
           },
+          {
+            "identity": "rim",
+            "map": ".functionCode"
+          }
+        ]
+      },
+      {
+        "id": "DiagnosticReport:shr-observation-Panel.performer.actor",
+        "path": "DiagnosticReport.performer.actor",
+        "short": "Practitioner or Organization  participant",
+        "definition": "The reference to the  practitioner or organization involved in producing the report. For example, the diagnostic service that is responsible for issuing the report.",
+        "comment": "This is not necessarily the source of the atomic data items. It is the entity that takes responsibility for the clinical report.",
+        "requirements": "Need to know whom to contact if there are queries about the results. Also may need to track the source of reports for secondary data analysis.",
+        "min": 1,
+        "max": "1",
+        "type": [
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
           },
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer.actor"
+          },
           {
             "identity": "v2",
-            "map": "ORC? OBR-2/3?"
+            "map": "PRT-8 (where this PRT-4-Participation = \"PO\")"
           },
           {
             "identity": "rim",
-            "map": "outboundRelationship[typeCode=FLFS].target"
+            "map": ".role"
           }
         ]
       },
@@ -753,7 +1017,7 @@
         "path": "DiagnosticReport.specimen",
         "short": "Specimens this report is based on",
         "definition": "Details about the specimens on which this diagnostic report is based.",
-        "comments": "If the specimen is sufficiently specified with a code in the test result name, then this additional data may be redundant. If there are multiple specimens, these may be represented per Observation or group.",
+        "comment": "If the specimen is sufficiently specified with a code in the test result name, then this additional data may be redundant. If there are multiple specimens, these may be represented per observation or group.",
         "requirements": "Need to be able to report information about the collected specimens on which the report is based.",
         "min": 0,
         "max": "*",
@@ -815,7 +1079,7 @@
         "path": "DiagnosticReport.imagingStudy",
         "short": "Reference to full details of imaging associated with the diagnostic report",
         "definition": "One or more links to full details of any imaging performed during the diagnostic investigation. Typically, this is imaging performed by DICOM enabled modalities, but this is not required. A fully enabled PACS viewer can use this information to provide views of the source images.",
-        "comments": "ImagingStudy and ImageManifest and the image element are somewhat overlapping - typically, the list of image references in the image element will also be found in one of the imaging study resources. However each caters to different types of displays for different types of purposes. Neither, either, or both may be provided.",
+        "comment": "ImagingStudy and ImageManifest and the image element are somewhat overlapping - typically, the list of image references in the image element will also be found in one of the imaging study resources. However each caters to different types of displays for different types of purposes. Neither, either, or both may be provided.",
         "min": 0,
         "max": "*",
         "type": [
@@ -907,7 +1171,7 @@
         "path": "DiagnosticReport.image.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -936,7 +1200,7 @@
         "path": "DiagnosticReport.image.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -968,7 +1232,7 @@
         "path": "DiagnosticReport.image.comment",
         "short": "Comment about the image (e.g. explanation)",
         "definition": "A comment about the image. Typically, this is used to provide an explanation for why the image is included, or to draw the viewer's attention to important features.",
-        "comments": "The comment should be displayed with the image. It would be common for the report to include additional discussion of the image contents in other sections such as the conclusion.",
+        "comment": "The comment should be displayed with the image. It would be common for the report to include additional discussion of the image contents in other sections such as the conclusion.",
         "requirements": "The provider of the report should make a comment about each image included in the report.",
         "min": 0,
         "max": "1",
@@ -1046,8 +1310,14 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AdjunctDiagnosis"
+            }
+          ],
           "strength": "example",
-          "description": "Diagnoses codes provided as adjuncts to the report.",
+          "description": "Diagnosis codes provided as adjuncts to the report.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/clinical-findings"
           }
@@ -1068,8 +1338,8 @@
         "path": "DiagnosticReport.presentedForm",
         "short": "Entire report as issued",
         "definition": "Rich text representation of the entire result as issued by the diagnostic service. Multiple formats are allowed but they SHALL be semantically equivalent.",
-        "comments": "\"application/pdf\" is recommended as the most reliable and interoperable in this context.",
-        "requirements": "Gives Laboratory the ability to provide its own fully formatted report for clinical fidelity.",
+        "comment": "\"application/pdf\" is recommended as the most reliable and interoperable in this context.",
+        "requirements": "Gives laboratory the ability to provide its own fully formatted report for clinical fidelity.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1155,12 +1425,16 @@
         ]
       },
       {
-        "id": "DiagnosticReport:shr-observation-Panel.encounter",
-        "path": "DiagnosticReport.encounter",
+        "id": "DiagnosticReport:shr-observation-Panel.context",
+        "path": "DiagnosticReport.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-observation-SocialHistory.json b/lib/resources/standard_health_record/StructureDefinition-shr-observation-SocialHistory.json
old mode 100755
new mode 100644
index 209c71e..4bd278b
--- a/lib/resources/standard_health_record/StructureDefinition-shr-observation-SocialHistory.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-observation-SocialHistory.json
@@ -3,7 +3,7 @@
   "id": "shr-observation-SocialHistory",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR SocialHistory Profile</b></p>\n  <p>The external elements and conditions which surround, influence, and affect the life and development of the subject. Includes social conditions such as poverty, violence, bullying.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.observation.SocialHistory maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR SocialHistory Profile</b></p>\n  <p>The external elements and conditions which surround, influence, and affect the life and development of the subject. Includes social conditions such as poverty, violence, bullying.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.observation.SocialHistory maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-observation-SocialHistory",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.observation.SocialHistory"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR SocialHistory Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.957Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.987Z",
   "description": "The external elements and conditions which surround, influence, and affect the life and development of the subject. Includes social conditions such as poverty, violence, bullying.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR SocialHistory Profile",
         "definition": "The external elements and conditions which surround, influence, and affect the life and development of the subject. Includes social conditions such as poverty, violence, bullying.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-observation-SocialHistory.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "67",
+          "id": "65",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -398,6 +435,7 @@
         "path": "Observation.extension",
         "sliceName": "setting",
         "definition": "Description of the place or type of surroundings where something is positioned or where an event takes place.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -430,6 +468,7 @@
         "path": "Observation.extension",
         "sliceName": "location",
         "definition": "A position, site, or point in space where something can be found.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -462,6 +501,7 @@
         "path": "Observation.extension",
         "sliceName": "frequency",
         "definition": "How many occurrences of an event per unit of time.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -493,16 +533,19 @@
         "id": "Observation:shr-observation-SocialHistory.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "68",
+          "id": "66",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -532,6 +575,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -562,8 +606,8 @@
       {
         "id": "Observation:shr-observation-SocialHistory.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -572,7 +616,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -587,6 +636,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-observation-SocialHistory.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-observation-SocialHistory.status",
         "extension": [
@@ -598,6 +704,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -609,6 +716,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -616,6 +729,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -634,17 +755,20 @@
         "id": "Observation:shr-observation-SocialHistory.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "66",
+          "id": "64",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 1,
         "max": "*",
         "type": [
@@ -654,8 +778,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -719,6 +849,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -729,6 +862,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -736,6 +875,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -744,6 +891,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -755,7 +906,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -779,6 +930,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -794,20 +949,32 @@
         ]
       },
       {
-        "id": "Observation:shr-observation-SocialHistory.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-observation-SocialHistory.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -827,8 +994,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -842,6 +1012,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -861,7 +1035,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -913,6 +1087,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -932,8 +1110,8 @@
         "path": "Observation.value[x]",
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -946,6 +1124,9 @@
           {
             "code": "string"
           },
+          {
+            "code": "boolean"
+          },
           {
             "code": "Range"
           },
@@ -973,6 +1154,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -980,6 +1169,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -988,7 +1181,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1001,6 +1194,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1008,6 +1207,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -1035,6 +1238,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1042,6 +1251,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1049,6 +1262,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1066,6 +1283,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -1081,8 +1302,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1091,6 +1311,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -1098,6 +1324,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -1105,6 +1335,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1113,7 +1347,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1124,6 +1358,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1146,7 +1386,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1156,6 +1396,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1163,6 +1407,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1171,7 +1419,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1185,6 +1433,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1192,6 +1444,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1200,7 +1456,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1269,7 +1525,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1298,7 +1554,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1380,30 +1636,82 @@
         ]
       },
       {
-        "id": "Observation:shr-observation-SocialHistory.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-observation-SocialHistory.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-observation-SocialHistory.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1459,8 +1767,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1522,7 +1830,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1551,7 +1859,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1583,7 +1891,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1593,6 +1901,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1643,7 +1957,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1706,7 +2020,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1735,7 +2049,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1777,6 +2091,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1784,6 +2104,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1803,8 +2127,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1841,6 +2165,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1848,6 +2176,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1856,7 +2188,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1869,6 +2201,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1891,7 +2229,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1904,6 +2242,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1911,6 +2255,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1918,6 +2266,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1926,7 +2278,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -2052,9 +2404,12 @@
         "id": "Observation:shr-observation-SocialHistory.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "66",
+          "id": "64",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -2145,12 +2500,16 @@
         ]
       },
       {
-        "id": "Observation:shr-observation-SocialHistory.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-observation-SocialHistory.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-problem-Abatement-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-problem-Abatement-extension.json
old mode 100755
new mode 100644
index 5f4bd51..e842b50
--- a/lib/resources/standard_health_record/StructureDefinition-shr-problem-Abatement-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-problem-Abatement-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.problem.Abatement"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Abatement Extension",
   "title": "SHR Abatement Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.734Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.919Z",
   "description": "The end, remission or resolution.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -105,9 +106,12 @@
         "id": "Extension:abatement.extension",
         "path": "Extension.extension",
         "slicing": {
-          "id": "41",
+          "id": "39",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -161,7 +165,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-problem-AcademicProblem.json b/lib/resources/standard_health_record/StructureDefinition-shr-problem-AcademicProblem.json
old mode 100755
new mode 100644
index df5ccbb..4708148
--- a/lib/resources/standard_health_record/StructureDefinition-shr-problem-AcademicProblem.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-problem-AcademicProblem.json
@@ -12,8 +12,10 @@
       "value": "shr.problem.AcademicProblem"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR AcademicProblem Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.638Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.888Z",
   "description": "A problem with learning or behavior in a learning environment.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "sct-concept",
@@ -107,7 +108,7 @@
             "severity": "error",
             "human": "If condition is abated, then clinicalStatus must be either inactive, resolved, or remission",
             "expression": "abatement.empty() or (abatement as boolean).not()  or clinicalStatus='resolved' or clinicalStatus='remission' or clinicalStatus='inactive'",
-            "xpath": "xpath: not(f:abatementBoolean='true' or (not(exists(f:abatementBoolean)) and exists(*[starts-with(local-name(.), 'abatement')])) or f:clinicalStatus/@value=('resolved', 'remission', 'inactive')"
+            "xpath": "not(f:abatementBoolean='true' or (not(exists(f:abatementBoolean)) and exists(*[starts-with(local-name(.), 'abatement')])) or f:clinicalStatus/@value=('resolved', 'remission', 'inactive'))"
           },
           {
             "key": "con-3",
@@ -145,7 +146,7 @@
         "path": "Condition.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -184,7 +185,7 @@
         "path": "Condition.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -205,7 +206,7 @@
         "path": "Condition.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -225,6 +226,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -239,7 +248,7 @@
         "path": "Condition.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -273,7 +282,7 @@
         "path": "Condition.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -302,16 +311,19 @@
         "id": "Condition:shr-problem-AcademicProblem.extension",
         "path": "Condition.extension",
         "slicing": {
-          "id": "29",
+          "id": "27",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -340,6 +352,7 @@
         "path": "Condition.extension",
         "sliceName": "generalizedlikelihood",
         "definition": "Quantitative or qualitative measure of likelihood.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -372,6 +385,7 @@
         "path": "Condition.extension",
         "sliceName": "supportingevidencequality",
         "definition": "An assessment of the quality and/or quantity of the source information that supports judgment.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -404,6 +418,7 @@
         "path": "Condition.extension",
         "sliceName": "includeonproblemlist",
         "definition": "Whether or not to include this problem on the subject's current problem list.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -436,6 +451,7 @@
         "path": "Condition.extension",
         "sliceName": "whenclinicallyrecognized",
         "definition": "The time at which a condition or problem was first identified in a healthcare context.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -468,6 +484,7 @@
         "path": "Condition.extension",
         "sliceName": "preexisting",
         "definition": "If the problem or condition existed before the current episode of care.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -500,6 +517,7 @@
         "path": "Condition.extension",
         "sliceName": "criticality",
         "definition": "A clinical judgment of potential clinical harm, or seriousness, of a condition. When the worst case result is assessed to have a life-threatening or organ system threatening potential, it is considered to be of high criticality.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -531,16 +549,19 @@
         "id": "Condition:shr-problem-AcademicProblem.modifierExtension",
         "path": "Condition.modifierExtension",
         "slicing": {
-          "id": "30",
+          "id": "28",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -570,6 +591,7 @@
         "path": "Condition.modifierExtension",
         "sliceName": "nonoccurrencemodifier",
         "definition": "When true, indicates either that the event or action documented in the entry did not occur, or the the thing documented is absent or does not exist.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -627,6 +649,7 @@
         "path": "Condition.clinicalStatus",
         "short": "active | recurrence | inactive | remission | resolved",
         "definition": "The clinical status of the condition.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the condition as not currently valid or of concern.",
         "min": 1,
         "max": "1",
         "type": [
@@ -634,9 +657,19 @@
             "code": "code"
           }
         ],
+        "condition": [
+          "con-3",
+          "con-4"
+        ],
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ConditionClinicalStatus"
+            }
+          ],
           "strength": "required",
           "description": "The clinical status of the condition or diagnosis.",
           "valueSetReference": {
@@ -652,6 +685,10 @@
             "identity": "v2",
             "map": "PRB-14 / DG1-6"
           },
+          {
+            "identity": "rim",
+            "map": "Observation ACT\n.inboundRelationship[typeCode=COMP].source[classCode=OBS, code=\"clinicalStatus\", moodCode=EVN].value"
+          },
           {
             "identity": "w5",
             "map": "status"
@@ -663,7 +700,7 @@
         "path": "Condition.verificationStatus",
         "short": "provisional | differential | confirmed | refuted | entered-in-error | unknown",
         "definition": "The verification status to support the clinical status of the condition.",
-        "comments": "verificationStatus is not required.  For example, when a patient has abdominal pain in the ED, there is not likely going to be a verification status.",
+        "comment": "verificationStatus is not required.  For example, when a patient has abdominal pain in the ED, there is not likely going to be a verification status.\n\nThis element is labeled as a modifier because the status contains the code refuted and entered-in-error that mark the Condition as not currently valid.",
         "min": 0,
         "max": "1",
         "type": [
@@ -672,9 +709,18 @@
           }
         ],
         "defaultValueCode": "unknown",
+        "condition": [
+          "con-3"
+        ],
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ConditionVerificationStatus"
+            }
+          ],
           "strength": "required",
           "description": "The verification status to support or decline the clinical status of the condition or diagnosis.",
           "valueSetReference": {
@@ -692,7 +738,7 @@
           },
           {
             "identity": "rim",
-            "map": ".code (pre or post-coordinated in)  Can use valueNegationInd for refuted"
+            "map": "Observation ACT\n.inboundRelationship[typeCode=COMP].source[classCode=OBS, code=\"verificationStatus\", moodCode=EVN].value"
           },
           {
             "identity": "sct-attr",
@@ -709,7 +755,7 @@
         "path": "Condition.category",
         "short": "problem-list-item | encounter-diagnosis",
         "definition": "A category assigned to the condition.",
-        "comments": "The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts.",
+        "comment": "The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts.",
         "min": 0,
         "max": "*",
         "type": [
@@ -721,7 +767,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-problem-ProblemCategoryVS"
+            "reference": "http://standardhealthrecord.org/shr/problem/vs/ProblemCategoryVS"
           }
         },
         "mapping": [
@@ -748,7 +794,7 @@
         "path": "Condition.severity",
         "short": "Subjective severity of condition",
         "definition": "A subjective assessment of the severity of the condition as evaluated by the clinician.",
-        "comments": "Coding of the severity with a terminology is preferred, where possible.",
+        "comment": "Coding of the severity with a terminology is preferred, where possible.",
         "min": 0,
         "max": "1",
         "type": [
@@ -758,6 +804,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ConditionSeverity"
+            }
+          ],
           "strength": "preferred",
           "description": "A subjective assessment of the severity of the condition as evaluated by the clinician.",
           "valueSetReference": {
@@ -792,6 +844,10 @@
         "path": "Condition.code",
         "short": "Identification of the condition, problem or diagnosis",
         "definition": "Identification of the condition, problem or diagnosis.",
+        "requirements": "0..1 to account for primarily narrative only resources.",
+        "alias": [
+          "type"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -802,6 +858,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ConditionKind"
+            }
+          ],
           "strength": "example",
           "description": "Identification of the condition or diagnosis.",
           "valueSetReference": {
@@ -836,7 +898,7 @@
         "path": "Condition.bodySite",
         "short": "Anatomical location, if relevant",
         "definition": "The anatomical location where this condition manifests itself.",
-        "comments": "Only used if not implicit in code found in Condition.code. If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [body-site-instance](extension-body-site-instance.html).  May be a summary code, or a reference to a very precise definition of the location, or both.",
+        "comment": "Only used if not implicit in code found in Condition.code. If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [body-site-instance](extension-body-site-instance.html).  May be a summary code, or a reference to a very precise definition of the location, or both.",
         "min": 0,
         "max": "0",
         "type": [
@@ -849,7 +911,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
           }
         },
         "mapping": [
@@ -873,6 +935,9 @@
         "short": "Who has the condition?",
         "definition": "Indicates the patient or group who the condition record is associated with.",
         "requirements": "Group is typically used for veterinary or public health use cases.",
+        "alias": [
+          "patient"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -904,9 +969,12 @@
       {
         "id": "Condition:shr-problem-AcademicProblem.context",
         "path": "Condition.context",
-        "short": "Encounter when condition first asserted",
+        "short": "Encounter or episode when condition first asserted",
         "definition": "Encounter during which the condition was first asserted.",
-        "comments": "This record indicates the encounter this particular record is associated with.  In the case of a \"new\" diagnosis reflecting ongoing/revised information about the condition, this might be distinct from the first encounter in which the underlying condition was first \"known\".",
+        "comment": "This record indicates the encounter this particular record is associated with.  In the case of a \"new\" diagnosis reflecting ongoing/revised information about the condition, this might be distinct from the first encounter in which the underlying condition was first \"known\".",
+        "alias": [
+          "encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -919,6 +987,7 @@
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -939,7 +1008,7 @@
         "path": "Condition.onset[x]",
         "short": "Estimated or actual date,  date-time, or age",
         "definition": "Estimated or actual date or date-time  the condition began, in the opinion of the clinician.",
-        "comments": "Age is generally used when the patient reports an age at which the Condition began to occur.",
+        "comment": "Age is generally used when the patient reports an age at which the Condition began to occur.",
         "min": 0,
         "max": "1",
         "type": [
@@ -980,7 +1049,7 @@
         "path": "Condition.abatement[x]",
         "short": "If/when in resolution/remission",
         "definition": "The date or estimated date that the condition resolved or went into remission. This is called \"abatement\" because of the many overloaded connotations associated with \"remission\" or \"resolution\" - Conditions are never really resolved, but they can abate.",
-        "comments": "There is no explicit distinction between resolution and remission because in many cases the distinction is not clear. Age is generally used when the patient reports an age at which the Condition abated.  If there is no abatement element, it is unknown whether the condition has resolved or entered remission; applications and users should generally assume that the condition is still valid.  When abatementString exists, it implies the condition is abated.",
+        "comment": "There is no explicit distinction between resolution and remission because in many cases the distinction is not clear. Age is generally used when the patient reports an age at which the Condition abated.  If there is no abatement element, it is unknown whether the condition has resolved or entered remission; applications and users should generally assume that the condition is still valid.  When abatementString exists, it implies the condition is abated.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1003,6 +1072,9 @@
             "code": "string"
           }
         ],
+        "condition": [
+          "con-4"
+        ],
         "mapping": [
           {
             "identity": "rim",
@@ -1019,14 +1091,15 @@
         "path": "Condition.assertedDate",
         "short": "Date record was believed accurate",
         "definition": "The date on which the existance of the Condition was first asserted or acknowledged.",
-        "comments": "The assertedDate represents the date when this particular Condition record was created in the EHR, not the date of the most recent update in terms of when severity, abatement, etc. were specified.  The date of the last record modification can be retrieved from the resource metadata.",
+        "comment": "The assertedDate represents the date when this particular Condition record was created in the EHR, not the date of the most recent update in terms of when severity, abatement, etc. were specified.  The date of the last record modification can be retrieved from the resource metadata.",
         "min": 1,
         "max": "1",
         "type": [
           {
-            "code": "date"
+            "code": "dateTime"
           }
         ],
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -1147,7 +1220,7 @@
         "path": "Condition.stage.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1176,7 +1249,7 @@
         "path": "Condition.stage.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1222,7 +1295,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-problem-GradeOrStageVS"
+            "reference": "http://standardhealthrecord.org/shr/problem/vs/GradeOrStageVS"
           }
         },
         "mapping": [
@@ -1276,7 +1349,7 @@
         "path": "Condition.evidence",
         "short": "Supporting evidence",
         "definition": "Supporting Evidence / manifestations that are the basis on which this condition is suspected or confirmed.",
-        "comments": "The evidence may be a simple list of coded symptoms/manifestations, or references to observations or formal assessments, or both.",
+        "comment": "The evidence may be a simple list of coded symptoms/manifestations, or references to observations or formal assessments, or both.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1340,7 +1413,7 @@
         "path": "Condition.evidence.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1369,7 +1442,7 @@
         "path": "Condition.evidence.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1402,7 +1475,7 @@
         "short": "Manifestation/symptom",
         "definition": "A manifestation or symptom that led to the recording of this condition.",
         "min": 0,
-        "max": "1",
+        "max": "*",
         "type": [
           {
             "code": "CodeableConcept",
@@ -1412,10 +1485,11 @@
         "condition": [
           "con-2"
         ],
+        "isSummary": true,
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-ManifestationVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/ManifestationVS"
           }
         },
         "mapping": [
@@ -1426,6 +1500,10 @@
           {
             "identity": "rim",
             "map": "[code=\"diagnosis\"].value"
+          },
+          {
+            "identity": "w5",
+            "map": "why"
           }
         ]
       },
@@ -1445,10 +1523,15 @@
         "condition": [
           "con-2"
         ],
+        "isSummary": true,
         "mapping": [
           {
             "identity": "rim",
             "map": ".self"
+          },
+          {
+            "identity": "w5",
+            "map": "why"
           }
         ]
       },
@@ -1615,7 +1698,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-problem-ProblemCategoryVS"
+            "reference": "http://standardhealthrecord.org/shr/problem/vs/ProblemCategoryVS"
           }
         }
       },
@@ -1632,6 +1715,8 @@
       {
         "id": "Condition:shr-problem-AcademicProblem.code",
         "path": "Condition.code",
+        "min": 1,
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept",
@@ -1653,7 +1738,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
           }
         }
       },
@@ -1697,7 +1782,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-problem-GradeOrStageVS"
+            "reference": "http://standardhealthrecord.org/shr/problem/vs/GradeOrStageVS"
           }
         }
       },
@@ -1717,7 +1802,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-ManifestationVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/ManifestationVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-problem-Asplenia.json b/lib/resources/standard_health_record/StructureDefinition-shr-problem-Asplenia.json
old mode 100755
new mode 100644
index b418b0c..1f0dfc5
--- a/lib/resources/standard_health_record/StructureDefinition-shr-problem-Asplenia.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-problem-Asplenia.json
@@ -12,8 +12,10 @@
       "value": "shr.problem.Asplenia"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Asplenia Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.691Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.906Z",
   "description": "Congenital absence of spleen.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "sct-concept",
@@ -107,7 +108,7 @@
             "severity": "error",
             "human": "If condition is abated, then clinicalStatus must be either inactive, resolved, or remission",
             "expression": "abatement.empty() or (abatement as boolean).not()  or clinicalStatus='resolved' or clinicalStatus='remission' or clinicalStatus='inactive'",
-            "xpath": "xpath: not(f:abatementBoolean='true' or (not(exists(f:abatementBoolean)) and exists(*[starts-with(local-name(.), 'abatement')])) or f:clinicalStatus/@value=('resolved', 'remission', 'inactive')"
+            "xpath": "not(f:abatementBoolean='true' or (not(exists(f:abatementBoolean)) and exists(*[starts-with(local-name(.), 'abatement')])) or f:clinicalStatus/@value=('resolved', 'remission', 'inactive'))"
           },
           {
             "key": "con-3",
@@ -145,7 +146,7 @@
         "path": "Condition.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -184,7 +185,7 @@
         "path": "Condition.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -205,7 +206,7 @@
         "path": "Condition.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -225,6 +226,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -239,7 +248,7 @@
         "path": "Condition.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -273,7 +282,7 @@
         "path": "Condition.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -302,16 +311,19 @@
         "id": "Condition:shr-problem-Asplenia.extension",
         "path": "Condition.extension",
         "slicing": {
-          "id": "35",
+          "id": "33",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -340,6 +352,7 @@
         "path": "Condition.extension",
         "sliceName": "generalizedlikelihood",
         "definition": "Quantitative or qualitative measure of likelihood.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -372,6 +385,7 @@
         "path": "Condition.extension",
         "sliceName": "supportingevidencequality",
         "definition": "An assessment of the quality and/or quantity of the source information that supports judgment.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -404,6 +418,7 @@
         "path": "Condition.extension",
         "sliceName": "includeonproblemlist",
         "definition": "Whether or not to include this problem on the subject's current problem list.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -436,6 +451,7 @@
         "path": "Condition.extension",
         "sliceName": "whenclinicallyrecognized",
         "definition": "The time at which a condition or problem was first identified in a healthcare context.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -468,6 +484,7 @@
         "path": "Condition.extension",
         "sliceName": "preexisting",
         "definition": "If the problem or condition existed before the current episode of care.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -500,6 +517,7 @@
         "path": "Condition.extension",
         "sliceName": "criticality",
         "definition": "A clinical judgment of potential clinical harm, or seriousness, of a condition. When the worst case result is assessed to have a life-threatening or organ system threatening potential, it is considered to be of high criticality.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -531,16 +549,19 @@
         "id": "Condition:shr-problem-Asplenia.modifierExtension",
         "path": "Condition.modifierExtension",
         "slicing": {
-          "id": "36",
+          "id": "34",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -570,6 +591,7 @@
         "path": "Condition.modifierExtension",
         "sliceName": "nonoccurrencemodifier",
         "definition": "When true, indicates either that the event or action documented in the entry did not occur, or the the thing documented is absent or does not exist.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -627,6 +649,7 @@
         "path": "Condition.clinicalStatus",
         "short": "active | recurrence | inactive | remission | resolved",
         "definition": "The clinical status of the condition.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the condition as not currently valid or of concern.",
         "min": 1,
         "max": "1",
         "type": [
@@ -634,9 +657,19 @@
             "code": "code"
           }
         ],
+        "condition": [
+          "con-3",
+          "con-4"
+        ],
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ConditionClinicalStatus"
+            }
+          ],
           "strength": "required",
           "description": "The clinical status of the condition or diagnosis.",
           "valueSetReference": {
@@ -652,6 +685,10 @@
             "identity": "v2",
             "map": "PRB-14 / DG1-6"
           },
+          {
+            "identity": "rim",
+            "map": "Observation ACT\n.inboundRelationship[typeCode=COMP].source[classCode=OBS, code=\"clinicalStatus\", moodCode=EVN].value"
+          },
           {
             "identity": "w5",
             "map": "status"
@@ -663,7 +700,7 @@
         "path": "Condition.verificationStatus",
         "short": "provisional | differential | confirmed | refuted | entered-in-error | unknown",
         "definition": "The verification status to support the clinical status of the condition.",
-        "comments": "verificationStatus is not required.  For example, when a patient has abdominal pain in the ED, there is not likely going to be a verification status.",
+        "comment": "verificationStatus is not required.  For example, when a patient has abdominal pain in the ED, there is not likely going to be a verification status.\n\nThis element is labeled as a modifier because the status contains the code refuted and entered-in-error that mark the Condition as not currently valid.",
         "min": 0,
         "max": "1",
         "type": [
@@ -672,9 +709,18 @@
           }
         ],
         "defaultValueCode": "unknown",
+        "condition": [
+          "con-3"
+        ],
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ConditionVerificationStatus"
+            }
+          ],
           "strength": "required",
           "description": "The verification status to support or decline the clinical status of the condition or diagnosis.",
           "valueSetReference": {
@@ -692,7 +738,7 @@
           },
           {
             "identity": "rim",
-            "map": ".code (pre or post-coordinated in)  Can use valueNegationInd for refuted"
+            "map": "Observation ACT\n.inboundRelationship[typeCode=COMP].source[classCode=OBS, code=\"verificationStatus\", moodCode=EVN].value"
           },
           {
             "identity": "sct-attr",
@@ -709,7 +755,7 @@
         "path": "Condition.category",
         "short": "problem-list-item | encounter-diagnosis",
         "definition": "A category assigned to the condition.",
-        "comments": "The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts.",
+        "comment": "The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts.",
         "min": 0,
         "max": "*",
         "type": [
@@ -721,7 +767,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-problem-ProblemCategoryVS"
+            "reference": "http://standardhealthrecord.org/shr/problem/vs/ProblemCategoryVS"
           }
         },
         "mapping": [
@@ -748,7 +794,7 @@
         "path": "Condition.severity",
         "short": "Subjective severity of condition",
         "definition": "A subjective assessment of the severity of the condition as evaluated by the clinician.",
-        "comments": "Coding of the severity with a terminology is preferred, where possible.",
+        "comment": "Coding of the severity with a terminology is preferred, where possible.",
         "min": 0,
         "max": "1",
         "type": [
@@ -758,6 +804,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ConditionSeverity"
+            }
+          ],
           "strength": "preferred",
           "description": "A subjective assessment of the severity of the condition as evaluated by the clinician.",
           "valueSetReference": {
@@ -792,6 +844,10 @@
         "path": "Condition.code",
         "short": "Identification of the condition, problem or diagnosis",
         "definition": "Identification of the condition, problem or diagnosis.",
+        "requirements": "0..1 to account for primarily narrative only resources.",
+        "alias": [
+          "type"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -810,6 +866,12 @@
         },
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ConditionKind"
+            }
+          ],
           "strength": "example",
           "description": "Identification of the condition or diagnosis.",
           "valueSetReference": {
@@ -844,7 +906,7 @@
         "path": "Condition.bodySite",
         "short": "Anatomical location, if relevant",
         "definition": "The anatomical location where this condition manifests itself.",
-        "comments": "Only used if not implicit in code found in Condition.code. If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [body-site-instance](extension-body-site-instance.html).  May be a summary code, or a reference to a very precise definition of the location, or both.",
+        "comment": "Only used if not implicit in code found in Condition.code. If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [body-site-instance](extension-body-site-instance.html).  May be a summary code, or a reference to a very precise definition of the location, or both.",
         "min": 0,
         "max": "*",
         "type": [
@@ -857,7 +919,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
           }
         },
         "mapping": [
@@ -881,6 +943,9 @@
         "short": "Who has the condition?",
         "definition": "Indicates the patient or group who the condition record is associated with.",
         "requirements": "Group is typically used for veterinary or public health use cases.",
+        "alias": [
+          "patient"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -912,9 +977,12 @@
       {
         "id": "Condition:shr-problem-Asplenia.context",
         "path": "Condition.context",
-        "short": "Encounter when condition first asserted",
+        "short": "Encounter or episode when condition first asserted",
         "definition": "Encounter during which the condition was first asserted.",
-        "comments": "This record indicates the encounter this particular record is associated with.  In the case of a \"new\" diagnosis reflecting ongoing/revised information about the condition, this might be distinct from the first encounter in which the underlying condition was first \"known\".",
+        "comment": "This record indicates the encounter this particular record is associated with.  In the case of a \"new\" diagnosis reflecting ongoing/revised information about the condition, this might be distinct from the first encounter in which the underlying condition was first \"known\".",
+        "alias": [
+          "encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -927,6 +995,7 @@
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -947,7 +1016,7 @@
         "path": "Condition.onset[x]",
         "short": "Estimated or actual date,  date-time, or age",
         "definition": "Estimated or actual date or date-time  the condition began, in the opinion of the clinician.",
-        "comments": "Age is generally used when the patient reports an age at which the Condition began to occur.",
+        "comment": "Age is generally used when the patient reports an age at which the Condition began to occur.",
         "min": 0,
         "max": "1",
         "type": [
@@ -988,7 +1057,7 @@
         "path": "Condition.abatement[x]",
         "short": "If/when in resolution/remission",
         "definition": "The date or estimated date that the condition resolved or went into remission. This is called \"abatement\" because of the many overloaded connotations associated with \"remission\" or \"resolution\" - Conditions are never really resolved, but they can abate.",
-        "comments": "There is no explicit distinction between resolution and remission because in many cases the distinction is not clear. Age is generally used when the patient reports an age at which the Condition abated.  If there is no abatement element, it is unknown whether the condition has resolved or entered remission; applications and users should generally assume that the condition is still valid.  When abatementString exists, it implies the condition is abated.",
+        "comment": "There is no explicit distinction between resolution and remission because in many cases the distinction is not clear. Age is generally used when the patient reports an age at which the Condition abated.  If there is no abatement element, it is unknown whether the condition has resolved or entered remission; applications and users should generally assume that the condition is still valid.  When abatementString exists, it implies the condition is abated.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1011,6 +1080,9 @@
             "code": "string"
           }
         ],
+        "condition": [
+          "con-4"
+        ],
         "mapping": [
           {
             "identity": "rim",
@@ -1027,14 +1099,15 @@
         "path": "Condition.assertedDate",
         "short": "Date record was believed accurate",
         "definition": "The date on which the existance of the Condition was first asserted or acknowledged.",
-        "comments": "The assertedDate represents the date when this particular Condition record was created in the EHR, not the date of the most recent update in terms of when severity, abatement, etc. were specified.  The date of the last record modification can be retrieved from the resource metadata.",
+        "comment": "The assertedDate represents the date when this particular Condition record was created in the EHR, not the date of the most recent update in terms of when severity, abatement, etc. were specified.  The date of the last record modification can be retrieved from the resource metadata.",
         "min": 1,
         "max": "1",
         "type": [
           {
-            "code": "date"
+            "code": "dateTime"
           }
         ],
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -1155,7 +1228,7 @@
         "path": "Condition.stage.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1184,7 +1257,7 @@
         "path": "Condition.stage.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1230,7 +1303,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-problem-GradeOrStageVS"
+            "reference": "http://standardhealthrecord.org/shr/problem/vs/GradeOrStageVS"
           }
         },
         "mapping": [
@@ -1284,7 +1357,7 @@
         "path": "Condition.evidence",
         "short": "Supporting evidence",
         "definition": "Supporting Evidence / manifestations that are the basis on which this condition is suspected or confirmed.",
-        "comments": "The evidence may be a simple list of coded symptoms/manifestations, or references to observations or formal assessments, or both.",
+        "comment": "The evidence may be a simple list of coded symptoms/manifestations, or references to observations or formal assessments, or both.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1348,7 +1421,7 @@
         "path": "Condition.evidence.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1377,7 +1450,7 @@
         "path": "Condition.evidence.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1410,7 +1483,7 @@
         "short": "Manifestation/symptom",
         "definition": "A manifestation or symptom that led to the recording of this condition.",
         "min": 0,
-        "max": "1",
+        "max": "*",
         "type": [
           {
             "code": "CodeableConcept",
@@ -1420,10 +1493,11 @@
         "condition": [
           "con-2"
         ],
+        "isSummary": true,
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-ManifestationVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/ManifestationVS"
           }
         },
         "mapping": [
@@ -1434,6 +1508,10 @@
           {
             "identity": "rim",
             "map": "[code=\"diagnosis\"].value"
+          },
+          {
+            "identity": "w5",
+            "map": "why"
           }
         ]
       },
@@ -1453,10 +1531,15 @@
         "condition": [
           "con-2"
         ],
+        "isSummary": true,
         "mapping": [
           {
             "identity": "rim",
             "map": ".self"
+          },
+          {
+            "identity": "w5",
+            "map": "why"
           }
         ]
       },
@@ -1623,7 +1706,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-problem-ProblemCategoryVS"
+            "reference": "http://standardhealthrecord.org/shr/problem/vs/ProblemCategoryVS"
           }
         }
       },
@@ -1640,6 +1723,8 @@
       {
         "id": "Condition:shr-problem-Asplenia.code",
         "path": "Condition.code",
+        "min": 1,
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept",
@@ -1667,7 +1752,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
           }
         }
       },
@@ -1711,7 +1796,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-problem-GradeOrStageVS"
+            "reference": "http://standardhealthrecord.org/shr/problem/vs/GradeOrStageVS"
           }
         }
       },
@@ -1731,7 +1816,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-ManifestationVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/ManifestationVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-problem-Criticality-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-problem-Criticality-extension.json
old mode 100755
new mode 100644
index 20b2607..1dafdf1
--- a/lib/resources/standard_health_record/StructureDefinition-shr-problem-Criticality-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-problem-Criticality-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.problem.Criticality"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Criticality Extension",
   "title": "SHR Criticality Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.596Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.866Z",
   "description": "A clinical judgment of potential clinical harm, or seriousness, of a condition. When the worst case result is assessed to have a life-threatening or organ system threatening potential, it is considered to be of high criticality.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-problem-IncludeOnProblemList-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-problem-IncludeOnProblemList-extension.json
old mode 100755
new mode 100644
index 5784eb2..861f156
--- a/lib/resources/standard_health_record/StructureDefinition-shr-problem-IncludeOnProblemList-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-problem-IncludeOnProblemList-extension.json
@@ -3,7 +3,7 @@
   "id": "shr-problem-IncludeOnProblemList-extension",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR IncludeOnProblemList Extension</b></p>\n  <p>Whether or not to include this problem on the subject&#039;s current problem list.</p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR IncludeOnProblemList Extension</b></p>\n  <p>Whether or not to include this problem on the subject's current problem list.</p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-problem-IncludeOnProblemList-extension",
   "identifier": [
@@ -12,9 +12,11 @@
       "value": "shr.problem.IncludeOnProblemList"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR IncludeOnProblemList Extension",
   "title": "SHR IncludeOnProblemList Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.595Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.865Z",
   "description": "Whether or not to include this problem on the subject's current problem list.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-problem-Injury.json b/lib/resources/standard_health_record/StructureDefinition-shr-problem-Injury.json
old mode 100755
new mode 100644
index 2eae2d6..665dd79
--- a/lib/resources/standard_health_record/StructureDefinition-shr-problem-Injury.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-problem-Injury.json
@@ -12,8 +12,10 @@
       "value": "shr.problem.Injury"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Injury Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.655Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.894Z",
   "description": "Damage inflicted on the body by an external force.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "sct-concept",
@@ -107,7 +108,7 @@
             "severity": "error",
             "human": "If condition is abated, then clinicalStatus must be either inactive, resolved, or remission",
             "expression": "abatement.empty() or (abatement as boolean).not()  or clinicalStatus='resolved' or clinicalStatus='remission' or clinicalStatus='inactive'",
-            "xpath": "xpath: not(f:abatementBoolean='true' or (not(exists(f:abatementBoolean)) and exists(*[starts-with(local-name(.), 'abatement')])) or f:clinicalStatus/@value=('resolved', 'remission', 'inactive')"
+            "xpath": "not(f:abatementBoolean='true' or (not(exists(f:abatementBoolean)) and exists(*[starts-with(local-name(.), 'abatement')])) or f:clinicalStatus/@value=('resolved', 'remission', 'inactive'))"
           },
           {
             "key": "con-3",
@@ -145,7 +146,7 @@
         "path": "Condition.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -184,7 +185,7 @@
         "path": "Condition.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -205,7 +206,7 @@
         "path": "Condition.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -225,6 +226,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -239,7 +248,7 @@
         "path": "Condition.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -273,7 +282,7 @@
         "path": "Condition.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -302,16 +311,19 @@
         "id": "Condition:shr-problem-Injury.extension",
         "path": "Condition.extension",
         "slicing": {
-          "id": "31",
+          "id": "29",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -340,6 +352,7 @@
         "path": "Condition.extension",
         "sliceName": "generalizedlikelihood",
         "definition": "Quantitative or qualitative measure of likelihood.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -372,6 +385,7 @@
         "path": "Condition.extension",
         "sliceName": "supportingevidencequality",
         "definition": "An assessment of the quality and/or quantity of the source information that supports judgment.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -404,6 +418,7 @@
         "path": "Condition.extension",
         "sliceName": "includeonproblemlist",
         "definition": "Whether or not to include this problem on the subject's current problem list.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -436,6 +451,7 @@
         "path": "Condition.extension",
         "sliceName": "whenclinicallyrecognized",
         "definition": "The time at which a condition or problem was first identified in a healthcare context.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -468,6 +484,7 @@
         "path": "Condition.extension",
         "sliceName": "preexisting",
         "definition": "If the problem or condition existed before the current episode of care.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -500,6 +517,7 @@
         "path": "Condition.extension",
         "sliceName": "criticality",
         "definition": "A clinical judgment of potential clinical harm, or seriousness, of a condition. When the worst case result is assessed to have a life-threatening or organ system threatening potential, it is considered to be of high criticality.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -532,6 +550,7 @@
         "path": "Condition.extension",
         "sliceName": "setting",
         "definition": "Description of the place or type of surroundings where something is positioned or where an event takes place.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -564,6 +583,7 @@
         "path": "Condition.extension",
         "sliceName": "location",
         "definition": "A position, site, or point in space where something can be found.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -595,16 +615,19 @@
         "id": "Condition:shr-problem-Injury.modifierExtension",
         "path": "Condition.modifierExtension",
         "slicing": {
-          "id": "32",
+          "id": "30",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -634,6 +657,7 @@
         "path": "Condition.modifierExtension",
         "sliceName": "nonoccurrencemodifier",
         "definition": "When true, indicates either that the event or action documented in the entry did not occur, or the the thing documented is absent or does not exist.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -691,6 +715,7 @@
         "path": "Condition.clinicalStatus",
         "short": "active | recurrence | inactive | remission | resolved",
         "definition": "The clinical status of the condition.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the condition as not currently valid or of concern.",
         "min": 1,
         "max": "1",
         "type": [
@@ -698,9 +723,19 @@
             "code": "code"
           }
         ],
+        "condition": [
+          "con-3",
+          "con-4"
+        ],
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ConditionClinicalStatus"
+            }
+          ],
           "strength": "required",
           "description": "The clinical status of the condition or diagnosis.",
           "valueSetReference": {
@@ -716,6 +751,10 @@
             "identity": "v2",
             "map": "PRB-14 / DG1-6"
           },
+          {
+            "identity": "rim",
+            "map": "Observation ACT\n.inboundRelationship[typeCode=COMP].source[classCode=OBS, code=\"clinicalStatus\", moodCode=EVN].value"
+          },
           {
             "identity": "w5",
             "map": "status"
@@ -727,7 +766,7 @@
         "path": "Condition.verificationStatus",
         "short": "provisional | differential | confirmed | refuted | entered-in-error | unknown",
         "definition": "The verification status to support the clinical status of the condition.",
-        "comments": "verificationStatus is not required.  For example, when a patient has abdominal pain in the ED, there is not likely going to be a verification status.",
+        "comment": "verificationStatus is not required.  For example, when a patient has abdominal pain in the ED, there is not likely going to be a verification status.\n\nThis element is labeled as a modifier because the status contains the code refuted and entered-in-error that mark the Condition as not currently valid.",
         "min": 0,
         "max": "1",
         "type": [
@@ -736,9 +775,18 @@
           }
         ],
         "defaultValueCode": "unknown",
+        "condition": [
+          "con-3"
+        ],
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ConditionVerificationStatus"
+            }
+          ],
           "strength": "required",
           "description": "The verification status to support or decline the clinical status of the condition or diagnosis.",
           "valueSetReference": {
@@ -756,7 +804,7 @@
           },
           {
             "identity": "rim",
-            "map": ".code (pre or post-coordinated in)  Can use valueNegationInd for refuted"
+            "map": "Observation ACT\n.inboundRelationship[typeCode=COMP].source[classCode=OBS, code=\"verificationStatus\", moodCode=EVN].value"
           },
           {
             "identity": "sct-attr",
@@ -773,7 +821,7 @@
         "path": "Condition.category",
         "short": "problem-list-item | encounter-diagnosis",
         "definition": "A category assigned to the condition.",
-        "comments": "The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts.",
+        "comment": "The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts.",
         "min": 0,
         "max": "*",
         "type": [
@@ -785,7 +833,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-problem-ProblemCategoryVS"
+            "reference": "http://standardhealthrecord.org/shr/problem/vs/ProblemCategoryVS"
           }
         },
         "mapping": [
@@ -812,7 +860,7 @@
         "path": "Condition.severity",
         "short": "Subjective severity of condition",
         "definition": "A subjective assessment of the severity of the condition as evaluated by the clinician.",
-        "comments": "Coding of the severity with a terminology is preferred, where possible.",
+        "comment": "Coding of the severity with a terminology is preferred, where possible.",
         "min": 0,
         "max": "1",
         "type": [
@@ -822,6 +870,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ConditionSeverity"
+            }
+          ],
           "strength": "preferred",
           "description": "A subjective assessment of the severity of the condition as evaluated by the clinician.",
           "valueSetReference": {
@@ -856,6 +910,10 @@
         "path": "Condition.code",
         "short": "Identification of the condition, problem or diagnosis",
         "definition": "Identification of the condition, problem or diagnosis.",
+        "requirements": "0..1 to account for primarily narrative only resources.",
+        "alias": [
+          "type"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -866,6 +924,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ConditionKind"
+            }
+          ],
           "strength": "example",
           "description": "Identification of the condition or diagnosis.",
           "valueSetReference": {
@@ -900,7 +964,7 @@
         "path": "Condition.bodySite",
         "short": "Anatomical location, if relevant",
         "definition": "The anatomical location where this condition manifests itself.",
-        "comments": "Only used if not implicit in code found in Condition.code. If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [body-site-instance](extension-body-site-instance.html).  May be a summary code, or a reference to a very precise definition of the location, or both.",
+        "comment": "Only used if not implicit in code found in Condition.code. If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [body-site-instance](extension-body-site-instance.html).  May be a summary code, or a reference to a very precise definition of the location, or both.",
         "min": 0,
         "max": "*",
         "type": [
@@ -913,7 +977,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
           }
         },
         "mapping": [
@@ -937,6 +1001,9 @@
         "short": "Who has the condition?",
         "definition": "Indicates the patient or group who the condition record is associated with.",
         "requirements": "Group is typically used for veterinary or public health use cases.",
+        "alias": [
+          "patient"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -968,9 +1035,12 @@
       {
         "id": "Condition:shr-problem-Injury.context",
         "path": "Condition.context",
-        "short": "Encounter when condition first asserted",
+        "short": "Encounter or episode when condition first asserted",
         "definition": "Encounter during which the condition was first asserted.",
-        "comments": "This record indicates the encounter this particular record is associated with.  In the case of a \"new\" diagnosis reflecting ongoing/revised information about the condition, this might be distinct from the first encounter in which the underlying condition was first \"known\".",
+        "comment": "This record indicates the encounter this particular record is associated with.  In the case of a \"new\" diagnosis reflecting ongoing/revised information about the condition, this might be distinct from the first encounter in which the underlying condition was first \"known\".",
+        "alias": [
+          "encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -983,6 +1053,7 @@
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -1003,7 +1074,7 @@
         "path": "Condition.onset[x]",
         "short": "Estimated or actual date,  date-time, or age",
         "definition": "Estimated or actual date or date-time  the condition began, in the opinion of the clinician.",
-        "comments": "Age is generally used when the patient reports an age at which the Condition began to occur.",
+        "comment": "Age is generally used when the patient reports an age at which the Condition began to occur.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1044,7 +1115,7 @@
         "path": "Condition.abatement[x]",
         "short": "If/when in resolution/remission",
         "definition": "The date or estimated date that the condition resolved or went into remission. This is called \"abatement\" because of the many overloaded connotations associated with \"remission\" or \"resolution\" - Conditions are never really resolved, but they can abate.",
-        "comments": "There is no explicit distinction between resolution and remission because in many cases the distinction is not clear. Age is generally used when the patient reports an age at which the Condition abated.  If there is no abatement element, it is unknown whether the condition has resolved or entered remission; applications and users should generally assume that the condition is still valid.  When abatementString exists, it implies the condition is abated.",
+        "comment": "There is no explicit distinction between resolution and remission because in many cases the distinction is not clear. Age is generally used when the patient reports an age at which the Condition abated.  If there is no abatement element, it is unknown whether the condition has resolved or entered remission; applications and users should generally assume that the condition is still valid.  When abatementString exists, it implies the condition is abated.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1067,6 +1138,9 @@
             "code": "string"
           }
         ],
+        "condition": [
+          "con-4"
+        ],
         "mapping": [
           {
             "identity": "rim",
@@ -1083,14 +1157,15 @@
         "path": "Condition.assertedDate",
         "short": "Date record was believed accurate",
         "definition": "The date on which the existance of the Condition was first asserted or acknowledged.",
-        "comments": "The assertedDate represents the date when this particular Condition record was created in the EHR, not the date of the most recent update in terms of when severity, abatement, etc. were specified.  The date of the last record modification can be retrieved from the resource metadata.",
+        "comment": "The assertedDate represents the date when this particular Condition record was created in the EHR, not the date of the most recent update in terms of when severity, abatement, etc. were specified.  The date of the last record modification can be retrieved from the resource metadata.",
         "min": 1,
         "max": "1",
         "type": [
           {
-            "code": "date"
+            "code": "dateTime"
           }
         ],
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -1211,7 +1286,7 @@
         "path": "Condition.stage.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1240,7 +1315,7 @@
         "path": "Condition.stage.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1286,7 +1361,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-problem-GradeOrStageVS"
+            "reference": "http://standardhealthrecord.org/shr/problem/vs/GradeOrStageVS"
           }
         },
         "mapping": [
@@ -1340,7 +1415,7 @@
         "path": "Condition.evidence",
         "short": "Supporting evidence",
         "definition": "Supporting Evidence / manifestations that are the basis on which this condition is suspected or confirmed.",
-        "comments": "The evidence may be a simple list of coded symptoms/manifestations, or references to observations or formal assessments, or both.",
+        "comment": "The evidence may be a simple list of coded symptoms/manifestations, or references to observations or formal assessments, or both.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1404,7 +1479,7 @@
         "path": "Condition.evidence.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1433,7 +1508,7 @@
         "path": "Condition.evidence.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1466,7 +1541,7 @@
         "short": "Manifestation/symptom",
         "definition": "A manifestation or symptom that led to the recording of this condition.",
         "min": 0,
-        "max": "1",
+        "max": "*",
         "type": [
           {
             "code": "CodeableConcept",
@@ -1476,10 +1551,11 @@
         "condition": [
           "con-2"
         ],
+        "isSummary": true,
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-ManifestationVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/ManifestationVS"
           }
         },
         "mapping": [
@@ -1490,6 +1566,10 @@
           {
             "identity": "rim",
             "map": "[code=\"diagnosis\"].value"
+          },
+          {
+            "identity": "w5",
+            "map": "why"
           }
         ]
       },
@@ -1509,10 +1589,15 @@
         "condition": [
           "con-2"
         ],
+        "isSummary": true,
         "mapping": [
           {
             "identity": "rim",
             "map": ".self"
+          },
+          {
+            "identity": "w5",
+            "map": "why"
           }
         ]
       },
@@ -1711,7 +1796,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-problem-ProblemCategoryVS"
+            "reference": "http://standardhealthrecord.org/shr/problem/vs/ProblemCategoryVS"
           }
         }
       },
@@ -1728,6 +1813,8 @@
       {
         "id": "Condition:shr-problem-Injury.code",
         "path": "Condition.code",
+        "min": 1,
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept",
@@ -1747,7 +1834,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
           }
         }
       },
@@ -1791,7 +1878,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-problem-GradeOrStageVS"
+            "reference": "http://standardhealthrecord.org/shr/problem/vs/GradeOrStageVS"
           }
         }
       },
@@ -1811,7 +1898,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-ManifestationVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/ManifestationVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-problem-Manifestation-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-problem-Manifestation-extension.json
old mode 100755
new mode 100644
index c9cd884..a3e2439
--- a/lib/resources/standard_health_record/StructureDefinition-shr-problem-Manifestation-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-problem-Manifestation-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.problem.Manifestation"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Manifestation Extension",
   "title": "SHR Manifestation Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.734Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.919Z",
   "description": "A complaint or observed (subjective) indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-problem-Manifestation.json b/lib/resources/standard_health_record/StructureDefinition-shr-problem-Manifestation.json
old mode 100755
new mode 100644
index 5649401..0c18e6d
--- a/lib/resources/standard_health_record/StructureDefinition-shr-problem-Manifestation.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-problem-Manifestation.json
@@ -3,7 +3,7 @@
   "id": "shr-problem-Manifestation",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR Manifestation Profile</b></p>\n  <p>A complaint or observed (subjective) indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.problem.Manifestation maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR Manifestation Profile</b></p>\n  <p>A complaint or observed (subjective) indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.problem.Manifestation maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-problem-Manifestation",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.problem.Manifestation"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Manifestation Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.609Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.882Z",
   "description": "A complaint or observed (subjective) indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR Manifestation Profile",
         "definition": "A complaint or observed (subjective) indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-problem-Manifestation.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "27",
+          "id": "25",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -398,6 +435,7 @@
         "path": "Observation.extension",
         "sliceName": "severity",
         "definition": "Degree of severity of a symptom, disorder, or problem.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -430,6 +468,7 @@
         "path": "Observation.extension",
         "sliceName": "bodysite",
         "definition": "Location on or in the body.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -461,16 +500,19 @@
         "id": "Observation:shr-problem-Manifestation.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "28",
+          "id": "26",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -500,6 +542,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -530,8 +573,8 @@
       {
         "id": "Observation:shr-problem-Manifestation.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -540,7 +583,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -555,6 +603,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-problem-Manifestation.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-problem-Manifestation.status",
         "extension": [
@@ -566,6 +671,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -577,6 +683,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -584,6 +696,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -603,8 +723,8 @@
         "path": "Observation.category",
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 0,
         "max": "*",
         "type": [
@@ -614,8 +734,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -637,6 +763,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -649,10 +778,18 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-ManifestationVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/ManifestationVS"
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -661,6 +798,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -672,7 +813,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -696,6 +837,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -711,20 +856,32 @@
         ]
       },
       {
-        "id": "Observation:shr-problem-Manifestation.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-problem-Manifestation.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -744,8 +901,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -759,6 +919,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -778,7 +942,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -830,6 +994,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -849,8 +1017,8 @@
         "path": "Observation.value[x]",
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -863,6 +1031,9 @@
           {
             "code": "string"
           },
+          {
+            "code": "boolean"
+          },
           {
             "code": "Range"
           },
@@ -890,6 +1061,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -897,6 +1076,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -905,7 +1088,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -918,6 +1101,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -925,6 +1114,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -952,6 +1145,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -959,6 +1158,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -966,6 +1169,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -983,6 +1190,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -998,8 +1209,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1008,6 +1218,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -1015,6 +1231,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -1022,6 +1242,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1030,7 +1254,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1041,6 +1265,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1063,7 +1293,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1073,6 +1303,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1080,6 +1314,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1088,7 +1326,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1102,6 +1340,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1109,6 +1351,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1117,7 +1363,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1186,7 +1432,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1215,7 +1461,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1297,30 +1543,82 @@
         ]
       },
       {
-        "id": "Observation:shr-problem-Manifestation.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-problem-Manifestation.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-problem-Manifestation.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1376,8 +1674,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1439,7 +1737,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1468,7 +1766,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1500,7 +1798,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1510,6 +1808,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1560,7 +1864,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1623,7 +1927,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1652,7 +1956,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1694,6 +1998,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1701,6 +2011,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1720,8 +2034,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1758,6 +2072,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1765,6 +2083,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1773,7 +2095,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1786,6 +2108,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1808,7 +2136,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1821,6 +2149,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1828,6 +2162,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1835,6 +2173,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1843,7 +2185,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1971,7 +2313,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-ManifestationVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/ManifestationVS"
           }
         }
       },
@@ -2000,12 +2342,16 @@
         ]
       },
       {
-        "id": "Observation:shr-problem-Manifestation.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-problem-Manifestation.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-problem-MentalHealthProblem.json b/lib/resources/standard_health_record/StructureDefinition-shr-problem-MentalHealthProblem.json
old mode 100755
new mode 100644
index 8ceadcc..e1b4c4d
--- a/lib/resources/standard_health_record/StructureDefinition-shr-problem-MentalHealthProblem.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-problem-MentalHealthProblem.json
@@ -12,8 +12,10 @@
       "value": "shr.problem.MentalHealthProblem"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR MentalHealthProblem Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.673Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.901Z",
   "description": "A problem relating to a person’s psychological and emotional well-being.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "sct-concept",
@@ -107,7 +108,7 @@
             "severity": "error",
             "human": "If condition is abated, then clinicalStatus must be either inactive, resolved, or remission",
             "expression": "abatement.empty() or (abatement as boolean).not()  or clinicalStatus='resolved' or clinicalStatus='remission' or clinicalStatus='inactive'",
-            "xpath": "xpath: not(f:abatementBoolean='true' or (not(exists(f:abatementBoolean)) and exists(*[starts-with(local-name(.), 'abatement')])) or f:clinicalStatus/@value=('resolved', 'remission', 'inactive')"
+            "xpath": "not(f:abatementBoolean='true' or (not(exists(f:abatementBoolean)) and exists(*[starts-with(local-name(.), 'abatement')])) or f:clinicalStatus/@value=('resolved', 'remission', 'inactive'))"
           },
           {
             "key": "con-3",
@@ -145,7 +146,7 @@
         "path": "Condition.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -184,7 +185,7 @@
         "path": "Condition.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -205,7 +206,7 @@
         "path": "Condition.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -225,6 +226,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -239,7 +248,7 @@
         "path": "Condition.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -273,7 +282,7 @@
         "path": "Condition.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -302,16 +311,19 @@
         "id": "Condition:shr-problem-MentalHealthProblem.extension",
         "path": "Condition.extension",
         "slicing": {
-          "id": "33",
+          "id": "31",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -340,6 +352,7 @@
         "path": "Condition.extension",
         "sliceName": "generalizedlikelihood",
         "definition": "Quantitative or qualitative measure of likelihood.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -372,6 +385,7 @@
         "path": "Condition.extension",
         "sliceName": "supportingevidencequality",
         "definition": "An assessment of the quality and/or quantity of the source information that supports judgment.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -404,6 +418,7 @@
         "path": "Condition.extension",
         "sliceName": "includeonproblemlist",
         "definition": "Whether or not to include this problem on the subject's current problem list.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -436,6 +451,7 @@
         "path": "Condition.extension",
         "sliceName": "whenclinicallyrecognized",
         "definition": "The time at which a condition or problem was first identified in a healthcare context.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -468,6 +484,7 @@
         "path": "Condition.extension",
         "sliceName": "preexisting",
         "definition": "If the problem or condition existed before the current episode of care.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -500,6 +517,7 @@
         "path": "Condition.extension",
         "sliceName": "criticality",
         "definition": "A clinical judgment of potential clinical harm, or seriousness, of a condition. When the worst case result is assessed to have a life-threatening or organ system threatening potential, it is considered to be of high criticality.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -531,16 +549,19 @@
         "id": "Condition:shr-problem-MentalHealthProblem.modifierExtension",
         "path": "Condition.modifierExtension",
         "slicing": {
-          "id": "34",
+          "id": "32",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -570,6 +591,7 @@
         "path": "Condition.modifierExtension",
         "sliceName": "nonoccurrencemodifier",
         "definition": "When true, indicates either that the event or action documented in the entry did not occur, or the the thing documented is absent or does not exist.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -627,6 +649,7 @@
         "path": "Condition.clinicalStatus",
         "short": "active | recurrence | inactive | remission | resolved",
         "definition": "The clinical status of the condition.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the condition as not currently valid or of concern.",
         "min": 1,
         "max": "1",
         "type": [
@@ -634,9 +657,19 @@
             "code": "code"
           }
         ],
+        "condition": [
+          "con-3",
+          "con-4"
+        ],
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ConditionClinicalStatus"
+            }
+          ],
           "strength": "required",
           "description": "The clinical status of the condition or diagnosis.",
           "valueSetReference": {
@@ -652,6 +685,10 @@
             "identity": "v2",
             "map": "PRB-14 / DG1-6"
           },
+          {
+            "identity": "rim",
+            "map": "Observation ACT\n.inboundRelationship[typeCode=COMP].source[classCode=OBS, code=\"clinicalStatus\", moodCode=EVN].value"
+          },
           {
             "identity": "w5",
             "map": "status"
@@ -663,7 +700,7 @@
         "path": "Condition.verificationStatus",
         "short": "provisional | differential | confirmed | refuted | entered-in-error | unknown",
         "definition": "The verification status to support the clinical status of the condition.",
-        "comments": "verificationStatus is not required.  For example, when a patient has abdominal pain in the ED, there is not likely going to be a verification status.",
+        "comment": "verificationStatus is not required.  For example, when a patient has abdominal pain in the ED, there is not likely going to be a verification status.\n\nThis element is labeled as a modifier because the status contains the code refuted and entered-in-error that mark the Condition as not currently valid.",
         "min": 0,
         "max": "1",
         "type": [
@@ -672,9 +709,18 @@
           }
         ],
         "defaultValueCode": "unknown",
+        "condition": [
+          "con-3"
+        ],
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ConditionVerificationStatus"
+            }
+          ],
           "strength": "required",
           "description": "The verification status to support or decline the clinical status of the condition or diagnosis.",
           "valueSetReference": {
@@ -692,7 +738,7 @@
           },
           {
             "identity": "rim",
-            "map": ".code (pre or post-coordinated in)  Can use valueNegationInd for refuted"
+            "map": "Observation ACT\n.inboundRelationship[typeCode=COMP].source[classCode=OBS, code=\"verificationStatus\", moodCode=EVN].value"
           },
           {
             "identity": "sct-attr",
@@ -709,7 +755,7 @@
         "path": "Condition.category",
         "short": "problem-list-item | encounter-diagnosis",
         "definition": "A category assigned to the condition.",
-        "comments": "The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts.",
+        "comment": "The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts.",
         "min": 0,
         "max": "*",
         "type": [
@@ -721,7 +767,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-problem-ProblemCategoryVS"
+            "reference": "http://standardhealthrecord.org/shr/problem/vs/ProblemCategoryVS"
           }
         },
         "mapping": [
@@ -748,7 +794,7 @@
         "path": "Condition.severity",
         "short": "Subjective severity of condition",
         "definition": "A subjective assessment of the severity of the condition as evaluated by the clinician.",
-        "comments": "Coding of the severity with a terminology is preferred, where possible.",
+        "comment": "Coding of the severity with a terminology is preferred, where possible.",
         "min": 0,
         "max": "1",
         "type": [
@@ -758,6 +804,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ConditionSeverity"
+            }
+          ],
           "strength": "preferred",
           "description": "A subjective assessment of the severity of the condition as evaluated by the clinician.",
           "valueSetReference": {
@@ -792,6 +844,10 @@
         "path": "Condition.code",
         "short": "Identification of the condition, problem or diagnosis",
         "definition": "Identification of the condition, problem or diagnosis.",
+        "requirements": "0..1 to account for primarily narrative only resources.",
+        "alias": [
+          "type"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -802,10 +858,9 @@
         ],
         "isSummary": true,
         "binding": {
-          "strength": "example",
-          "description": "Identification of the condition or diagnosis.",
+          "strength": "required",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/condition-code"
+            "reference": "http://standardhealthrecord.org/shr/problem/vs/DSMVS"
           }
         },
         "mapping": [
@@ -836,7 +891,7 @@
         "path": "Condition.bodySite",
         "short": "Anatomical location, if relevant",
         "definition": "The anatomical location where this condition manifests itself.",
-        "comments": "Only used if not implicit in code found in Condition.code. If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [body-site-instance](extension-body-site-instance.html).  May be a summary code, or a reference to a very precise definition of the location, or both.",
+        "comment": "Only used if not implicit in code found in Condition.code. If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [body-site-instance](extension-body-site-instance.html).  May be a summary code, or a reference to a very precise definition of the location, or both.",
         "min": 0,
         "max": "*",
         "type": [
@@ -849,7 +904,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
           }
         },
         "mapping": [
@@ -873,6 +928,9 @@
         "short": "Who has the condition?",
         "definition": "Indicates the patient or group who the condition record is associated with.",
         "requirements": "Group is typically used for veterinary or public health use cases.",
+        "alias": [
+          "patient"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -904,9 +962,12 @@
       {
         "id": "Condition:shr-problem-MentalHealthProblem.context",
         "path": "Condition.context",
-        "short": "Encounter when condition first asserted",
+        "short": "Encounter or episode when condition first asserted",
         "definition": "Encounter during which the condition was first asserted.",
-        "comments": "This record indicates the encounter this particular record is associated with.  In the case of a \"new\" diagnosis reflecting ongoing/revised information about the condition, this might be distinct from the first encounter in which the underlying condition was first \"known\".",
+        "comment": "This record indicates the encounter this particular record is associated with.  In the case of a \"new\" diagnosis reflecting ongoing/revised information about the condition, this might be distinct from the first encounter in which the underlying condition was first \"known\".",
+        "alias": [
+          "encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -919,6 +980,7 @@
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -939,7 +1001,7 @@
         "path": "Condition.onset[x]",
         "short": "Estimated or actual date,  date-time, or age",
         "definition": "Estimated or actual date or date-time  the condition began, in the opinion of the clinician.",
-        "comments": "Age is generally used when the patient reports an age at which the Condition began to occur.",
+        "comment": "Age is generally used when the patient reports an age at which the Condition began to occur.",
         "min": 0,
         "max": "1",
         "type": [
@@ -980,7 +1042,7 @@
         "path": "Condition.abatement[x]",
         "short": "If/when in resolution/remission",
         "definition": "The date or estimated date that the condition resolved or went into remission. This is called \"abatement\" because of the many overloaded connotations associated with \"remission\" or \"resolution\" - Conditions are never really resolved, but they can abate.",
-        "comments": "There is no explicit distinction between resolution and remission because in many cases the distinction is not clear. Age is generally used when the patient reports an age at which the Condition abated.  If there is no abatement element, it is unknown whether the condition has resolved or entered remission; applications and users should generally assume that the condition is still valid.  When abatementString exists, it implies the condition is abated.",
+        "comment": "There is no explicit distinction between resolution and remission because in many cases the distinction is not clear. Age is generally used when the patient reports an age at which the Condition abated.  If there is no abatement element, it is unknown whether the condition has resolved or entered remission; applications and users should generally assume that the condition is still valid.  When abatementString exists, it implies the condition is abated.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1003,6 +1065,9 @@
             "code": "string"
           }
         ],
+        "condition": [
+          "con-4"
+        ],
         "mapping": [
           {
             "identity": "rim",
@@ -1019,14 +1084,15 @@
         "path": "Condition.assertedDate",
         "short": "Date record was believed accurate",
         "definition": "The date on which the existance of the Condition was first asserted or acknowledged.",
-        "comments": "The assertedDate represents the date when this particular Condition record was created in the EHR, not the date of the most recent update in terms of when severity, abatement, etc. were specified.  The date of the last record modification can be retrieved from the resource metadata.",
+        "comment": "The assertedDate represents the date when this particular Condition record was created in the EHR, not the date of the most recent update in terms of when severity, abatement, etc. were specified.  The date of the last record modification can be retrieved from the resource metadata.",
         "min": 1,
         "max": "1",
         "type": [
           {
-            "code": "date"
+            "code": "dateTime"
           }
         ],
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -1147,7 +1213,7 @@
         "path": "Condition.stage.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1176,7 +1242,7 @@
         "path": "Condition.stage.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1222,7 +1288,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-problem-GradeOrStageVS"
+            "reference": "http://standardhealthrecord.org/shr/problem/vs/GradeOrStageVS"
           }
         },
         "mapping": [
@@ -1276,7 +1342,7 @@
         "path": "Condition.evidence",
         "short": "Supporting evidence",
         "definition": "Supporting Evidence / manifestations that are the basis on which this condition is suspected or confirmed.",
-        "comments": "The evidence may be a simple list of coded symptoms/manifestations, or references to observations or formal assessments, or both.",
+        "comment": "The evidence may be a simple list of coded symptoms/manifestations, or references to observations or formal assessments, or both.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1340,7 +1406,7 @@
         "path": "Condition.evidence.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1369,7 +1435,7 @@
         "path": "Condition.evidence.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1402,7 +1468,7 @@
         "short": "Manifestation/symptom",
         "definition": "A manifestation or symptom that led to the recording of this condition.",
         "min": 0,
-        "max": "1",
+        "max": "*",
         "type": [
           {
             "code": "CodeableConcept",
@@ -1412,10 +1478,11 @@
         "condition": [
           "con-2"
         ],
+        "isSummary": true,
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-ManifestationVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/ManifestationVS"
           }
         },
         "mapping": [
@@ -1426,6 +1493,10 @@
           {
             "identity": "rim",
             "map": "[code=\"diagnosis\"].value"
+          },
+          {
+            "identity": "w5",
+            "map": "why"
           }
         ]
       },
@@ -1445,10 +1516,15 @@
         "condition": [
           "con-2"
         ],
+        "isSummary": true,
         "mapping": [
           {
             "identity": "rim",
             "map": ".self"
+          },
+          {
+            "identity": "w5",
+            "map": "why"
           }
         ]
       },
@@ -1615,7 +1691,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-problem-ProblemCategoryVS"
+            "reference": "http://standardhealthrecord.org/shr/problem/vs/ProblemCategoryVS"
           }
         }
       },
@@ -1632,12 +1708,20 @@
       {
         "id": "Condition:shr-problem-MentalHealthProblem.code",
         "path": "Condition.code",
+        "min": 1,
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept",
             "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
           }
-        ]
+        ],
+        "binding": {
+          "strength": "required",
+          "valueSetReference": {
+            "reference": "http://standardhealthrecord.org/shr/problem/vs/DSMVS"
+          }
+        }
       },
       {
         "id": "Condition:shr-problem-MentalHealthProblem.bodySite",
@@ -1651,7 +1735,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
           }
         }
       },
@@ -1695,7 +1779,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-problem-GradeOrStageVS"
+            "reference": "http://standardhealthrecord.org/shr/problem/vs/GradeOrStageVS"
           }
         }
       },
@@ -1715,7 +1799,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-ManifestationVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/ManifestationVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-problem-Preexisting-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-problem-Preexisting-extension.json
old mode 100755
new mode 100644
index e3a7e5e..fbe49eb
--- a/lib/resources/standard_health_record/StructureDefinition-shr-problem-Preexisting-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-problem-Preexisting-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.problem.Preexisting"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Preexisting Extension",
   "title": "SHR Preexisting Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.596Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.866Z",
   "description": "If the problem or condition existed before the current episode of care.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-problem-Problem.json b/lib/resources/standard_health_record/StructureDefinition-shr-problem-Problem.json
old mode 100755
new mode 100644
index 37aefe1..0393600
--- a/lib/resources/standard_health_record/StructureDefinition-shr-problem-Problem.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-problem-Problem.json
@@ -12,8 +12,10 @@
       "value": "shr.problem.Problem"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Problem Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.585Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.863Z",
   "description": "A statement about a disorder, abnormality, problem, injury, complaint, functionality, concern, illness, disease, ailment, sickness, affliction, upset, difficulty, disorder, symptom, or trouble. May be used to state the existence or non-existence of a problem.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "sct-concept",
@@ -107,7 +108,7 @@
             "severity": "error",
             "human": "If condition is abated, then clinicalStatus must be either inactive, resolved, or remission",
             "expression": "abatement.empty() or (abatement as boolean).not()  or clinicalStatus='resolved' or clinicalStatus='remission' or clinicalStatus='inactive'",
-            "xpath": "xpath: not(f:abatementBoolean='true' or (not(exists(f:abatementBoolean)) and exists(*[starts-with(local-name(.), 'abatement')])) or f:clinicalStatus/@value=('resolved', 'remission', 'inactive')"
+            "xpath": "not(f:abatementBoolean='true' or (not(exists(f:abatementBoolean)) and exists(*[starts-with(local-name(.), 'abatement')])) or f:clinicalStatus/@value=('resolved', 'remission', 'inactive'))"
           },
           {
             "key": "con-3",
@@ -145,7 +146,7 @@
         "path": "Condition.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -184,7 +185,7 @@
         "path": "Condition.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -205,7 +206,7 @@
         "path": "Condition.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -225,6 +226,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -239,7 +248,7 @@
         "path": "Condition.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -273,7 +282,7 @@
         "path": "Condition.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -302,16 +311,19 @@
         "id": "Condition:shr-problem-Problem.extension",
         "path": "Condition.extension",
         "slicing": {
-          "id": "24",
+          "id": "22",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -340,6 +352,7 @@
         "path": "Condition.extension",
         "sliceName": "generalizedlikelihood",
         "definition": "Quantitative or qualitative measure of likelihood.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -372,6 +385,7 @@
         "path": "Condition.extension",
         "sliceName": "supportingevidencequality",
         "definition": "An assessment of the quality and/or quantity of the source information that supports judgment.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -404,6 +418,7 @@
         "path": "Condition.extension",
         "sliceName": "includeonproblemlist",
         "definition": "Whether or not to include this problem on the subject's current problem list.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -436,6 +451,7 @@
         "path": "Condition.extension",
         "sliceName": "whenclinicallyrecognized",
         "definition": "The time at which a condition or problem was first identified in a healthcare context.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -468,6 +484,7 @@
         "path": "Condition.extension",
         "sliceName": "preexisting",
         "definition": "If the problem or condition existed before the current episode of care.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -500,6 +517,7 @@
         "path": "Condition.extension",
         "sliceName": "criticality",
         "definition": "A clinical judgment of potential clinical harm, or seriousness, of a condition. When the worst case result is assessed to have a life-threatening or organ system threatening potential, it is considered to be of high criticality.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -531,16 +549,19 @@
         "id": "Condition:shr-problem-Problem.modifierExtension",
         "path": "Condition.modifierExtension",
         "slicing": {
-          "id": "25",
+          "id": "23",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -570,6 +591,7 @@
         "path": "Condition.modifierExtension",
         "sliceName": "nonoccurrencemodifier",
         "definition": "When true, indicates either that the event or action documented in the entry did not occur, or the the thing documented is absent or does not exist.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -627,6 +649,7 @@
         "path": "Condition.clinicalStatus",
         "short": "active | recurrence | inactive | remission | resolved",
         "definition": "The clinical status of the condition.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the condition as not currently valid or of concern.",
         "min": 1,
         "max": "1",
         "type": [
@@ -634,9 +657,19 @@
             "code": "code"
           }
         ],
+        "condition": [
+          "con-3",
+          "con-4"
+        ],
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ConditionClinicalStatus"
+            }
+          ],
           "strength": "required",
           "description": "The clinical status of the condition or diagnosis.",
           "valueSetReference": {
@@ -652,6 +685,10 @@
             "identity": "v2",
             "map": "PRB-14 / DG1-6"
           },
+          {
+            "identity": "rim",
+            "map": "Observation ACT\n.inboundRelationship[typeCode=COMP].source[classCode=OBS, code=\"clinicalStatus\", moodCode=EVN].value"
+          },
           {
             "identity": "w5",
             "map": "status"
@@ -663,7 +700,7 @@
         "path": "Condition.verificationStatus",
         "short": "provisional | differential | confirmed | refuted | entered-in-error | unknown",
         "definition": "The verification status to support the clinical status of the condition.",
-        "comments": "verificationStatus is not required.  For example, when a patient has abdominal pain in the ED, there is not likely going to be a verification status.",
+        "comment": "verificationStatus is not required.  For example, when a patient has abdominal pain in the ED, there is not likely going to be a verification status.\n\nThis element is labeled as a modifier because the status contains the code refuted and entered-in-error that mark the Condition as not currently valid.",
         "min": 0,
         "max": "1",
         "type": [
@@ -672,9 +709,18 @@
           }
         ],
         "defaultValueCode": "unknown",
+        "condition": [
+          "con-3"
+        ],
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ConditionVerificationStatus"
+            }
+          ],
           "strength": "required",
           "description": "The verification status to support or decline the clinical status of the condition or diagnosis.",
           "valueSetReference": {
@@ -692,7 +738,7 @@
           },
           {
             "identity": "rim",
-            "map": ".code (pre or post-coordinated in)  Can use valueNegationInd for refuted"
+            "map": "Observation ACT\n.inboundRelationship[typeCode=COMP].source[classCode=OBS, code=\"verificationStatus\", moodCode=EVN].value"
           },
           {
             "identity": "sct-attr",
@@ -709,7 +755,7 @@
         "path": "Condition.category",
         "short": "problem-list-item | encounter-diagnosis",
         "definition": "A category assigned to the condition.",
-        "comments": "The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts.",
+        "comment": "The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts.",
         "min": 0,
         "max": "*",
         "type": [
@@ -721,7 +767,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-problem-ProblemCategoryVS"
+            "reference": "http://standardhealthrecord.org/shr/problem/vs/ProblemCategoryVS"
           }
         },
         "mapping": [
@@ -748,7 +794,7 @@
         "path": "Condition.severity",
         "short": "Subjective severity of condition",
         "definition": "A subjective assessment of the severity of the condition as evaluated by the clinician.",
-        "comments": "Coding of the severity with a terminology is preferred, where possible.",
+        "comment": "Coding of the severity with a terminology is preferred, where possible.",
         "min": 0,
         "max": "1",
         "type": [
@@ -758,6 +804,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ConditionSeverity"
+            }
+          ],
           "strength": "preferred",
           "description": "A subjective assessment of the severity of the condition as evaluated by the clinician.",
           "valueSetReference": {
@@ -792,6 +844,10 @@
         "path": "Condition.code",
         "short": "Identification of the condition, problem or diagnosis",
         "definition": "Identification of the condition, problem or diagnosis.",
+        "requirements": "0..1 to account for primarily narrative only resources.",
+        "alias": [
+          "type"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -802,6 +858,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ConditionKind"
+            }
+          ],
           "strength": "example",
           "description": "Identification of the condition or diagnosis.",
           "valueSetReference": {
@@ -836,7 +898,7 @@
         "path": "Condition.bodySite",
         "short": "Anatomical location, if relevant",
         "definition": "The anatomical location where this condition manifests itself.",
-        "comments": "Only used if not implicit in code found in Condition.code. If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [body-site-instance](extension-body-site-instance.html).  May be a summary code, or a reference to a very precise definition of the location, or both.",
+        "comment": "Only used if not implicit in code found in Condition.code. If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [body-site-instance](extension-body-site-instance.html).  May be a summary code, or a reference to a very precise definition of the location, or both.",
         "min": 0,
         "max": "*",
         "type": [
@@ -849,7 +911,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
           }
         },
         "mapping": [
@@ -873,6 +935,9 @@
         "short": "Who has the condition?",
         "definition": "Indicates the patient or group who the condition record is associated with.",
         "requirements": "Group is typically used for veterinary or public health use cases.",
+        "alias": [
+          "patient"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -904,9 +969,12 @@
       {
         "id": "Condition:shr-problem-Problem.context",
         "path": "Condition.context",
-        "short": "Encounter when condition first asserted",
+        "short": "Encounter or episode when condition first asserted",
         "definition": "Encounter during which the condition was first asserted.",
-        "comments": "This record indicates the encounter this particular record is associated with.  In the case of a \"new\" diagnosis reflecting ongoing/revised information about the condition, this might be distinct from the first encounter in which the underlying condition was first \"known\".",
+        "comment": "This record indicates the encounter this particular record is associated with.  In the case of a \"new\" diagnosis reflecting ongoing/revised information about the condition, this might be distinct from the first encounter in which the underlying condition was first \"known\".",
+        "alias": [
+          "encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -919,6 +987,7 @@
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -939,7 +1008,7 @@
         "path": "Condition.onset[x]",
         "short": "Estimated or actual date,  date-time, or age",
         "definition": "Estimated or actual date or date-time  the condition began, in the opinion of the clinician.",
-        "comments": "Age is generally used when the patient reports an age at which the Condition began to occur.",
+        "comment": "Age is generally used when the patient reports an age at which the Condition began to occur.",
         "min": 0,
         "max": "1",
         "type": [
@@ -980,7 +1049,7 @@
         "path": "Condition.abatement[x]",
         "short": "If/when in resolution/remission",
         "definition": "The date or estimated date that the condition resolved or went into remission. This is called \"abatement\" because of the many overloaded connotations associated with \"remission\" or \"resolution\" - Conditions are never really resolved, but they can abate.",
-        "comments": "There is no explicit distinction between resolution and remission because in many cases the distinction is not clear. Age is generally used when the patient reports an age at which the Condition abated.  If there is no abatement element, it is unknown whether the condition has resolved or entered remission; applications and users should generally assume that the condition is still valid.  When abatementString exists, it implies the condition is abated.",
+        "comment": "There is no explicit distinction between resolution and remission because in many cases the distinction is not clear. Age is generally used when the patient reports an age at which the Condition abated.  If there is no abatement element, it is unknown whether the condition has resolved or entered remission; applications and users should generally assume that the condition is still valid.  When abatementString exists, it implies the condition is abated.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1003,6 +1072,9 @@
             "code": "string"
           }
         ],
+        "condition": [
+          "con-4"
+        ],
         "mapping": [
           {
             "identity": "rim",
@@ -1019,14 +1091,15 @@
         "path": "Condition.assertedDate",
         "short": "Date record was believed accurate",
         "definition": "The date on which the existance of the Condition was first asserted or acknowledged.",
-        "comments": "The assertedDate represents the date when this particular Condition record was created in the EHR, not the date of the most recent update in terms of when severity, abatement, etc. were specified.  The date of the last record modification can be retrieved from the resource metadata.",
+        "comment": "The assertedDate represents the date when this particular Condition record was created in the EHR, not the date of the most recent update in terms of when severity, abatement, etc. were specified.  The date of the last record modification can be retrieved from the resource metadata.",
         "min": 1,
         "max": "1",
         "type": [
           {
-            "code": "date"
+            "code": "dateTime"
           }
         ],
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -1147,7 +1220,7 @@
         "path": "Condition.stage.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1176,7 +1249,7 @@
         "path": "Condition.stage.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1222,7 +1295,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-problem-GradeOrStageVS"
+            "reference": "http://standardhealthrecord.org/shr/problem/vs/GradeOrStageVS"
           }
         },
         "mapping": [
@@ -1276,7 +1349,7 @@
         "path": "Condition.evidence",
         "short": "Supporting evidence",
         "definition": "Supporting Evidence / manifestations that are the basis on which this condition is suspected or confirmed.",
-        "comments": "The evidence may be a simple list of coded symptoms/manifestations, or references to observations or formal assessments, or both.",
+        "comment": "The evidence may be a simple list of coded symptoms/manifestations, or references to observations or formal assessments, or both.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1340,7 +1413,7 @@
         "path": "Condition.evidence.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1369,7 +1442,7 @@
         "path": "Condition.evidence.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1402,7 +1475,7 @@
         "short": "Manifestation/symptom",
         "definition": "A manifestation or symptom that led to the recording of this condition.",
         "min": 0,
-        "max": "1",
+        "max": "*",
         "type": [
           {
             "code": "CodeableConcept",
@@ -1412,10 +1485,11 @@
         "condition": [
           "con-2"
         ],
+        "isSummary": true,
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-ManifestationVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/ManifestationVS"
           }
         },
         "mapping": [
@@ -1426,6 +1500,10 @@
           {
             "identity": "rim",
             "map": "[code=\"diagnosis\"].value"
+          },
+          {
+            "identity": "w5",
+            "map": "why"
           }
         ]
       },
@@ -1445,10 +1523,15 @@
         "condition": [
           "con-2"
         ],
+        "isSummary": true,
         "mapping": [
           {
             "identity": "rim",
             "map": ".self"
+          },
+          {
+            "identity": "w5",
+            "map": "why"
           }
         ]
       },
@@ -1615,7 +1698,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-problem-ProblemCategoryVS"
+            "reference": "http://standardhealthrecord.org/shr/problem/vs/ProblemCategoryVS"
           }
         }
       },
@@ -1632,6 +1715,8 @@
       {
         "id": "Condition:shr-problem-Problem.code",
         "path": "Condition.code",
+        "min": 1,
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept",
@@ -1651,7 +1736,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
           }
         }
       },
@@ -1695,7 +1780,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-problem-GradeOrStageVS"
+            "reference": "http://standardhealthrecord.org/shr/problem/vs/GradeOrStageVS"
           }
         }
       },
@@ -1715,7 +1800,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-ManifestationVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/ManifestationVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-problem-Severity-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-problem-Severity-extension.json
old mode 100755
new mode 100644
index d58c28f..fe689e2
--- a/lib/resources/standard_health_record/StructureDefinition-shr-problem-Severity-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-problem-Severity-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.problem.Severity"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Severity Extension",
   "title": "SHR Severity Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.623Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.884Z",
   "description": "Degree of severity of a symptom, disorder, or problem.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-problem-SupportingEvidenceQuality-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-problem-SupportingEvidenceQuality-extension.json
old mode 100755
new mode 100644
index b4fec0f..1e0f136
--- a/lib/resources/standard_health_record/StructureDefinition-shr-problem-SupportingEvidenceQuality-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-problem-SupportingEvidenceQuality-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.problem.SupportingEvidenceQuality"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR SupportingEvidenceQuality Extension",
   "title": "SHR SupportingEvidenceQuality Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.594Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.865Z",
   "description": "An assessment of the quality and/or quantity of the source information that supports judgment.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -170,7 +170,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-problem-EvidenceQualityVS"
+            "reference": "http://standardhealthrecord.org/shr/problem/vs/EvidenceQualityVS"
           }
         },
         "mapping": [
@@ -221,7 +221,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-problem-EvidenceQualityVS"
+            "reference": "http://standardhealthrecord.org/shr/problem/vs/EvidenceQualityVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-problem-WhenClinicallyRecognized-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-problem-WhenClinicallyRecognized-extension.json
old mode 100755
new mode 100644
index d0d75bd..2e673d1
--- a/lib/resources/standard_health_record/StructureDefinition-shr-problem-WhenClinicallyRecognized-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-problem-WhenClinicallyRecognized-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.problem.WhenClinicallyRecognized"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR WhenClinicallyRecognized Extension",
   "title": "SHR WhenClinicallyRecognized Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.595Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.865Z",
   "description": "The time at which a condition or problem was first identified in a healthcare context.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -105,9 +106,12 @@
         "id": "Extension:whenclinicallyrecognized.extension",
         "path": "Extension.extension",
         "slicing": {
-          "id": "21",
+          "id": "19",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -161,7 +165,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-procedure-Procedure.json b/lib/resources/standard_health_record/StructureDefinition-shr-procedure-Procedure.json
old mode 100755
new mode 100644
index 27c81fe..6360e7c
--- a/lib/resources/standard_health_record/StructureDefinition-shr-procedure-Procedure.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-procedure-Procedure.json
@@ -3,7 +3,7 @@
   "id": "shr-procedure-Procedure",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR Procedure Profile</b></p>\n  <p>An action that is or was performed on a patient. This can be a physical intervention like an operation, or less invasive like counseling or hypnotherapy.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.procedure.Procedure maps to Procedure:\n  ProcedureStatus maps to status\n  NonOccurrenceModifier maps to notPerformed\n  NonOccurrenceModifier.Reason maps to reasonNotPerformed\n  OccurrenceTime.dateTime maps to performed[x].dateTime\n  OccurrenceTime.TimePeriod maps to performed[x].Period\n  ProcedureParticipant maps to performer\n  ProcedureParticipant.PersonOfRecord maps to performer.actor\n  ProcedureParticipant.Practitioner maps to performer.actor\n  ProcedureParticipant.RelatedPerson maps to performer.actor\n  ProcedureParticipant.ParticipationType maps to performer.role\n  Facility maps to location\n  Reason maps to reasonCode\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR Procedure Profile</b></p>\n  <p>An action that is or was performed on a patient. This can be a physical intervention like an operation, or less invasive like counseling or hypnotherapy.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.procedure.Procedure maps to Procedure:\n  ProcedureStatus maps to status\n  NonOccurrenceModifier maps to notDone\n  NonOccurrenceModifier.Reason maps to notDoneReason\n  OccurrenceTime.dateTime maps to performed[x].dateTime\n  OccurrenceTime.TimePeriod maps to performed[x].Period\n  ProcedureParticipant maps to performer\n  ProcedureParticipant.PersonOfRecord maps to performer.actor\n  ProcedureParticipant.Practitioner maps to performer.actor\n  ProcedureParticipant.RelatedPerson maps to performer.actor\n  ProcedureParticipant.ParticipationType maps to performer.role\n  Facility maps to location\n  Reason maps to reasonCode\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-procedure-Procedure",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.procedure.Procedure"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Procedure Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.451Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.318Z",
   "description": "An action that is or was performed on a patient. This can be a physical intervention like an operation, or less invasive like counseling or hypnotherapy.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "rim",
@@ -95,9 +96,9 @@
           {
             "key": "pro-1",
             "severity": "error",
-            "human": "Reason not performed is only permitted if notPerformed indicator is true",
-            "expression": "reasonNotPerformed.empty() or notPerformed = true",
-            "xpath": "not(exists(f:reasonNotPerformed)) or f:notPerformed/@value=true()"
+            "human": "Reason not done is only permitted if notDone indicator is true",
+            "expression": "notDoneReason.empty() or notDone = true",
+            "xpath": "not(exists(f:notDoneReason)) or f:notDone/@value=true()"
           }
         ],
         "mapping": [
@@ -120,7 +121,7 @@
         "path": "Procedure.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -159,7 +160,7 @@
         "path": "Procedure.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -180,7 +181,7 @@
         "path": "Procedure.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -200,6 +201,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -214,7 +223,7 @@
         "path": "Procedure.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -248,7 +257,7 @@
         "path": "Procedure.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -277,16 +286,19 @@
         "id": "Procedure:shr-procedure-Procedure.extension",
         "path": "Procedure.extension",
         "slicing": {
-          "id": "193",
+          "id": "188",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -315,6 +327,7 @@
         "path": "Procedure.extension",
         "sliceName": "codeableconcept",
         "definition": "A set of codes drawn from different coding systems, representing the same concept.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -347,7 +360,7 @@
         "path": "Procedure.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -401,12 +414,106 @@
           }
         ]
       },
+      {
+        "id": "Procedure:shr-procedure-Procedure.definition",
+        "path": "Procedure.definition",
+        "short": "Instantiates protocol or definition",
+        "definition": "A protocol, guideline, orderset or other definition that was adhered to in whole or in part by this procedure.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/PlanDefinition"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ActivityDefinition"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/HealthcareService"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=DEFN].target"
+          }
+        ]
+      },
+      {
+        "id": "Procedure:shr-procedure-Procedure.basedOn",
+        "path": "Procedure.basedOn",
+        "short": "A request for this procedure",
+        "definition": "A reference to a resource that contains details of the request for this procedure.",
+        "alias": [
+          "fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target[classCode=(various e.g. PROC, OBS, PCPR, ACT,  moodCode=RQO].code"
+          }
+        ]
+      },
+      {
+        "id": "Procedure:shr-procedure-Procedure.partOf",
+        "path": "Procedure.partOf",
+        "short": "Part of referenced event",
+        "definition": "A larger event of which this particular procedure is a component or step.",
+        "comment": "The MedicationAdministration has a partOf reference to Procedure, but this is not a circular reference.  For a surgical procedure, the anesthesia related medicationAdministration is part of the procedure.  For an IV medication administration,  the procedure to insert the IV port is part of the medication administration.",
+        "alias": [
+          "container"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Procedure"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Observation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationAdministration"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".inboundRelationship[typeCode=COMP].source[classCode=SBADM or PROC or OBS, moodCode=EVN]"
+          }
+        ]
+      },
       {
         "id": "Procedure:shr-procedure-Procedure.status",
         "path": "Procedure.status",
-        "short": "in-progress | aborted | completed | entered-in-error | unknown",
+        "short": "preparation | in-progress | suspended | aborted | completed | entered-in-error | unknown",
         "definition": "A code specifying the state of the procedure. Generally this will be in-progress or completed state.",
-        "comments": "The unknown code is not to be used to convey other statuses.  The unknown code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the procedure.",
+        "comment": "The unknown code is not to be used to convey other statuses.  The unknown code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the procedure.\n\nThis element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "min": 1,
         "max": "1",
         "type": [
@@ -417,19 +524,89 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ProcedureStatus"
+            }
+          ],
           "strength": "required",
           "description": "A code specifying the state of the procedure.",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/procedure-status"
+            "reference": "http://hl7.org/fhir/ValueSet/event-status"
           }
         },
         "mapping": [
+          {
+            "identity": "rim",
+            "map": "statusCode"
+          },
           {
             "identity": "w5",
             "map": "status"
           }
         ]
       },
+      {
+        "id": "Procedure:shr-procedure-Procedure.notDone",
+        "path": "Procedure.notDone",
+        "short": "True if procedure was not performed as scheduled",
+        "definition": "Set this to true if the record is saying that the procedure was NOT performed.",
+        "comment": "If true, it means the procedure did not occur as described.  Typically it would be accompanied by attributes describing the type of activity.  It might also be accompanied by body site information or time information (i.e. no procedure was done to the left arm or no procedure was done in this 2-year period).  Specifying additional information such as performer, outcome, etc. is generally inappropriate.  For example, it's not that useful to say \"There was no appendectomy done at 12:03pm June 6th by Dr. Smith with a successful outcome\" as it implies that there *could* have been an appendectomy done at any other time, by any other clinician or with any other outcome.\n\nThis element is labeled as a modifier because it indicates that a procedure didn't happen.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "boolean"
+          }
+        ],
+        "defaultValueBoolean": false,
+        "isModifier": true,
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".actionNegationInd"
+          }
+        ]
+      },
+      {
+        "id": "Procedure:shr-procedure-Procedure.notDoneReason",
+        "path": "Procedure.notDoneReason",
+        "short": "Reason procedure was not performed",
+        "definition": "A code indicating why the procedure was not performed.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+          }
+        ],
+        "condition": [
+          "pro-1"
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ProcedureNegationReason"
+            }
+          ],
+          "strength": "example",
+          "description": "A code that identifies the reason a procedure was not performed.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/procedure-not-performed-reason"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".reason.Observation.value"
+          }
+        ]
+      },
       {
         "id": "Procedure:shr-procedure-Procedure.category",
         "path": "Procedure.category",
@@ -444,6 +621,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ProcedureCategory"
+            }
+          ],
           "strength": "example",
           "description": "A code that classifies a procedure for searching, sorting and display purposes.",
           "valueSetReference": {
@@ -466,7 +649,11 @@
         "path": "Procedure.code",
         "short": "Identification of the procedure",
         "definition": "The specific procedure that is performed. Use text if the exact nature of the procedure cannot be coded (e.g. \"Laparoscopic Appendectomy\").",
-        "min": 1,
+        "requirements": "0..1 to account for primarily narrative only resources.",
+        "alias": [
+          "type"
+        ],
+        "min": 0,
         "max": "1",
         "type": [
           {
@@ -475,6 +662,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ProcedureCode"
+            }
+          ],
           "strength": "example",
           "description": "A code to identify a specific procedure .",
           "valueSetReference": {
@@ -501,6 +694,9 @@
         "path": "Procedure.subject",
         "short": "Who the procedure was performed on",
         "definition": "The person, animal or group on which the procedure was performed.",
+        "alias": [
+          "patient"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -530,16 +726,23 @@
         ]
       },
       {
-        "id": "Procedure:shr-procedure-Procedure.encounter",
-        "path": "Procedure.encounter",
-        "short": "The encounter associated with the procedure",
+        "id": "Procedure:shr-procedure-Procedure.context",
+        "path": "Procedure.context",
+        "short": "Encounter or episode associated with the procedure",
         "definition": "The encounter during which the procedure was performed.",
+        "alias": [
+          "encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "isSummary": true,
@@ -616,7 +819,7 @@
         "mapping": [
           {
             "identity": "rim",
-            "map": ".participation[typeCode=PFM]"
+            "map": ".participation[typeCode=PRF]"
           }
         ]
       },
@@ -652,7 +855,7 @@
         "path": "Procedure.performer.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -681,7 +884,7 @@
         "path": "Procedure.performer.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -708,12 +911,44 @@
           }
         ]
       },
+      {
+        "id": "Procedure:shr-procedure-Procedure.performer.role",
+        "path": "Procedure.performer.role",
+        "short": "The role the actor was in",
+        "definition": "For example: surgeon, anaethetist, endoscopist.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "strength": "required",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/v3-ParticipationType"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "v2",
+            "map": "Some combination of STF-18 / PRA-3 / PRT-4 / ROL-3 / ORC-12 / OBR-16 / PV1-7 / PV1-8 / PV1-9 / PV1-17 / OBX-25"
+          },
+          {
+            "identity": "rim",
+            "map": ".functionCode"
+          }
+        ]
+      },
       {
         "id": "Procedure:shr-procedure-Procedure.performer.actor",
         "path": "Procedure.performer.actor",
         "short": "The reference to the practitioner",
         "definition": "The practitioner who was involved in the procedure.",
-        "min": 0,
+        "requirements": "A reference to Device supports use cases, such as pacemakers.",
+        "min": 1,
         "max": "1",
         "type": [
           {
@@ -731,6 +966,10 @@
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-actor-RelatedPerson"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Device"
           }
         ],
         "isSummary": true,
@@ -750,33 +989,23 @@
         ]
       },
       {
-        "id": "Procedure:shr-procedure-Procedure.performer.role",
-        "path": "Procedure.performer.role",
-        "short": "The role the actor was in",
-        "definition": "For example: surgeon, anaethetist, endoscopist.",
+        "id": "Procedure:shr-procedure-Procedure.performer.onBehalfOf",
+        "path": "Procedure.performer.onBehalfOf",
+        "short": "Organization the device or practitioner was acting for",
+        "definition": "The organization the device or practitioner was acting on behalf of.",
+        "requirements": "Practitioners and Devices can be associated with multiple organizations.  This element indicates which organization they were acting on behalf of when performing the action.",
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "CodeableConcept",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
           }
         ],
-        "isSummary": true,
-        "binding": {
-          "strength": "required",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/v3-ParticipationType"
-          }
-        },
         "mapping": [
-          {
-            "identity": "v2",
-            "map": "Some combination of STF-18 / PRA-3 / PRT-4 / ROL-3 / ORC-12 / OBR-16 / PV1-7 / PV1-8 / PV1-9 / PV1-17 / OBX-25"
-          },
           {
             "identity": "rim",
-            "map": ".functionCode"
+            "map": ".scoper"
           }
         ]
       },
@@ -795,36 +1024,14 @@
           }
         ],
         "isSummary": true,
-        "mapping": [
-          {
-            "identity": "w5",
-            "map": "where"
-          }
-        ]
-      },
-      {
-        "id": "Procedure:shr-procedure-Procedure.reasonReference",
-        "path": "Procedure.reasonReference",
-        "short": "Condition that is the reason the procedure performed",
-        "definition": "The condition that is the reason why the procedure was performed.",
-        "comments": "e.g. endoscopy for dilatation and biopsy, combination diagnosis and therapeutic.",
-        "min": 0,
-        "max": "*",
-        "type": [
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Condition"
-          }
-        ],
-        "isSummary": true,
         "mapping": [
           {
             "identity": "rim",
-            "map": ".reasonCode"
+            "map": ".participation[typeCode=LOC].role[classCode=SDLOC]"
           },
           {
             "identity": "w5",
-            "map": "why"
+            "map": "where"
           }
         ]
       },
@@ -843,6 +1050,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ProcedureReason"
+            }
+          ],
           "strength": "example",
           "description": "A code that identifies the reason a procedure is  required.",
           "valueSetReference": {
@@ -861,55 +1074,32 @@
         ]
       },
       {
-        "id": "Procedure:shr-procedure-Procedure.notPerformed",
-        "path": "Procedure.notPerformed",
-        "short": "True if procedure was not performed as scheduled",
-        "definition": "Set this to true if the record is saying that the procedure was NOT performed.",
-        "comments": "If true, it means the procedure did not occur as described.  Typically it would be accompanied by attributes describing the type of activity.  It might also be accompanied by body site information or time information (i.e. no procedure was done to the left arm or no procedure was done in this 2-year period).  Specifying additional information such as performer, outcome, etc. is generally inappropriate.  For example, it's not that useful to say \"There was no appendectomy done at 12:03pm June 6th by Dr. Smith with a successful outcome\" as it implies that there *could* have been an appendectomy done at any other time, by any other clinician or with any other outcome.",
+        "id": "Procedure:shr-procedure-Procedure.reasonReference",
+        "path": "Procedure.reasonReference",
+        "short": "Condition that is the reason the procedure performed",
+        "definition": "The condition that is the reason why the procedure was performed.",
+        "comment": "e.g. endoscopy for dilatation and biopsy, combination diagnosis and therapeutic.",
         "min": 0,
-        "max": "1",
+        "max": "*",
         "type": [
           {
-            "code": "boolean"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Condition"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Observation"
           }
         ],
-        "defaultValueBoolean": false,
-        "isModifier": true,
         "isSummary": true,
         "mapping": [
           {
             "identity": "rim",
-            "map": ".actionNegationInd"
-          }
-        ]
-      },
-      {
-        "id": "Procedure:shr-procedure-Procedure.reasonNotPerformed",
-        "path": "Procedure.reasonNotPerformed",
-        "short": "Reason procedure was not performed",
-        "definition": "A code indicating why the procedure was not performed.",
-        "min": 0,
-        "max": "1",
-        "type": [
-          {
-            "code": "CodeableConcept",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
-          }
-        ],
-        "condition": [
-          "pro-1"
-        ],
-        "binding": {
-          "strength": "example",
-          "description": "A code that identifies the reason a procedure was not performed.",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/procedure-not-performed-reason"
-          }
-        },
-        "mapping": [
+            "map": ".reasonCode"
+          },
           {
-            "identity": "rim",
-            "map": ".reason.Observation.value"
+            "identity": "w5",
+            "map": "why"
           }
         ]
       },
@@ -927,6 +1117,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -949,7 +1145,7 @@
         "path": "Procedure.outcome",
         "short": "The result of procedure",
         "definition": "The outcome of the procedure - did it resolve reasons for the procedure being performed?",
-        "comments": "If outcome contains narrative text only, it can be captured using the CodeableConcept.text.",
+        "comment": "If outcome contains narrative text only, it can be captured using the CodeableConcept.text.",
         "min": 0,
         "max": "1",
         "type": [
@@ -959,6 +1155,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ProcedureOutcome"
+            }
+          ],
           "strength": "example",
           "description": "An outcome of a procedure - whether it was resolved or otherwise.",
           "valueSetReference": {
@@ -977,7 +1179,7 @@
         "path": "Procedure.report",
         "short": "Any report resulting from the procedure",
         "definition": "This could be a histology result, pathology report, surgical report, etc..",
-        "comments": "There could potentially be multiple reports - e.g. if this was a procedure which took multiple biopsies resulting in a number of anatomical pathology reports.",
+        "comment": "There could potentially be multiple reports - e.g. if this was a procedure which took multiple biopsies resulting in a number of anatomical pathology reports.",
         "min": 0,
         "max": "*",
         "type": [
@@ -998,7 +1200,7 @@
         "path": "Procedure.complication",
         "short": "Complication following the procedure",
         "definition": "Any complications that occurred during the procedure, or in the immediate post-performance period. These are generally tracked separately from the notes, which will typically describe the procedure itself rather than any 'post procedure' issues.",
-        "comments": "If complications are only expressed by the narrative text, they can be captured using the CodeableConcept.text.",
+        "comment": "If complications are only expressed by the narrative text, they can be captured using the CodeableConcept.text.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1007,6 +1209,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ProcedureComplication"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing complications that resulted from a procedure.",
           "valueSetReference": {
@@ -1016,7 +1224,28 @@
         "mapping": [
           {
             "identity": "rim",
-            "map": "Need specialization of OUT for this."
+            "map": ".outboundRelationship[typeCode=OUTC].target[classCode=OBS, code=\"complication\", moodCode=EVN].value"
+          }
+        ]
+      },
+      {
+        "id": "Procedure:shr-procedure-Procedure.complicationDetail",
+        "path": "Procedure.complicationDetail",
+        "short": "A condition that is a result of the procedure",
+        "definition": "Any complications that occurred during the procedure, or in the immediate post-performance period.",
+        "requirements": "This is used to document a condition that is a result of the procedure, not the condition that was the reason for the procedure.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Condition"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=OUTC].target[classCode=OBS, code=\"complication\", moodCode=EVN].value"
           }
         ]
       },
@@ -1033,6 +1262,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ProcedureFollowUp"
+            }
+          ],
           "strength": "example",
           "description": "Specific follow up required for a procedure e.g. removal of sutures.",
           "valueSetReference": {
@@ -1047,34 +1282,8 @@
         ]
       },
       {
-        "id": "Procedure:shr-procedure-Procedure.request",
-        "path": "Procedure.request",
-        "short": "A request for this procedure",
-        "definition": "A reference to a resource that contains details of the request for this procedure.",
-        "min": 0,
-        "max": "1",
-        "type": [
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
-          },
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DiagnosticRequest"
-          },
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
-          },
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
-          }
-        ]
-      },
-      {
-        "id": "Procedure:shr-procedure-Procedure.notes",
-        "path": "Procedure.notes",
+        "id": "Procedure:shr-procedure-Procedure.note",
+        "path": "Procedure.note",
         "short": "Additional information about the procedure",
         "definition": "Any other notes about the procedure.  E.g. the operative notes.",
         "min": 0,
@@ -1116,6 +1325,12 @@
             "xpath": "@value|f:*|h:div",
             "source": "Element"
           }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".participation[typeCode=DEV].role[classCode=MANU]"
+          }
         ]
       },
       {
@@ -1150,7 +1365,7 @@
         "path": "Procedure.focalDevice.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1179,7 +1394,7 @@
         "path": "Procedure.focalDevice.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1219,12 +1434,24 @@
           }
         ],
         "binding": {
-          "strength": "required",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "DeviceActionKind"
+            }
+          ],
+          "strength": "preferred",
           "description": "A kind of change that happened to the device during the procedure.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/device-action"
           }
-        }
+        },
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=\"procedure device action\"].value=:procedure device action codes"
+          }
+        ]
       },
       {
         "id": "Procedure:shr-procedure-Procedure.focalDevice.manipulated",
@@ -1238,6 +1465,12 @@
             "code": "Reference",
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/Device"
           }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".participation[typeCode=DEV].role[classCode=SDLOC]"
+          }
         ]
       },
       {
@@ -1245,7 +1478,7 @@
         "path": "Procedure.usedReference",
         "short": "Items used during procedure",
         "definition": "Identifies medications, devices and any other substance used as part of the procedure.",
-        "comments": "For devices actually implanted or removed, use Procedure.device.",
+        "comment": "For devices actually implanted or removed, use Procedure.device.",
         "requirements": "Used for tracking contamination, etc.",
         "min": 0,
         "max": "*",
@@ -1262,6 +1495,12 @@
             "code": "Reference",
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/Substance"
           }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".participation[typeCode=DEV].role[classCode=MANU] or\n.participation[typeCode=CSM].role[classCode=ADMM] (for Medication or Substance)"
+          }
         ]
       },
       {
@@ -1269,7 +1508,7 @@
         "path": "Procedure.usedCode",
         "short": "Coded items used during the procedure",
         "definition": "Identifies coded items that were used as part of the procedure.",
-        "comments": "For devices actually implanted or removed, use Procedure.device.",
+        "comment": "For devices actually implanted or removed, use Procedure.device.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1278,29 +1517,22 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ProcedureUsed"
+            }
+          ],
           "strength": "example",
-          "description": "Codes describing items used during a procedure"
-        }
-      },
-      {
-        "id": "Procedure:shr-procedure-Procedure.component",
-        "path": "Procedure.component",
-        "short": "Events related to the procedure",
-        "definition": "Identifies medication administrations, other procedures or observations that are related to this procedure.",
-        "min": 0,
-        "max": "*",
-        "type": [
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationAdministration"
-          },
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Procedure"
-          },
+          "description": "Codes describing items used during a procedure",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/device-kind"
+          }
+        },
+        "mapping": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Observation"
+            "identity": "rim",
+            "map": "participation[typeCode=Dev].role[classCode=MANU]"
           }
         ]
       }
@@ -1330,6 +1562,16 @@
         "isModifier": false,
         "isSummary": false
       },
+      {
+        "id": "Procedure:shr-procedure-Procedure.notDoneReason",
+        "path": "Procedure.notDoneReason",
+        "type": [
+          {
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+          }
+        ]
+      },
       {
         "id": "Procedure:shr-procedure-Procedure.performed[x]",
         "path": "Procedure.performed[x]",
@@ -1347,6 +1589,22 @@
         "id": "Procedure:shr-procedure-Procedure.performer",
         "path": "Procedure.performer"
       },
+      {
+        "id": "Procedure:shr-procedure-Procedure.performer.role",
+        "path": "Procedure.performer.role",
+        "type": [
+          {
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+          }
+        ],
+        "binding": {
+          "strength": "required",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/v3-ParticipationType"
+          }
+        }
+      },
       {
         "id": "Procedure:shr-procedure-Procedure.performer.actor",
         "path": "Procedure.performer.actor",
@@ -1366,24 +1624,12 @@
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-actor-RelatedPerson"
-          }
-        ]
-      },
-      {
-        "id": "Procedure:shr-procedure-Procedure.performer.role",
-        "path": "Procedure.performer.role",
-        "type": [
+          },
           {
-            "code": "CodeableConcept",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
-          }
-        ],
-        "binding": {
-          "strength": "required",
-          "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/v3-ParticipationType"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Device"
           }
-        }
+        ]
       },
       {
         "id": "Procedure:shr-procedure-Procedure.location",
@@ -1404,18 +1650,6 @@
             "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
           }
         ]
-      },
-      {
-        "id": "Procedure:shr-procedure-Procedure.reasonNotPerformed",
-        "path": "Procedure.reasonNotPerformed",
-        "min": 0,
-        "max": "1",
-        "type": [
-          {
-            "code": "CodeableConcept",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
-          }
-        ]
       }
     ]
   }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-sex-ContraceptiveMethodRecommendation.json b/lib/resources/standard_health_record/StructureDefinition-shr-sex-ContraceptiveMethodRecommendation.json
old mode 100755
new mode 100644
index ceace80..6265941
--- a/lib/resources/standard_health_record/StructureDefinition-shr-sex-ContraceptiveMethodRecommendation.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-sex-ContraceptiveMethodRecommendation.json
@@ -12,8 +12,10 @@
       "value": "shr.sex.ContraceptiveMethodRecommendation"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ContraceptiveMethodRecommendation Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.035Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,10 +27,9 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.488Z",
   "description": "The contraceptive method(s) recommended or prescribed by a provider, after counseling and assessment. More than one method can be selected, if applicable. .",
   "purpose": "Need some way to safely (without breaking interoperability) allow implementers to exchange content not supported by the initial set of declared resources.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "rim",
@@ -114,7 +115,7 @@
         "path": "Basic.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -153,7 +154,7 @@
         "path": "Basic.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -174,7 +175,7 @@
         "path": "Basic.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -194,6 +195,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -208,7 +217,7 @@
         "path": "Basic.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -242,7 +251,7 @@
         "path": "Basic.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -271,16 +280,19 @@
         "id": "Basic:shr-sex-ContraceptiveMethodRecommendation.extension",
         "path": "Basic.extension",
         "slicing": {
-          "id": "252",
+          "id": "242",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -309,6 +321,7 @@
         "path": "Basic.extension",
         "sliceName": "codeableconcept",
         "definition": "A set of codes drawn from different coding systems, representing the same concept.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -332,7 +345,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-sex-ContraceptiveMethodVS"
+            "reference": "http://standardhealthrecord.org/shr/sex/vs/ContraceptiveMethodVS"
           }
         },
         "mapping": [
@@ -347,6 +360,7 @@
         "path": "Basic.extension",
         "sliceName": "reasonfornotrecommendingcontraceptive",
         "definition": "If not using a method of contraception, why.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -379,6 +393,7 @@
         "path": "Basic.extension",
         "sliceName": "dispensed",
         "definition": "Whether an item, such as a medication or device, was given to a subject.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -411,7 +426,7 @@
         "path": "Basic.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -465,8 +480,8 @@
         "path": "Basic.code",
         "short": "Kind of Resource",
         "definition": "Identifies the 'type' of resource - equivalent to the resource name for other resources.",
-        "comments": "Because resource references will only be able to indicate 'Basic', the type of reference will need to be specified in a Profile identified as part of the resource.  Refer to the resource notes section for information on appropriate terminologies for this code.",
-        "requirements": "Must be able to distinguish different types of \"basic\" resources.",
+        "comment": "Because resource references will only be able to indicate 'Basic', the type of reference will need to be specified in a Profile identified as part of the resource.  Refer to the resource notes section for information on appropriate terminologies for this code.\n\nThis element is labeled as a modifier because the it defines the meaning of the resource and cannot be ignored.",
+        "requirements": "Must be able to distinguish different types of Basic resources.",
         "min": 1,
         "max": "1",
         "type": [
@@ -485,6 +500,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BasicResourceType"
+            }
+          ],
           "strength": "example",
           "description": "Codes for identifying types of resources not yet defined by FHIR",
           "valueSetReference": {
@@ -507,7 +528,7 @@
         "path": "Basic.subject",
         "short": "Identifies the focus of this resource",
         "definition": "Identifies the patient, practitioner, device or any other resource that is the \"focus\" of this resource.",
-        "comments": "Optional as not all resources potential resources will have subjects.  Resources associated with multiple subjects can handle this via extension.",
+        "comment": "Optional as not all potential resources will have subjects.  Resources associated with multiple subjects can handle this via extension.",
         "requirements": "Needed for partitioning the resource by Patient.",
         "min": 0,
         "max": "1",
@@ -616,7 +637,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-sex-ContraceptiveMethodVS"
+            "reference": "http://standardhealthrecord.org/shr/sex/vs/ContraceptiveMethodVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-sex-ContraceptiveMethodsUsed.json b/lib/resources/standard_health_record/StructureDefinition-shr-sex-ContraceptiveMethodsUsed.json
old mode 100755
new mode 100644
index 370f25b..84ebb39
--- a/lib/resources/standard_health_record/StructureDefinition-shr-sex-ContraceptiveMethodsUsed.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-sex-ContraceptiveMethodsUsed.json
@@ -3,7 +3,7 @@
   "id": "shr-sex-ContraceptiveMethodsUsed",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR ContraceptiveMethodsUsed Profile</b></p>\n  <p>The method or methods of contraception used.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.sex.ContraceptiveMethodsUsed maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR ContraceptiveMethodsUsed Profile</b></p>\n  <p>The method or methods of contraception used.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.sex.ContraceptiveMethodsUsed maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-sex-ContraceptiveMethodsUsed",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.sex.ContraceptiveMethodsUsed"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ContraceptiveMethodsUsed Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.014Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.485Z",
   "description": "The method or methods of contraception used.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR ContraceptiveMethodsUsed Profile",
         "definition": "The method or methods of contraception used.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-sex-ContraceptiveMethodsUsed.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "250",
+          "id": "240",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "codeableconcept",
         "definition": "A set of codes drawn from different coding systems, representing the same concept.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -357,7 +393,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-sex-ContraceptiveMethodVS"
+            "reference": "http://standardhealthrecord.org/shr/sex/vs/ContraceptiveMethodVS"
           }
         },
         "mapping": [
@@ -372,6 +408,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -404,6 +441,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -435,16 +473,19 @@
         "id": "Observation:shr-sex-ContraceptiveMethodsUsed.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "251",
+          "id": "241",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -474,6 +515,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -504,8 +546,8 @@
       {
         "id": "Observation:shr-sex-ContraceptiveMethodsUsed.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -514,7 +556,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -529,6 +576,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-sex-ContraceptiveMethodsUsed.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-sex-ContraceptiveMethodsUsed.status",
         "extension": [
@@ -540,6 +644,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -551,6 +656,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -558,6 +669,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -577,8 +696,8 @@
         "path": "Observation.category",
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 0,
         "max": "*",
         "type": [
@@ -588,8 +707,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -611,6 +736,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -629,6 +757,12 @@
         },
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -636,6 +770,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -644,6 +786,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -655,7 +801,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -679,6 +825,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -694,20 +844,32 @@
         ]
       },
       {
-        "id": "Observation:shr-sex-ContraceptiveMethodsUsed.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-sex-ContraceptiveMethodsUsed.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -727,8 +889,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -742,6 +907,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -761,7 +930,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -813,6 +982,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -832,8 +1005,8 @@
         "path": "Observation.value[x]",
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -846,6 +1019,9 @@
           {
             "code": "string"
           },
+          {
+            "code": "boolean"
+          },
           {
             "code": "Range"
           },
@@ -873,6 +1049,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -880,6 +1064,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -888,7 +1076,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -901,6 +1089,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -908,6 +1102,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -935,6 +1133,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -942,6 +1146,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -949,6 +1157,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -966,6 +1178,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -981,8 +1197,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -991,6 +1206,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -998,6 +1219,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -1005,6 +1230,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1013,7 +1242,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1024,6 +1253,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1046,7 +1281,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1056,6 +1291,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1063,6 +1302,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1071,7 +1314,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1085,6 +1328,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1092,6 +1339,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1100,7 +1351,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1169,7 +1420,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1198,7 +1449,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1280,30 +1531,82 @@
         ]
       },
       {
-        "id": "Observation:shr-sex-ContraceptiveMethodsUsed.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-sex-ContraceptiveMethodsUsed.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-sex-ContraceptiveMethodsUsed.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1359,8 +1662,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1422,7 +1725,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1451,7 +1754,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1483,7 +1786,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1493,6 +1796,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1543,7 +1852,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1606,7 +1915,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1635,7 +1944,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1677,6 +1986,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1684,6 +1999,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1703,8 +2022,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1741,6 +2060,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1748,6 +2071,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1756,7 +2083,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1769,6 +2096,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1791,7 +2124,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1804,6 +2137,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1811,6 +2150,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1818,6 +2161,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1826,7 +2173,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1870,7 +2217,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-sex-ContraceptiveMethodVS"
+            "reference": "http://standardhealthrecord.org/shr/sex/vs/ContraceptiveMethodVS"
           }
         }
       },
@@ -1975,12 +2322,16 @@
         ]
       },
       {
-        "id": "Observation:shr-sex-ContraceptiveMethodsUsed.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-sex-ContraceptiveMethodsUsed.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-sex-CurrentPregnancyStatus-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-sex-CurrentPregnancyStatus-extension.json
old mode 100755
new mode 100644
index f37ecc1..4425211
--- a/lib/resources/standard_health_record/StructureDefinition-shr-sex-CurrentPregnancyStatus-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-sex-CurrentPregnancyStatus-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.sex.CurrentPregnancyStatus"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR CurrentPregnancyStatus Extension",
   "title": "SHR CurrentPregnancyStatus Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.051Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.493Z",
   "description": "Whether or not the subject is currently pregnant.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-sex-DifficultyWithIntercourse-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-sex-DifficultyWithIntercourse-extension.json
old mode 100755
new mode 100644
index 08d954f..1553b9f
--- a/lib/resources/standard_health_record/StructureDefinition-shr-sex-DifficultyWithIntercourse-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-sex-DifficultyWithIntercourse-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.sex.DifficultyWithIntercourse"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR DifficultyWithIntercourse Extension",
   "title": "SHR DifficultyWithIntercourse Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.007Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.478Z",
   "description": "Problem with sexual intercourse.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -170,7 +170,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-sex-DifficultyWithIntercourseVS"
+            "reference": "http://standardhealthrecord.org/shr/sex/vs/DifficultyWithIntercourseVS"
           }
         },
         "mapping": [
@@ -221,7 +221,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-sex-DifficultyWithIntercourseVS"
+            "reference": "http://standardhealthrecord.org/shr/sex/vs/DifficultyWithIntercourseVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-sex-Dispensed-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-sex-Dispensed-extension.json
old mode 100755
new mode 100644
index 64e8550..daef355
--- a/lib/resources/standard_health_record/StructureDefinition-shr-sex-Dispensed-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-sex-Dispensed-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.sex.Dispensed"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR Dispensed Extension",
   "title": "SHR Dispensed Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.035Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.489Z",
   "description": "Whether an item, such as a medication or device, was given to a subject.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-sex-GenderIdentity-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-sex-GenderIdentity-extension.json
old mode 100755
new mode 100644
index 26248e5..342efaf
--- a/lib/resources/standard_health_record/StructureDefinition-shr-sex-GenderIdentity-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-sex-GenderIdentity-extension.json
@@ -3,7 +3,7 @@
   "id": "shr-sex-GenderIdentity-extension",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR GenderIdentity Extension</b></p>\n  <p>Subjective personal perception of one&#039;s own gender, which can be male, female, a blend of both, or neither.</p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR GenderIdentity Extension</b></p>\n  <p>Subjective personal perception of one's own gender, which can be male, female, a blend of both, or neither.</p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-sex-GenderIdentity-extension",
   "identifier": [
@@ -12,9 +12,11 @@
       "value": "shr.sex.GenderIdentity"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR GenderIdentity Extension",
   "title": "SHR GenderIdentity Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.965Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.467Z",
   "description": "Subjective personal perception of one's own gender, which can be male, female, a blend of both, or neither.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-sex-GenderIdentity.json b/lib/resources/standard_health_record/StructureDefinition-shr-sex-GenderIdentity.json
old mode 100755
new mode 100644
index 0951965..336a205
--- a/lib/resources/standard_health_record/StructureDefinition-shr-sex-GenderIdentity.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-sex-GenderIdentity.json
@@ -3,7 +3,7 @@
   "id": "shr-sex-GenderIdentity",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR GenderIdentity Profile</b></p>\n  <p>Subjective personal perception of one&#039;s own gender, which can be male, female, a blend of both, or neither.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.sex.GenderIdentity maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR GenderIdentity Profile</b></p>\n  <p>Subjective personal perception of one's own gender, which can be male, female, a blend of both, or neither.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.sex.GenderIdentity maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-sex-GenderIdentity",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.sex.GenderIdentity"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR GenderIdentity Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.971Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.474Z",
   "description": "Subjective personal perception of one's own gender, which can be male, female, a blend of both, or neither.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR GenderIdentity Profile",
         "definition": "Subjective personal perception of one's own gender, which can be male, female, a blend of both, or neither.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-sex-GenderIdentity.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "247",
+          "id": "237",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "codeableconcept",
         "definition": "A set of codes drawn from different coding systems, representing the same concept.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -357,7 +393,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-sex-GenderIdentityVS"
+            "reference": "http://standardhealthrecord.org/shr/sex/vs/GenderIdentityVS"
           }
         },
         "mapping": [
@@ -372,6 +408,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -404,6 +441,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -435,16 +473,19 @@
         "id": "Observation:shr-sex-GenderIdentity.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "248",
+          "id": "238",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -474,6 +515,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -504,8 +546,8 @@
       {
         "id": "Observation:shr-sex-GenderIdentity.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -514,7 +556,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -529,6 +576,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-sex-GenderIdentity.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-sex-GenderIdentity.status",
         "extension": [
@@ -540,6 +644,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -551,6 +656,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -558,6 +669,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -577,8 +696,8 @@
         "path": "Observation.category",
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 0,
         "max": "*",
         "type": [
@@ -588,8 +707,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -611,6 +736,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -621,6 +749,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -628,6 +762,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -636,6 +778,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -647,7 +793,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -671,6 +817,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -686,20 +836,32 @@
         ]
       },
       {
-        "id": "Observation:shr-sex-GenderIdentity.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-sex-GenderIdentity.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -719,8 +881,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -734,6 +899,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -753,7 +922,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -805,6 +974,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -824,8 +997,8 @@
         "path": "Observation.value[x]",
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -838,6 +1011,9 @@
           {
             "code": "string"
           },
+          {
+            "code": "boolean"
+          },
           {
             "code": "Range"
           },
@@ -865,6 +1041,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -872,6 +1056,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -880,7 +1068,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -893,6 +1081,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -900,6 +1094,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -927,6 +1125,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -934,6 +1138,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -941,6 +1149,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -958,6 +1170,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -973,8 +1189,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -983,6 +1198,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -990,6 +1211,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -997,6 +1222,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1005,7 +1234,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1016,6 +1245,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1038,7 +1273,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1048,6 +1283,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1055,6 +1294,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1063,7 +1306,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1077,6 +1320,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1084,6 +1331,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1092,7 +1343,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1161,7 +1412,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1190,7 +1441,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1272,30 +1523,82 @@
         ]
       },
       {
-        "id": "Observation:shr-sex-GenderIdentity.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-sex-GenderIdentity.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-sex-GenderIdentity.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1351,8 +1654,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1414,7 +1717,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1443,7 +1746,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1475,7 +1778,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1485,6 +1788,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1535,7 +1844,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1598,7 +1907,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1627,7 +1936,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1669,6 +1978,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1676,6 +1991,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1695,8 +2014,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1733,6 +2052,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1740,6 +2063,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1748,7 +2075,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1761,6 +2088,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1783,7 +2116,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1796,6 +2129,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1803,6 +2142,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1810,6 +2153,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1818,7 +2165,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1862,7 +2209,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-sex-GenderIdentityVS"
+            "reference": "http://standardhealthrecord.org/shr/sex/vs/GenderIdentityVS"
           }
         }
       },
@@ -1959,12 +2306,16 @@
         ]
       },
       {
-        "id": "Observation:shr-sex-GenderIdentity.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-sex-GenderIdentity.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-sex-NumberOfLivingChildren-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-sex-NumberOfLivingChildren-extension.json
old mode 100755
new mode 100644
index 03729e0..5cc5a94
--- a/lib/resources/standard_health_record/StructureDefinition-shr-sex-NumberOfLivingChildren-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-sex-NumberOfLivingChildren-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.sex.NumberOfLivingChildren"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR NumberOfLivingChildren Extension",
   "title": "SHR NumberOfLivingChildren Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.051Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.493Z",
   "description": "Number of living children.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-sex-NumberOfPreviousPregnancies-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-sex-NumberOfPreviousPregnancies-extension.json
old mode 100755
new mode 100644
index d6752a6..2a177f6
--- a/lib/resources/standard_health_record/StructureDefinition-shr-sex-NumberOfPreviousPregnancies-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-sex-NumberOfPreviousPregnancies-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.sex.NumberOfPreviousPregnancies"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR NumberOfPreviousPregnancies Extension",
   "title": "SHR NumberOfPreviousPregnancies Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.051Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.493Z",
   "description": "Number of previous pregnancies.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-sex-NumberOfSexualPartnersPastYear-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-sex-NumberOfSexualPartnersPastYear-extension.json
old mode 100755
new mode 100644
index 26da935..0dacb99
--- a/lib/resources/standard_health_record/StructureDefinition-shr-sex-NumberOfSexualPartnersPastYear-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-sex-NumberOfSexualPartnersPastYear-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.sex.NumberOfSexualPartnersPastYear"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR NumberOfSexualPartnersPastYear Extension",
   "title": "SHR NumberOfSexualPartnersPastYear Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.007Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.478Z",
   "description": "Number of sexual partners in past year.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-sex-PregnancyHistory.json b/lib/resources/standard_health_record/StructureDefinition-shr-sex-PregnancyHistory.json
old mode 100755
new mode 100644
index e401731..eb8ed5d
--- a/lib/resources/standard_health_record/StructureDefinition-shr-sex-PregnancyHistory.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-sex-PregnancyHistory.json
@@ -3,7 +3,7 @@
   "id": "shr-sex-PregnancyHistory",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR PregnancyHistory Profile</b></p>\n  <p>Information about current and past pregnancies.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.sex.PregnancyHistory maps to DiagnosticReport:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  CodeableConcept maps to codedDiagnosis\n  Observation maps to result\n  TBD &quot;Specimen&quot; maps to specimen\n  Interpretation maps to conclusion\n  ObservationCategory maps to category\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR PregnancyHistory Profile</b></p>\n  <p>Information about current and past pregnancies.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.sex.PregnancyHistory maps to DiagnosticReport:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  CodeableConcept maps to codedDiagnosis\n  Observation maps to result\n  &lt;TBD &quot;Specimen&quot;&gt; maps to specimen\n  Interpretation maps to conclusion\n  ObservationCategory maps to category\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-sex-PregnancyHistory",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.sex.PregnancyHistory"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR PregnancyHistory Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.039Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,15 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.492Z",
   "description": "Information about current and past pregnancies.",
   "purpose": "To support reporting for any diagnostic report into a clinical data repository.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -58,7 +64,7 @@
         "path": "DiagnosticReport",
         "short": "SHR PregnancyHistory Profile",
         "definition": "Information about current and past pregnancies.",
-        "comments": "This is intended to capture a single report, and is not suitable for use in displaying summary information that covers multiple reports.  For example, this resource has not been designed for laboratory cumulative reporting formats nor detailed structured reports for sequencing.",
+        "comment": "This is intended to capture a single report, and is not suitable for use in displaying summary information that covers multiple reports.  For example, this resource has not been designed for laboratory cumulative reporting formats nor detailed structured reports for sequencing.",
         "alias": [
           "Report",
           "Test",
@@ -108,6 +114,10 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
           {
             "identity": "v2",
             "map": "ORU -> OBR"
@@ -127,7 +137,7 @@
         "path": "DiagnosticReport.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -166,7 +176,7 @@
         "path": "DiagnosticReport.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -187,7 +197,7 @@
         "path": "DiagnosticReport.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -207,6 +217,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -221,7 +239,7 @@
         "path": "DiagnosticReport.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -255,7 +273,7 @@
         "path": "DiagnosticReport.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -284,16 +302,19 @@
         "id": "DiagnosticReport:shr-sex-PregnancyHistory.extension",
         "path": "DiagnosticReport.extension",
         "slicing": {
-          "id": "253",
+          "id": "243",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -322,6 +343,7 @@
         "path": "DiagnosticReport.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -354,6 +376,7 @@
         "path": "DiagnosticReport.extension",
         "sliceName": "currentpregnancystatus",
         "definition": "Whether or not the subject is currently pregnant.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -386,6 +409,7 @@
         "path": "DiagnosticReport.extension",
         "sliceName": "numberofpreviouspregnancies",
         "definition": "Number of previous pregnancies.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -418,6 +442,7 @@
         "path": "DiagnosticReport.extension",
         "sliceName": "numberoflivingchildren",
         "definition": "Number of living children.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -450,7 +475,7 @@
         "path": "DiagnosticReport.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -478,11 +503,14 @@
       {
         "id": "DiagnosticReport:shr-sex-PregnancyHistory.identifier",
         "path": "DiagnosticReport.identifier",
-        "short": "Id for external references to this report",
-        "definition": "The local ID assigned to the report by the order filler, usually by the Information System of the diagnostic service provider.",
+        "short": "Business identifier for report",
+        "definition": "Identifiers assigned to this report by the performer or other systems.",
+        "comment": "Usually assigned by the Information System of the diagnostic service provider (filler id).",
         "requirements": "Need to know what identifier to use when making queries about this report from the source laboratory, and for linking to the report outside FHIR context.",
         "alias": [
-          "ReportID"
+          "ReportID",
+          "Filler ID",
+          "Placer ID"
         ],
         "min": 0,
         "max": "*",
@@ -493,6 +521,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBR-51"
@@ -507,12 +539,65 @@
           }
         ]
       },
+      {
+        "id": "DiagnosticReport:shr-sex-PregnancyHistory.basedOn",
+        "path": "DiagnosticReport.basedOn",
+        "short": "What was requested",
+        "definition": "Details concerning a test or procedure requested.",
+        "comment": "Note: Usually there is one test request for each result, however in some circumstances multiple test requests may be represented using a single test result resource. Note that there are also cases where one request leads to multiple reports.",
+        "requirements": "This allows tracing of authorization for the report and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Request"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC? OBR-2/3?"
+          },
+          {
+            "identity": "rim",
+            "map": "outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "DiagnosticReport:shr-sex-PregnancyHistory.status",
         "path": "DiagnosticReport.status",
-        "short": "registered | partial | final | corrected | appended | cancelled | entered-in-error",
+        "short": "registered | partial | preliminary | final +",
         "definition": "The status of the diagnostic report as a whole.",
-        "comments": "This is labeled as \"Is Modifier\" because applications need to take appropriate action if a report is withdrawn.",
+        "comment": "This is labeled as \"Is Modifier\" because applications need to take appropriate action if a report is withdrawn.",
         "requirements": "Diagnostic services routinely issue provisional/incomplete reports, and sometimes withdraw previously released reports.",
         "min": 1,
         "max": "1",
@@ -524,6 +609,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "DiagnosticReportStatus"
+            }
+          ],
           "strength": "required",
           "description": "The status of the diagnostic report as a whole.",
           "valueSetReference": {
@@ -531,6 +622,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
           {
             "identity": "v2",
             "map": "OBR-25 (not 1:1 mapping)"
@@ -550,12 +645,12 @@
         "path": "DiagnosticReport.category",
         "short": "Service category",
         "definition": "A code that classifies the clinical discipline, department or diagnostic service that created the report (e.g. cardiology, biochemistry, hematology, MRI). This is used for searching, sorting and display purposes.",
-        "comments": "The level of granularity is defined by the category concepts in the value set. More fine-grained filtering can be performed using the metadata and/or terminology hierarchy in DiagnosticReport.code.",
+        "comment": "The level of granularity is defined by the category concepts in the value set. More fine-grained filtering can be performed using the metadata and/or terminology hierarchy in DiagnosticReport.code.",
         "alias": [
           "Department",
           "Sub-department",
-          "service",
-          "discipline"
+          "Service",
+          "Discipline"
         ],
         "min": 0,
         "max": "1",
@@ -592,6 +687,9 @@
         "path": "DiagnosticReport.code",
         "short": "Name/Code for this diagnostic report",
         "definition": "A code or name that describes this diagnostic report.",
+        "alias": [
+          "Type"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -601,6 +699,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "DiagnosticReportCodes"
+            }
+          ],
           "strength": "preferred",
           "description": "Codes that describe Diagnostic Reports.",
           "valueSetReference": {
@@ -608,6 +712,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
           {
             "identity": "v2",
             "map": "OBR-4 (HL7 v2 doesn't provide an easy way to indicate both the ordered test and the performed panel)"
@@ -625,7 +733,7 @@
       {
         "id": "DiagnosticReport:shr-sex-PregnancyHistory.subject",
         "path": "DiagnosticReport.subject",
-        "short": "The subject of the report, usually, but not always, the patient",
+        "short": "The subject of the report - usually, but not always, the patient",
         "definition": "The subject of the report. Usually, but not always, this is a patient. However diagnostic services also perform analyses on specimens collected from a variety of other sources.",
         "requirements": "SHALL know the subject context.",
         "alias": [
@@ -653,6 +761,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3 (no HL7 v2 mapping for Group or Device)"
@@ -668,20 +780,33 @@
         ]
       },
       {
-        "id": "DiagnosticReport:shr-sex-PregnancyHistory.encounter",
-        "path": "DiagnosticReport.encounter",
+        "id": "DiagnosticReport:shr-sex-PregnancyHistory.context",
+        "path": "DiagnosticReport.context",
         "short": "Health care event when test ordered",
-        "definition": "The link to the health care event (encounter) when the order was made.",
+        "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) which this DiagnosticReport per is about.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
+        "requirements": "Links the request to the Encounter context.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1-19"
@@ -699,13 +824,14 @@
       {
         "id": "DiagnosticReport:shr-sex-PregnancyHistory.effective[x]",
         "path": "DiagnosticReport.effective[x]",
-        "short": "Clinically Relevant time/time-period for report",
+        "short": "Clinically relevant time/time-period for report",
         "definition": "The time or time-period the observed values are related to. When the subject of the report is a patient, this is usually either the time of the procedure or of specimen collection(s), but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "If the diagnostic procedure was performed on the patient, this is the time it was performed. If there are specimens, the diagnostically relevant time can be derived from the specimen collection times, but the specimen information is not always available, and the exact relationship between the specimens and the diagnostically relevant time is not always automatic.",
+        "comment": "If the diagnostic procedure was performed on the patient, this is the time it was performed. If there are specimens, the diagnostically relevant time can be derived from the specimen collection times, but the specimen information is not always available, and the exact relationship between the specimens and the diagnostically relevant time is not always automatic.",
         "requirements": "Need to know where in the patient history to file/present this report.",
         "alias": [
           "Observation time",
-          "Effective Time"
+          "Effective Time",
+          "Occurrence"
         ],
         "min": 0,
         "max": "1",
@@ -719,6 +845,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBR-7"
@@ -738,7 +868,7 @@
         "path": "DiagnosticReport.issued",
         "short": "DateTime this version was released",
         "definition": "The date and time that this version of the report was released from the source diagnostic service.",
-        "comments": "May be different from the update time of the resource itself, because that is the status of the record (potentially a secondary copy), not the actual release time of the report.",
+        "comment": "May be different from the update time of the resource itself, because that is the status of the record (potentially a secondary copy), not the actual release time of the report.",
         "requirements": "Clinicians need to be able to check the date that the report was released.",
         "alias": [
           "Date Created",
@@ -771,10 +901,8 @@
       {
         "id": "DiagnosticReport:shr-sex-PregnancyHistory.performer",
         "path": "DiagnosticReport.performer",
-        "short": "Responsible Diagnostic Service",
-        "definition": "The diagnostic service that is responsible for issuing the report.",
-        "comments": "This is not necessarily the source of the atomic data items. It is the entity that takes responsibility for the clinical report.",
-        "requirements": "Need to know whom to contact if there are queries about the results. Also may need to track the source of reports for secondary data analysis.",
+        "short": "Participants in producing the report",
+        "definition": "Indicates who or what participated in producing the report.",
         "alias": [
           "Laboratory",
           "Service",
@@ -786,23 +914,32 @@
         "max": "*",
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
-          },
+            "code": "BackboneElement"
+          }
+        ],
+        "constraint": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
+            "key": "ele-1",
+            "severity": "error",
+            "human": "All FHIR elements must have a @value or children",
+            "expression": "children().count() > id.count()",
+            "xpath": "@value|f:*|h:div",
+            "source": "Element"
           }
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "PRT-8 (where this PRT-4-Participation = \"PO\")"
           },
           {
             "identity": "rim",
-            "map": "participation[typeCode=AUT].role[classCode=ASSIGN].scoper"
+            "map": ".participation[typeCode=PRF]"
           },
           {
             "identity": "w5",
@@ -811,36 +948,166 @@
         ]
       },
       {
-        "id": "DiagnosticReport:shr-sex-PregnancyHistory.request",
-        "path": "DiagnosticReport.request",
-        "short": "What was requested",
-        "definition": "Details concerning a test or procedure requested.",
-        "comments": "Note: Usually there is one test request for each result, however in some circumstances multiple test requests may be represented using a single test result resource. Note that there are also cases where one request leads to multiple reports.",
-        "requirements": "Need to be able to track completion of requests based on reports issued and also to report what diagnostic tests were requested (not always the same as what is delivered).",
+        "id": "DiagnosticReport:shr-sex-PregnancyHistory.performer.id",
+        "path": "DiagnosticReport.performer.id",
+        "representation": [
+          "xmlAttr"
+        ],
+        "short": "xml:id (or equivalent in JSON)",
+        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Element.id",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "DiagnosticReport:shr-sex-PregnancyHistory.performer.extension",
+        "path": "DiagnosticReport.performer.extension",
+        "short": "Additional Content defined by implementations",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content"
+        ],
         "min": 0,
         "max": "*",
+        "base": {
+          "path": "Element.extension",
+          "min": 0,
+          "max": "*"
+        },
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DiagnosticRequest"
+            "code": "Extension"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "DiagnosticReport:shr-sex-PregnancyHistory.performer.modifierExtension",
+        "path": "DiagnosticReport.performer.modifierExtension",
+        "short": "Extensions that cannot be ignored",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content",
+          "modifiers"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "BackboneElement.modifierExtension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "isModifier": true,
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "N/A"
+          }
+        ]
+      },
+      {
+        "id": "DiagnosticReport:shr-sex-PregnancyHistory.performer.role",
+        "path": "DiagnosticReport.performer.role",
+        "short": "Type of performer",
+        "definition": "Describes the type of participation (e.g.  a responsible party, author, or verifier).",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Role"
+            }
+          ],
+          "strength": "example",
+          "description": "Indicate a role of diagnostic report performer",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/performer-role"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer.role"
+          },
+          {
+            "identity": "v2",
+            "map": "PRT-8 (where this PRT-4-Participation = \"PO\")"
           },
+          {
+            "identity": "rim",
+            "map": ".functionCode"
+          }
+        ]
+      },
+      {
+        "id": "DiagnosticReport:shr-sex-PregnancyHistory.performer.actor",
+        "path": "DiagnosticReport.performer.actor",
+        "short": "Practitioner or Organization  participant",
+        "definition": "The reference to the  practitioner or organization involved in producing the report. For example, the diagnostic service that is responsible for issuing the report.",
+        "comment": "This is not necessarily the source of the atomic data items. It is the entity that takes responsibility for the clinical report.",
+        "requirements": "Need to know whom to contact if there are queries about the results. Also may need to track the source of reports for secondary data analysis.",
+        "min": 1,
+        "max": "1",
+        "type": [
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
           },
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer.actor"
+          },
           {
             "identity": "v2",
-            "map": "ORC? OBR-2/3?"
+            "map": "PRT-8 (where this PRT-4-Participation = \"PO\")"
           },
           {
             "identity": "rim",
-            "map": "outboundRelationship[typeCode=FLFS].target"
+            "map": ".role"
           }
         ]
       },
@@ -849,7 +1116,7 @@
         "path": "DiagnosticReport.specimen",
         "short": "Specimens this report is based on",
         "definition": "Details about the specimens on which this diagnostic report is based.",
-        "comments": "If the specimen is sufficiently specified with a code in the test result name, then this additional data may be redundant. If there are multiple specimens, these may be represented per Observation or group.",
+        "comment": "If the specimen is sufficiently specified with a code in the test result name, then this additional data may be redundant. If there are multiple specimens, these may be represented per observation or group.",
         "requirements": "Need to be able to report information about the collected specimens on which the report is based.",
         "min": 0,
         "max": "*",
@@ -911,7 +1178,7 @@
         "path": "DiagnosticReport.imagingStudy",
         "short": "Reference to full details of imaging associated with the diagnostic report",
         "definition": "One or more links to full details of any imaging performed during the diagnostic investigation. Typically, this is imaging performed by DICOM enabled modalities, but this is not required. A fully enabled PACS viewer can use this information to provide views of the source images.",
-        "comments": "ImagingStudy and ImageManifest and the image element are somewhat overlapping - typically, the list of image references in the image element will also be found in one of the imaging study resources. However each caters to different types of displays for different types of purposes. Neither, either, or both may be provided.",
+        "comment": "ImagingStudy and ImageManifest and the image element are somewhat overlapping - typically, the list of image references in the image element will also be found in one of the imaging study resources. However each caters to different types of displays for different types of purposes. Neither, either, or both may be provided.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1003,7 +1270,7 @@
         "path": "DiagnosticReport.image.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1032,7 +1299,7 @@
         "path": "DiagnosticReport.image.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1064,7 +1331,7 @@
         "path": "DiagnosticReport.image.comment",
         "short": "Comment about the image (e.g. explanation)",
         "definition": "A comment about the image. Typically, this is used to provide an explanation for why the image is included, or to draw the viewer's attention to important features.",
-        "comments": "The comment should be displayed with the image. It would be common for the report to include additional discussion of the image contents in other sections such as the conclusion.",
+        "comment": "The comment should be displayed with the image. It would be common for the report to include additional discussion of the image contents in other sections such as the conclusion.",
         "requirements": "The provider of the report should make a comment about each image included in the report.",
         "min": 0,
         "max": "1",
@@ -1142,8 +1409,14 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AdjunctDiagnosis"
+            }
+          ],
           "strength": "example",
-          "description": "Diagnoses codes provided as adjuncts to the report.",
+          "description": "Diagnosis codes provided as adjuncts to the report.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/clinical-findings"
           }
@@ -1164,8 +1437,8 @@
         "path": "DiagnosticReport.presentedForm",
         "short": "Entire report as issued",
         "definition": "Rich text representation of the entire result as issued by the diagnostic service. Multiple formats are allowed but they SHALL be semantically equivalent.",
-        "comments": "\"application/pdf\" is recommended as the most reliable and interoperable in this context.",
-        "requirements": "Gives Laboratory the ability to provide its own fully formatted report for clinical fidelity.",
+        "comment": "\"application/pdf\" is recommended as the most reliable and interoperable in this context.",
+        "requirements": "Gives laboratory the ability to provide its own fully formatted report for clinical fidelity.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1299,12 +1572,16 @@
         ]
       },
       {
-        "id": "DiagnosticReport:shr-sex-PregnancyHistory.encounter",
-        "path": "DiagnosticReport.encounter",
+        "id": "DiagnosticReport:shr-sex-PregnancyHistory.context",
+        "path": "DiagnosticReport.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-sex-PregnancyIntention.json b/lib/resources/standard_health_record/StructureDefinition-shr-sex-PregnancyIntention.json
old mode 100755
new mode 100644
index d155415..9378ffd
--- a/lib/resources/standard_health_record/StructureDefinition-shr-sex-PregnancyIntention.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-sex-PregnancyIntention.json
@@ -3,7 +3,7 @@
   "id": "shr-sex-PregnancyIntention",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR PregnancyIntention Profile</b></p>\n  <p>Whether the subject or his/her partner has a plan or desire to either become pregnant or have a child in the next year/near future.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.sex.PregnancyIntention maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR PregnancyIntention Profile</b></p>\n  <p>Whether the subject or his/her partner has a plan or desire to either become pregnant or have a child in the next year/near future.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.sex.PregnancyIntention maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-sex-PregnancyIntention",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.sex.PregnancyIntention"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR PregnancyIntention Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.930Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.463Z",
   "description": "Whether the subject or his/her partner has a plan or desire to either become pregnant or have a child in the next year/near future.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR PregnancyIntention Profile",
         "definition": "Whether the subject or his/her partner has a plan or desire to either become pregnant or have a child in the next year/near future.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-sex-PregnancyIntention.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "244",
+          "id": "234",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "codeableconcept",
         "definition": "A set of codes drawn from different coding systems, representing the same concept.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -357,7 +393,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-ThreeValueLogicVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/ThreeValueLogicVS"
           }
         },
         "mapping": [
@@ -372,6 +408,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -404,6 +441,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -435,16 +473,19 @@
         "id": "Observation:shr-sex-PregnancyIntention.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "245",
+          "id": "235",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -474,6 +515,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -504,8 +546,8 @@
       {
         "id": "Observation:shr-sex-PregnancyIntention.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -514,7 +556,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -529,6 +576,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-sex-PregnancyIntention.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-sex-PregnancyIntention.status",
         "extension": [
@@ -540,6 +644,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -551,6 +656,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -558,6 +669,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -577,8 +696,8 @@
         "path": "Observation.category",
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 0,
         "max": "*",
         "type": [
@@ -588,8 +707,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -611,6 +736,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -629,6 +757,12 @@
         },
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -636,6 +770,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -644,6 +786,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -655,7 +801,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -679,6 +825,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -694,20 +844,32 @@
         ]
       },
       {
-        "id": "Observation:shr-sex-PregnancyIntention.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-sex-PregnancyIntention.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -727,8 +889,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -742,6 +907,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -761,7 +930,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -813,6 +982,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -832,8 +1005,8 @@
         "path": "Observation.value[x]",
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -846,6 +1019,9 @@
           {
             "code": "string"
           },
+          {
+            "code": "boolean"
+          },
           {
             "code": "Range"
           },
@@ -873,6 +1049,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -880,6 +1064,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -888,7 +1076,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -901,6 +1089,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -908,6 +1102,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -935,6 +1133,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -942,6 +1146,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -949,6 +1157,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -966,6 +1178,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -981,8 +1197,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -991,6 +1206,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -998,6 +1219,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -1005,6 +1230,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1013,7 +1242,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1024,6 +1253,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1046,7 +1281,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1056,6 +1291,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1063,6 +1302,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1071,7 +1314,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1085,6 +1328,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1092,6 +1339,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1100,7 +1351,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1169,7 +1420,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1198,7 +1449,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1280,30 +1531,82 @@
         ]
       },
       {
-        "id": "Observation:shr-sex-PregnancyIntention.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-sex-PregnancyIntention.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-sex-PregnancyIntention.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1359,8 +1662,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1422,7 +1725,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1451,7 +1754,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1483,7 +1786,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1493,6 +1796,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1543,7 +1852,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1606,7 +1915,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1635,7 +1944,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1677,6 +1986,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1684,6 +1999,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1703,8 +2022,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1741,6 +2060,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1748,6 +2071,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1756,7 +2083,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1769,6 +2096,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1791,7 +2124,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1804,6 +2137,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1811,6 +2150,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1818,6 +2161,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1826,7 +2173,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1870,7 +2217,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-ThreeValueLogicVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/ThreeValueLogicVS"
           }
         }
       },
@@ -1975,12 +2322,16 @@
         ]
       },
       {
-        "id": "Observation:shr-sex-PregnancyIntention.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-sex-PregnancyIntention.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-sex-ReasonForNotRecommendingContraceptive-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-sex-ReasonForNotRecommendingContraceptive-extension.json
old mode 100755
new mode 100644
index ffd80cd..6a4df24
--- a/lib/resources/standard_health_record/StructureDefinition-shr-sex-ReasonForNotRecommendingContraceptive-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-sex-ReasonForNotRecommendingContraceptive-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.sex.ReasonForNotRecommendingContraceptive"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ReasonForNotRecommendingContraceptive Extension",
   "title": "SHR ReasonForNotRecommendingContraceptive Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.035Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.488Z",
   "description": "If not using a method of contraception, why.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -170,7 +170,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-sex-ContraceptiveNotUsedReasonVS"
+            "reference": "http://standardhealthrecord.org/shr/sex/vs/ContraceptiveNotUsedReasonVS"
           }
         },
         "mapping": [
@@ -221,7 +221,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-sex-ContraceptiveNotUsedReasonVS"
+            "reference": "http://standardhealthrecord.org/shr/sex/vs/ContraceptiveNotUsedReasonVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-sex-SexualActivity-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-sex-SexualActivity-extension.json
old mode 100755
new mode 100644
index dc028f9..502d8d2
--- a/lib/resources/standard_health_record/StructureDefinition-shr-sex-SexualActivity-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-sex-SexualActivity-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.sex.SexualActivity"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR SexualActivity Extension",
   "title": "SHR SexualActivity Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.007Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.478Z",
   "description": "Characterization of the sexual activity of the subject.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -170,7 +170,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-sex-SexualActivityVS"
+            "reference": "http://standardhealthrecord.org/shr/sex/vs/SexualActivityVS"
           }
         },
         "mapping": [
@@ -221,7 +221,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-sex-SexualActivityVS"
+            "reference": "http://standardhealthrecord.org/shr/sex/vs/SexualActivityVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-sex-SexualBehavior.json b/lib/resources/standard_health_record/StructureDefinition-shr-sex-SexualBehavior.json
old mode 100755
new mode 100644
index e4aaa27..88f6efc
--- a/lib/resources/standard_health_record/StructureDefinition-shr-sex-SexualBehavior.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-sex-SexualBehavior.json
@@ -3,7 +3,7 @@
   "id": "shr-sex-SexualBehavior",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR SexualBehavior Profile</b></p>\n  <p>Experience with sexual intercourse.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.sex.SexualBehavior maps to DiagnosticReport:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  CodeableConcept maps to codedDiagnosis\n  Observation maps to result\n  TBD &quot;Specimen&quot; maps to specimen\n  Interpretation maps to conclusion\n  ObservationCategory maps to category\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR SexualBehavior Profile</b></p>\n  <p>Experience with sexual intercourse.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.sex.SexualBehavior maps to DiagnosticReport:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  CodeableConcept maps to codedDiagnosis\n  Observation maps to result\n  &lt;TBD &quot;Specimen&quot;&gt; maps to specimen\n  Interpretation maps to conclusion\n  ObservationCategory maps to category\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-sex-SexualBehavior",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.sex.SexualBehavior"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR SexualBehavior Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.996Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,15 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.477Z",
   "description": "Experience with sexual intercourse.",
   "purpose": "To support reporting for any diagnostic report into a clinical data repository.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -58,7 +64,7 @@
         "path": "DiagnosticReport",
         "short": "SHR SexualBehavior Profile",
         "definition": "Experience with sexual intercourse.",
-        "comments": "This is intended to capture a single report, and is not suitable for use in displaying summary information that covers multiple reports.  For example, this resource has not been designed for laboratory cumulative reporting formats nor detailed structured reports for sequencing.",
+        "comment": "This is intended to capture a single report, and is not suitable for use in displaying summary information that covers multiple reports.  For example, this resource has not been designed for laboratory cumulative reporting formats nor detailed structured reports for sequencing.",
         "alias": [
           "Report",
           "Test",
@@ -108,6 +114,10 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
           {
             "identity": "v2",
             "map": "ORU -> OBR"
@@ -127,7 +137,7 @@
         "path": "DiagnosticReport.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -166,7 +176,7 @@
         "path": "DiagnosticReport.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -187,7 +197,7 @@
         "path": "DiagnosticReport.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -207,6 +217,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -221,7 +239,7 @@
         "path": "DiagnosticReport.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -255,7 +273,7 @@
         "path": "DiagnosticReport.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -284,16 +302,19 @@
         "id": "DiagnosticReport:shr-sex-SexualBehavior.extension",
         "path": "DiagnosticReport.extension",
         "slicing": {
-          "id": "249",
+          "id": "239",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -322,6 +343,7 @@
         "path": "DiagnosticReport.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -354,6 +376,7 @@
         "path": "DiagnosticReport.extension",
         "sliceName": "observationcode",
         "definition": "A term from a controlled vocabulary that defines the data element (the question, not the answer) as specifically as possible. The specific code should always align with the concept of the element, but may be more specific. For example, the concept associated with medications is code for 'medication used', but the ObservationCode is the code for the particular medication used. For tests, ObservationCode identifies the specific test being performed, and for observations, the specific question being asked.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -435,7 +458,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -494,6 +516,7 @@
         "path": "DiagnosticReport.extension",
         "sliceName": "sexualactivity",
         "definition": "Characterization of the sexual activity of the subject.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -526,6 +549,7 @@
         "path": "DiagnosticReport.extension",
         "sliceName": "numberofsexualpartnerspastyear",
         "definition": "Number of sexual partners in past year.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -558,6 +582,7 @@
         "path": "DiagnosticReport.extension",
         "sliceName": "difficultywithintercourse",
         "definition": "Problem with sexual intercourse.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -590,7 +615,7 @@
         "path": "DiagnosticReport.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -618,11 +643,14 @@
       {
         "id": "DiagnosticReport:shr-sex-SexualBehavior.identifier",
         "path": "DiagnosticReport.identifier",
-        "short": "Id for external references to this report",
-        "definition": "The local ID assigned to the report by the order filler, usually by the Information System of the diagnostic service provider.",
+        "short": "Business identifier for report",
+        "definition": "Identifiers assigned to this report by the performer or other systems.",
+        "comment": "Usually assigned by the Information System of the diagnostic service provider (filler id).",
         "requirements": "Need to know what identifier to use when making queries about this report from the source laboratory, and for linking to the report outside FHIR context.",
         "alias": [
-          "ReportID"
+          "ReportID",
+          "Filler ID",
+          "Placer ID"
         ],
         "min": 0,
         "max": "*",
@@ -633,6 +661,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBR-51"
@@ -647,12 +679,65 @@
           }
         ]
       },
+      {
+        "id": "DiagnosticReport:shr-sex-SexualBehavior.basedOn",
+        "path": "DiagnosticReport.basedOn",
+        "short": "What was requested",
+        "definition": "Details concerning a test or procedure requested.",
+        "comment": "Note: Usually there is one test request for each result, however in some circumstances multiple test requests may be represented using a single test result resource. Note that there are also cases where one request leads to multiple reports.",
+        "requirements": "This allows tracing of authorization for the report and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Request"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC? OBR-2/3?"
+          },
+          {
+            "identity": "rim",
+            "map": "outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "DiagnosticReport:shr-sex-SexualBehavior.status",
         "path": "DiagnosticReport.status",
-        "short": "registered | partial | final | corrected | appended | cancelled | entered-in-error",
+        "short": "registered | partial | preliminary | final +",
         "definition": "The status of the diagnostic report as a whole.",
-        "comments": "This is labeled as \"Is Modifier\" because applications need to take appropriate action if a report is withdrawn.",
+        "comment": "This is labeled as \"Is Modifier\" because applications need to take appropriate action if a report is withdrawn.",
         "requirements": "Diagnostic services routinely issue provisional/incomplete reports, and sometimes withdraw previously released reports.",
         "min": 1,
         "max": "1",
@@ -664,6 +749,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "DiagnosticReportStatus"
+            }
+          ],
           "strength": "required",
           "description": "The status of the diagnostic report as a whole.",
           "valueSetReference": {
@@ -671,6 +762,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
           {
             "identity": "v2",
             "map": "OBR-25 (not 1:1 mapping)"
@@ -690,12 +785,12 @@
         "path": "DiagnosticReport.category",
         "short": "Service category",
         "definition": "A code that classifies the clinical discipline, department or diagnostic service that created the report (e.g. cardiology, biochemistry, hematology, MRI). This is used for searching, sorting and display purposes.",
-        "comments": "The level of granularity is defined by the category concepts in the value set. More fine-grained filtering can be performed using the metadata and/or terminology hierarchy in DiagnosticReport.code.",
+        "comment": "The level of granularity is defined by the category concepts in the value set. More fine-grained filtering can be performed using the metadata and/or terminology hierarchy in DiagnosticReport.code.",
         "alias": [
           "Department",
           "Sub-department",
-          "service",
-          "discipline"
+          "Service",
+          "Discipline"
         ],
         "min": 0,
         "max": "1",
@@ -732,6 +827,9 @@
         "path": "DiagnosticReport.code",
         "short": "Name/Code for this diagnostic report",
         "definition": "A code or name that describes this diagnostic report.",
+        "alias": [
+          "Type"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -741,6 +839,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "DiagnosticReportCodes"
+            }
+          ],
           "strength": "preferred",
           "description": "Codes that describe Diagnostic Reports.",
           "valueSetReference": {
@@ -748,6 +852,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
           {
             "identity": "v2",
             "map": "OBR-4 (HL7 v2 doesn't provide an easy way to indicate both the ordered test and the performed panel)"
@@ -765,7 +873,7 @@
       {
         "id": "DiagnosticReport:shr-sex-SexualBehavior.subject",
         "path": "DiagnosticReport.subject",
-        "short": "The subject of the report, usually, but not always, the patient",
+        "short": "The subject of the report - usually, but not always, the patient",
         "definition": "The subject of the report. Usually, but not always, this is a patient. However diagnostic services also perform analyses on specimens collected from a variety of other sources.",
         "requirements": "SHALL know the subject context.",
         "alias": [
@@ -793,6 +901,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3 (no HL7 v2 mapping for Group or Device)"
@@ -808,20 +920,33 @@
         ]
       },
       {
-        "id": "DiagnosticReport:shr-sex-SexualBehavior.encounter",
-        "path": "DiagnosticReport.encounter",
+        "id": "DiagnosticReport:shr-sex-SexualBehavior.context",
+        "path": "DiagnosticReport.context",
         "short": "Health care event when test ordered",
-        "definition": "The link to the health care event (encounter) when the order was made.",
+        "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) which this DiagnosticReport per is about.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
+        "requirements": "Links the request to the Encounter context.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1-19"
@@ -839,13 +964,14 @@
       {
         "id": "DiagnosticReport:shr-sex-SexualBehavior.effective[x]",
         "path": "DiagnosticReport.effective[x]",
-        "short": "Clinically Relevant time/time-period for report",
+        "short": "Clinically relevant time/time-period for report",
         "definition": "The time or time-period the observed values are related to. When the subject of the report is a patient, this is usually either the time of the procedure or of specimen collection(s), but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "If the diagnostic procedure was performed on the patient, this is the time it was performed. If there are specimens, the diagnostically relevant time can be derived from the specimen collection times, but the specimen information is not always available, and the exact relationship between the specimens and the diagnostically relevant time is not always automatic.",
+        "comment": "If the diagnostic procedure was performed on the patient, this is the time it was performed. If there are specimens, the diagnostically relevant time can be derived from the specimen collection times, but the specimen information is not always available, and the exact relationship between the specimens and the diagnostically relevant time is not always automatic.",
         "requirements": "Need to know where in the patient history to file/present this report.",
         "alias": [
           "Observation time",
-          "Effective Time"
+          "Effective Time",
+          "Occurrence"
         ],
         "min": 0,
         "max": "1",
@@ -859,6 +985,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBR-7"
@@ -878,7 +1008,7 @@
         "path": "DiagnosticReport.issued",
         "short": "DateTime this version was released",
         "definition": "The date and time that this version of the report was released from the source diagnostic service.",
-        "comments": "May be different from the update time of the resource itself, because that is the status of the record (potentially a secondary copy), not the actual release time of the report.",
+        "comment": "May be different from the update time of the resource itself, because that is the status of the record (potentially a secondary copy), not the actual release time of the report.",
         "requirements": "Clinicians need to be able to check the date that the report was released.",
         "alias": [
           "Date Created",
@@ -911,10 +1041,8 @@
       {
         "id": "DiagnosticReport:shr-sex-SexualBehavior.performer",
         "path": "DiagnosticReport.performer",
-        "short": "Responsible Diagnostic Service",
-        "definition": "The diagnostic service that is responsible for issuing the report.",
-        "comments": "This is not necessarily the source of the atomic data items. It is the entity that takes responsibility for the clinical report.",
-        "requirements": "Need to know whom to contact if there are queries about the results. Also may need to track the source of reports for secondary data analysis.",
+        "short": "Participants in producing the report",
+        "definition": "Indicates who or what participated in producing the report.",
         "alias": [
           "Laboratory",
           "Service",
@@ -926,23 +1054,32 @@
         "max": "*",
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
-          },
+            "code": "BackboneElement"
+          }
+        ],
+        "constraint": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
+            "key": "ele-1",
+            "severity": "error",
+            "human": "All FHIR elements must have a @value or children",
+            "expression": "children().count() > id.count()",
+            "xpath": "@value|f:*|h:div",
+            "source": "Element"
           }
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "PRT-8 (where this PRT-4-Participation = \"PO\")"
           },
           {
             "identity": "rim",
-            "map": "participation[typeCode=AUT].role[classCode=ASSIGN].scoper"
+            "map": ".participation[typeCode=PRF]"
           },
           {
             "identity": "w5",
@@ -951,36 +1088,166 @@
         ]
       },
       {
-        "id": "DiagnosticReport:shr-sex-SexualBehavior.request",
-        "path": "DiagnosticReport.request",
-        "short": "What was requested",
-        "definition": "Details concerning a test or procedure requested.",
-        "comments": "Note: Usually there is one test request for each result, however in some circumstances multiple test requests may be represented using a single test result resource. Note that there are also cases where one request leads to multiple reports.",
-        "requirements": "Need to be able to track completion of requests based on reports issued and also to report what diagnostic tests were requested (not always the same as what is delivered).",
+        "id": "DiagnosticReport:shr-sex-SexualBehavior.performer.id",
+        "path": "DiagnosticReport.performer.id",
+        "representation": [
+          "xmlAttr"
+        ],
+        "short": "xml:id (or equivalent in JSON)",
+        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Element.id",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "DiagnosticReport:shr-sex-SexualBehavior.performer.extension",
+        "path": "DiagnosticReport.performer.extension",
+        "short": "Additional Content defined by implementations",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content"
+        ],
         "min": 0,
         "max": "*",
+        "base": {
+          "path": "Element.extension",
+          "min": 0,
+          "max": "*"
+        },
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DiagnosticRequest"
+            "code": "Extension"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "DiagnosticReport:shr-sex-SexualBehavior.performer.modifierExtension",
+        "path": "DiagnosticReport.performer.modifierExtension",
+        "short": "Extensions that cannot be ignored",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content",
+          "modifiers"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "BackboneElement.modifierExtension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "isModifier": true,
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "N/A"
+          }
+        ]
+      },
+      {
+        "id": "DiagnosticReport:shr-sex-SexualBehavior.performer.role",
+        "path": "DiagnosticReport.performer.role",
+        "short": "Type of performer",
+        "definition": "Describes the type of participation (e.g.  a responsible party, author, or verifier).",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Role"
+            }
+          ],
+          "strength": "example",
+          "description": "Indicate a role of diagnostic report performer",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/performer-role"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer.role"
+          },
+          {
+            "identity": "v2",
+            "map": "PRT-8 (where this PRT-4-Participation = \"PO\")"
           },
+          {
+            "identity": "rim",
+            "map": ".functionCode"
+          }
+        ]
+      },
+      {
+        "id": "DiagnosticReport:shr-sex-SexualBehavior.performer.actor",
+        "path": "DiagnosticReport.performer.actor",
+        "short": "Practitioner or Organization  participant",
+        "definition": "The reference to the  practitioner or organization involved in producing the report. For example, the diagnostic service that is responsible for issuing the report.",
+        "comment": "This is not necessarily the source of the atomic data items. It is the entity that takes responsibility for the clinical report.",
+        "requirements": "Need to know whom to contact if there are queries about the results. Also may need to track the source of reports for secondary data analysis.",
+        "min": 1,
+        "max": "1",
+        "type": [
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
           },
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer.actor"
+          },
           {
             "identity": "v2",
-            "map": "ORC? OBR-2/3?"
+            "map": "PRT-8 (where this PRT-4-Participation = \"PO\")"
           },
           {
             "identity": "rim",
-            "map": "outboundRelationship[typeCode=FLFS].target"
+            "map": ".role"
           }
         ]
       },
@@ -989,7 +1256,7 @@
         "path": "DiagnosticReport.specimen",
         "short": "Specimens this report is based on",
         "definition": "Details about the specimens on which this diagnostic report is based.",
-        "comments": "If the specimen is sufficiently specified with a code in the test result name, then this additional data may be redundant. If there are multiple specimens, these may be represented per Observation or group.",
+        "comment": "If the specimen is sufficiently specified with a code in the test result name, then this additional data may be redundant. If there are multiple specimens, these may be represented per observation or group.",
         "requirements": "Need to be able to report information about the collected specimens on which the report is based.",
         "min": 0,
         "max": "*",
@@ -1051,7 +1318,7 @@
         "path": "DiagnosticReport.imagingStudy",
         "short": "Reference to full details of imaging associated with the diagnostic report",
         "definition": "One or more links to full details of any imaging performed during the diagnostic investigation. Typically, this is imaging performed by DICOM enabled modalities, but this is not required. A fully enabled PACS viewer can use this information to provide views of the source images.",
-        "comments": "ImagingStudy and ImageManifest and the image element are somewhat overlapping - typically, the list of image references in the image element will also be found in one of the imaging study resources. However each caters to different types of displays for different types of purposes. Neither, either, or both may be provided.",
+        "comment": "ImagingStudy and ImageManifest and the image element are somewhat overlapping - typically, the list of image references in the image element will also be found in one of the imaging study resources. However each caters to different types of displays for different types of purposes. Neither, either, or both may be provided.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1143,7 +1410,7 @@
         "path": "DiagnosticReport.image.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1172,7 +1439,7 @@
         "path": "DiagnosticReport.image.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1204,7 +1471,7 @@
         "path": "DiagnosticReport.image.comment",
         "short": "Comment about the image (e.g. explanation)",
         "definition": "A comment about the image. Typically, this is used to provide an explanation for why the image is included, or to draw the viewer's attention to important features.",
-        "comments": "The comment should be displayed with the image. It would be common for the report to include additional discussion of the image contents in other sections such as the conclusion.",
+        "comment": "The comment should be displayed with the image. It would be common for the report to include additional discussion of the image contents in other sections such as the conclusion.",
         "requirements": "The provider of the report should make a comment about each image included in the report.",
         "min": 0,
         "max": "1",
@@ -1282,8 +1549,14 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AdjunctDiagnosis"
+            }
+          ],
           "strength": "example",
-          "description": "Diagnoses codes provided as adjuncts to the report.",
+          "description": "Diagnosis codes provided as adjuncts to the report.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/clinical-findings"
           }
@@ -1304,8 +1577,8 @@
         "path": "DiagnosticReport.presentedForm",
         "short": "Entire report as issued",
         "definition": "Rich text representation of the entire result as issued by the diagnostic service. Multiple formats are allowed but they SHALL be semantically equivalent.",
-        "comments": "\"application/pdf\" is recommended as the most reliable and interoperable in this context.",
-        "requirements": "Gives Laboratory the ability to provide its own fully formatted report for clinical fidelity.",
+        "comment": "\"application/pdf\" is recommended as the most reliable and interoperable in this context.",
+        "requirements": "Gives laboratory the ability to provide its own fully formatted report for clinical fidelity.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1463,12 +1736,16 @@
         ]
       },
       {
-        "id": "DiagnosticReport:shr-sex-SexualBehavior.encounter",
-        "path": "DiagnosticReport.encounter",
+        "id": "DiagnosticReport:shr-sex-SexualBehavior.context",
+        "path": "DiagnosticReport.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-sex-SexualIdentity.json b/lib/resources/standard_health_record/StructureDefinition-shr-sex-SexualIdentity.json
old mode 100755
new mode 100644
index 0824949..3327d75
--- a/lib/resources/standard_health_record/StructureDefinition-shr-sex-SexualIdentity.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-sex-SexualIdentity.json
@@ -3,7 +3,7 @@
   "id": "shr-sex-SexualIdentity",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR SexualIdentity Profile</b></p>\n  <p>Information on gender identity and sexual orientation.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.sex.SexualIdentity maps to DiagnosticReport:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  CodeableConcept maps to codedDiagnosis\n  Observation maps to result\n  TBD &quot;Specimen&quot; maps to specimen\n  Interpretation maps to conclusion\n  ObservationCategory maps to category\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR SexualIdentity Profile</b></p>\n  <p>Information on gender identity and sexual orientation.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.sex.SexualIdentity maps to DiagnosticReport:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  CodeableConcept maps to codedDiagnosis\n  Observation maps to result\n  &lt;TBD &quot;Specimen&quot;&gt; maps to specimen\n  Interpretation maps to conclusion\n  ObservationCategory maps to category\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-sex-SexualIdentity",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.sex.SexualIdentity"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR SexualIdentity Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.954Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,15 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.466Z",
   "description": "Information on gender identity and sexual orientation.",
   "purpose": "To support reporting for any diagnostic report into a clinical data repository.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -58,7 +64,7 @@
         "path": "DiagnosticReport",
         "short": "SHR SexualIdentity Profile",
         "definition": "Information on gender identity and sexual orientation.",
-        "comments": "This is intended to capture a single report, and is not suitable for use in displaying summary information that covers multiple reports.  For example, this resource has not been designed for laboratory cumulative reporting formats nor detailed structured reports for sequencing.",
+        "comment": "This is intended to capture a single report, and is not suitable for use in displaying summary information that covers multiple reports.  For example, this resource has not been designed for laboratory cumulative reporting formats nor detailed structured reports for sequencing.",
         "alias": [
           "Report",
           "Test",
@@ -108,6 +114,10 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
           {
             "identity": "v2",
             "map": "ORU -> OBR"
@@ -127,7 +137,7 @@
         "path": "DiagnosticReport.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -166,7 +176,7 @@
         "path": "DiagnosticReport.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -187,7 +197,7 @@
         "path": "DiagnosticReport.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -207,6 +217,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -221,7 +239,7 @@
         "path": "DiagnosticReport.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -255,7 +273,7 @@
         "path": "DiagnosticReport.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -284,16 +302,19 @@
         "id": "DiagnosticReport:shr-sex-SexualIdentity.extension",
         "path": "DiagnosticReport.extension",
         "slicing": {
-          "id": "246",
+          "id": "236",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -322,6 +343,7 @@
         "path": "DiagnosticReport.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -354,6 +376,7 @@
         "path": "DiagnosticReport.extension",
         "sliceName": "observationcode",
         "definition": "A term from a controlled vocabulary that defines the data element (the question, not the answer) as specifically as possible. The specific code should always align with the concept of the element, but may be more specific. For example, the concept associated with medications is code for 'medication used', but the ObservationCode is the code for the particular medication used. For tests, ObservationCode identifies the specific test being performed, and for observations, the specific question being asked.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -435,7 +458,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -486,6 +508,7 @@
         "path": "DiagnosticReport.extension",
         "sliceName": "genderidentity",
         "definition": "Subjective personal perception of one's own gender, which can be male, female, a blend of both, or neither.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -518,6 +541,7 @@
         "path": "DiagnosticReport.extension",
         "sliceName": "sexualorientation",
         "definition": "An inherent and enduring emotional, romantic or sexual attraction to other people.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -550,7 +574,7 @@
         "path": "DiagnosticReport.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -578,11 +602,14 @@
       {
         "id": "DiagnosticReport:shr-sex-SexualIdentity.identifier",
         "path": "DiagnosticReport.identifier",
-        "short": "Id for external references to this report",
-        "definition": "The local ID assigned to the report by the order filler, usually by the Information System of the diagnostic service provider.",
+        "short": "Business identifier for report",
+        "definition": "Identifiers assigned to this report by the performer or other systems.",
+        "comment": "Usually assigned by the Information System of the diagnostic service provider (filler id).",
         "requirements": "Need to know what identifier to use when making queries about this report from the source laboratory, and for linking to the report outside FHIR context.",
         "alias": [
-          "ReportID"
+          "ReportID",
+          "Filler ID",
+          "Placer ID"
         ],
         "min": 0,
         "max": "*",
@@ -593,6 +620,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBR-51"
@@ -607,12 +638,65 @@
           }
         ]
       },
+      {
+        "id": "DiagnosticReport:shr-sex-SexualIdentity.basedOn",
+        "path": "DiagnosticReport.basedOn",
+        "short": "What was requested",
+        "definition": "Details concerning a test or procedure requested.",
+        "comment": "Note: Usually there is one test request for each result, however in some circumstances multiple test requests may be represented using a single test result resource. Note that there are also cases where one request leads to multiple reports.",
+        "requirements": "This allows tracing of authorization for the report and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Request"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC? OBR-2/3?"
+          },
+          {
+            "identity": "rim",
+            "map": "outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "DiagnosticReport:shr-sex-SexualIdentity.status",
         "path": "DiagnosticReport.status",
-        "short": "registered | partial | final | corrected | appended | cancelled | entered-in-error",
+        "short": "registered | partial | preliminary | final +",
         "definition": "The status of the diagnostic report as a whole.",
-        "comments": "This is labeled as \"Is Modifier\" because applications need to take appropriate action if a report is withdrawn.",
+        "comment": "This is labeled as \"Is Modifier\" because applications need to take appropriate action if a report is withdrawn.",
         "requirements": "Diagnostic services routinely issue provisional/incomplete reports, and sometimes withdraw previously released reports.",
         "min": 1,
         "max": "1",
@@ -624,6 +708,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "DiagnosticReportStatus"
+            }
+          ],
           "strength": "required",
           "description": "The status of the diagnostic report as a whole.",
           "valueSetReference": {
@@ -631,6 +721,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
           {
             "identity": "v2",
             "map": "OBR-25 (not 1:1 mapping)"
@@ -650,12 +744,12 @@
         "path": "DiagnosticReport.category",
         "short": "Service category",
         "definition": "A code that classifies the clinical discipline, department or diagnostic service that created the report (e.g. cardiology, biochemistry, hematology, MRI). This is used for searching, sorting and display purposes.",
-        "comments": "The level of granularity is defined by the category concepts in the value set. More fine-grained filtering can be performed using the metadata and/or terminology hierarchy in DiagnosticReport.code.",
+        "comment": "The level of granularity is defined by the category concepts in the value set. More fine-grained filtering can be performed using the metadata and/or terminology hierarchy in DiagnosticReport.code.",
         "alias": [
           "Department",
           "Sub-department",
-          "service",
-          "discipline"
+          "Service",
+          "Discipline"
         ],
         "min": 0,
         "max": "1",
@@ -692,6 +786,9 @@
         "path": "DiagnosticReport.code",
         "short": "Name/Code for this diagnostic report",
         "definition": "A code or name that describes this diagnostic report.",
+        "alias": [
+          "Type"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -701,6 +798,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "DiagnosticReportCodes"
+            }
+          ],
           "strength": "preferred",
           "description": "Codes that describe Diagnostic Reports.",
           "valueSetReference": {
@@ -708,6 +811,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
           {
             "identity": "v2",
             "map": "OBR-4 (HL7 v2 doesn't provide an easy way to indicate both the ordered test and the performed panel)"
@@ -725,7 +832,7 @@
       {
         "id": "DiagnosticReport:shr-sex-SexualIdentity.subject",
         "path": "DiagnosticReport.subject",
-        "short": "The subject of the report, usually, but not always, the patient",
+        "short": "The subject of the report - usually, but not always, the patient",
         "definition": "The subject of the report. Usually, but not always, this is a patient. However diagnostic services also perform analyses on specimens collected from a variety of other sources.",
         "requirements": "SHALL know the subject context.",
         "alias": [
@@ -753,6 +860,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3 (no HL7 v2 mapping for Group or Device)"
@@ -768,20 +879,33 @@
         ]
       },
       {
-        "id": "DiagnosticReport:shr-sex-SexualIdentity.encounter",
-        "path": "DiagnosticReport.encounter",
+        "id": "DiagnosticReport:shr-sex-SexualIdentity.context",
+        "path": "DiagnosticReport.context",
         "short": "Health care event when test ordered",
-        "definition": "The link to the health care event (encounter) when the order was made.",
+        "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) which this DiagnosticReport per is about.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
+        "requirements": "Links the request to the Encounter context.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1-19"
@@ -799,13 +923,14 @@
       {
         "id": "DiagnosticReport:shr-sex-SexualIdentity.effective[x]",
         "path": "DiagnosticReport.effective[x]",
-        "short": "Clinically Relevant time/time-period for report",
+        "short": "Clinically relevant time/time-period for report",
         "definition": "The time or time-period the observed values are related to. When the subject of the report is a patient, this is usually either the time of the procedure or of specimen collection(s), but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "If the diagnostic procedure was performed on the patient, this is the time it was performed. If there are specimens, the diagnostically relevant time can be derived from the specimen collection times, but the specimen information is not always available, and the exact relationship between the specimens and the diagnostically relevant time is not always automatic.",
+        "comment": "If the diagnostic procedure was performed on the patient, this is the time it was performed. If there are specimens, the diagnostically relevant time can be derived from the specimen collection times, but the specimen information is not always available, and the exact relationship between the specimens and the diagnostically relevant time is not always automatic.",
         "requirements": "Need to know where in the patient history to file/present this report.",
         "alias": [
           "Observation time",
-          "Effective Time"
+          "Effective Time",
+          "Occurrence"
         ],
         "min": 0,
         "max": "1",
@@ -819,6 +944,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBR-7"
@@ -838,7 +967,7 @@
         "path": "DiagnosticReport.issued",
         "short": "DateTime this version was released",
         "definition": "The date and time that this version of the report was released from the source diagnostic service.",
-        "comments": "May be different from the update time of the resource itself, because that is the status of the record (potentially a secondary copy), not the actual release time of the report.",
+        "comment": "May be different from the update time of the resource itself, because that is the status of the record (potentially a secondary copy), not the actual release time of the report.",
         "requirements": "Clinicians need to be able to check the date that the report was released.",
         "alias": [
           "Date Created",
@@ -871,10 +1000,8 @@
       {
         "id": "DiagnosticReport:shr-sex-SexualIdentity.performer",
         "path": "DiagnosticReport.performer",
-        "short": "Responsible Diagnostic Service",
-        "definition": "The diagnostic service that is responsible for issuing the report.",
-        "comments": "This is not necessarily the source of the atomic data items. It is the entity that takes responsibility for the clinical report.",
-        "requirements": "Need to know whom to contact if there are queries about the results. Also may need to track the source of reports for secondary data analysis.",
+        "short": "Participants in producing the report",
+        "definition": "Indicates who or what participated in producing the report.",
         "alias": [
           "Laboratory",
           "Service",
@@ -886,23 +1013,32 @@
         "max": "*",
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
-          },
+            "code": "BackboneElement"
+          }
+        ],
+        "constraint": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
+            "key": "ele-1",
+            "severity": "error",
+            "human": "All FHIR elements must have a @value or children",
+            "expression": "children().count() > id.count()",
+            "xpath": "@value|f:*|h:div",
+            "source": "Element"
           }
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "PRT-8 (where this PRT-4-Participation = \"PO\")"
           },
           {
             "identity": "rim",
-            "map": "participation[typeCode=AUT].role[classCode=ASSIGN].scoper"
+            "map": ".participation[typeCode=PRF]"
           },
           {
             "identity": "w5",
@@ -911,36 +1047,166 @@
         ]
       },
       {
-        "id": "DiagnosticReport:shr-sex-SexualIdentity.request",
-        "path": "DiagnosticReport.request",
-        "short": "What was requested",
-        "definition": "Details concerning a test or procedure requested.",
-        "comments": "Note: Usually there is one test request for each result, however in some circumstances multiple test requests may be represented using a single test result resource. Note that there are also cases where one request leads to multiple reports.",
-        "requirements": "Need to be able to track completion of requests based on reports issued and also to report what diagnostic tests were requested (not always the same as what is delivered).",
+        "id": "DiagnosticReport:shr-sex-SexualIdentity.performer.id",
+        "path": "DiagnosticReport.performer.id",
+        "representation": [
+          "xmlAttr"
+        ],
+        "short": "xml:id (or equivalent in JSON)",
+        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Element.id",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "DiagnosticReport:shr-sex-SexualIdentity.performer.extension",
+        "path": "DiagnosticReport.performer.extension",
+        "short": "Additional Content defined by implementations",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content"
+        ],
         "min": 0,
         "max": "*",
+        "base": {
+          "path": "Element.extension",
+          "min": 0,
+          "max": "*"
+        },
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DiagnosticRequest"
+            "code": "Extension"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "DiagnosticReport:shr-sex-SexualIdentity.performer.modifierExtension",
+        "path": "DiagnosticReport.performer.modifierExtension",
+        "short": "Extensions that cannot be ignored",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content",
+          "modifiers"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "BackboneElement.modifierExtension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "isModifier": true,
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "N/A"
+          }
+        ]
+      },
+      {
+        "id": "DiagnosticReport:shr-sex-SexualIdentity.performer.role",
+        "path": "DiagnosticReport.performer.role",
+        "short": "Type of performer",
+        "definition": "Describes the type of participation (e.g.  a responsible party, author, or verifier).",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Role"
+            }
+          ],
+          "strength": "example",
+          "description": "Indicate a role of diagnostic report performer",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/performer-role"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer.role"
+          },
+          {
+            "identity": "v2",
+            "map": "PRT-8 (where this PRT-4-Participation = \"PO\")"
           },
+          {
+            "identity": "rim",
+            "map": ".functionCode"
+          }
+        ]
+      },
+      {
+        "id": "DiagnosticReport:shr-sex-SexualIdentity.performer.actor",
+        "path": "DiagnosticReport.performer.actor",
+        "short": "Practitioner or Organization  participant",
+        "definition": "The reference to the  practitioner or organization involved in producing the report. For example, the diagnostic service that is responsible for issuing the report.",
+        "comment": "This is not necessarily the source of the atomic data items. It is the entity that takes responsibility for the clinical report.",
+        "requirements": "Need to know whom to contact if there are queries about the results. Also may need to track the source of reports for secondary data analysis.",
+        "min": 1,
+        "max": "1",
+        "type": [
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
           },
           {
             "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer.actor"
+          },
           {
             "identity": "v2",
-            "map": "ORC? OBR-2/3?"
+            "map": "PRT-8 (where this PRT-4-Participation = \"PO\")"
           },
           {
             "identity": "rim",
-            "map": "outboundRelationship[typeCode=FLFS].target"
+            "map": ".role"
           }
         ]
       },
@@ -949,7 +1215,7 @@
         "path": "DiagnosticReport.specimen",
         "short": "Specimens this report is based on",
         "definition": "Details about the specimens on which this diagnostic report is based.",
-        "comments": "If the specimen is sufficiently specified with a code in the test result name, then this additional data may be redundant. If there are multiple specimens, these may be represented per Observation or group.",
+        "comment": "If the specimen is sufficiently specified with a code in the test result name, then this additional data may be redundant. If there are multiple specimens, these may be represented per observation or group.",
         "requirements": "Need to be able to report information about the collected specimens on which the report is based.",
         "min": 0,
         "max": "*",
@@ -1011,7 +1277,7 @@
         "path": "DiagnosticReport.imagingStudy",
         "short": "Reference to full details of imaging associated with the diagnostic report",
         "definition": "One or more links to full details of any imaging performed during the diagnostic investigation. Typically, this is imaging performed by DICOM enabled modalities, but this is not required. A fully enabled PACS viewer can use this information to provide views of the source images.",
-        "comments": "ImagingStudy and ImageManifest and the image element are somewhat overlapping - typically, the list of image references in the image element will also be found in one of the imaging study resources. However each caters to different types of displays for different types of purposes. Neither, either, or both may be provided.",
+        "comment": "ImagingStudy and ImageManifest and the image element are somewhat overlapping - typically, the list of image references in the image element will also be found in one of the imaging study resources. However each caters to different types of displays for different types of purposes. Neither, either, or both may be provided.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1103,7 +1369,7 @@
         "path": "DiagnosticReport.image.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1132,7 +1398,7 @@
         "path": "DiagnosticReport.image.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1164,7 +1430,7 @@
         "path": "DiagnosticReport.image.comment",
         "short": "Comment about the image (e.g. explanation)",
         "definition": "A comment about the image. Typically, this is used to provide an explanation for why the image is included, or to draw the viewer's attention to important features.",
-        "comments": "The comment should be displayed with the image. It would be common for the report to include additional discussion of the image contents in other sections such as the conclusion.",
+        "comment": "The comment should be displayed with the image. It would be common for the report to include additional discussion of the image contents in other sections such as the conclusion.",
         "requirements": "The provider of the report should make a comment about each image included in the report.",
         "min": 0,
         "max": "1",
@@ -1242,8 +1508,14 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "AdjunctDiagnosis"
+            }
+          ],
           "strength": "example",
-          "description": "Diagnoses codes provided as adjuncts to the report.",
+          "description": "Diagnosis codes provided as adjuncts to the report.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/clinical-findings"
           }
@@ -1264,8 +1536,8 @@
         "path": "DiagnosticReport.presentedForm",
         "short": "Entire report as issued",
         "definition": "Rich text representation of the entire result as issued by the diagnostic service. Multiple formats are allowed but they SHALL be semantically equivalent.",
-        "comments": "\"application/pdf\" is recommended as the most reliable and interoperable in this context.",
-        "requirements": "Gives Laboratory the ability to provide its own fully formatted report for clinical fidelity.",
+        "comment": "\"application/pdf\" is recommended as the most reliable and interoperable in this context.",
+        "requirements": "Gives laboratory the ability to provide its own fully formatted report for clinical fidelity.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1399,12 +1671,16 @@
         ]
       },
       {
-        "id": "DiagnosticReport:shr-sex-SexualIdentity.encounter",
-        "path": "DiagnosticReport.encounter",
+        "id": "DiagnosticReport:shr-sex-SexualIdentity.context",
+        "path": "DiagnosticReport.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-sex-SexualOrientation-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-sex-SexualOrientation-extension.json
old mode 100755
new mode 100644
index a79971d..8e7d2d7
--- a/lib/resources/standard_health_record/StructureDefinition-shr-sex-SexualOrientation-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-sex-SexualOrientation-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.sex.SexualOrientation"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR SexualOrientation Extension",
   "title": "SHR SexualOrientation Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:22.965Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.467Z",
   "description": "An inherent and enduring emotional, romantic or sexual attraction to other people.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -170,7 +170,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-sex-SexualOrientationVS"
+            "reference": "http://standardhealthrecord.org/shr/sex/vs/SexualOrientationVS"
           }
         },
         "mapping": [
@@ -221,7 +221,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-sex-SexualOrientationVS"
+            "reference": "http://standardhealthrecord.org/shr/sex/vs/SexualOrientationVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-skin-CausativeFactor-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-skin-CausativeFactor-extension.json
old mode 100755
new mode 100644
index 7303346..163620c
--- a/lib/resources/standard_health_record/StructureDefinition-shr-skin-CausativeFactor-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-skin-CausativeFactor-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.skin.CausativeFactor"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR CausativeFactor Extension",
   "title": "SHR CausativeFactor Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.077Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.503Z",
   "description": "The cause the irritation or inflammation.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -153,9 +153,12 @@
         "id": "Extension:causativefactor.value[x]",
         "path": "Extension.value[x]",
         "slicing": {
-          "id": "257",
+          "id": "247",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -233,9 +236,12 @@
         "id": "Extension:causativefactor.value[x]",
         "path": "Extension.value[x]",
         "slicing": {
-          "id": "257",
+          "id": "247",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-skin-ImmersionDepth-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-skin-ImmersionDepth-extension.json
old mode 100755
new mode 100644
index 62c1b5d..4870fd0
--- a/lib/resources/standard_health_record/StructureDefinition-shr-skin-ImmersionDepth-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-skin-ImmersionDepth-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.skin.ImmersionDepth"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ImmersionDepth Extension",
   "title": "SHR ImmersionDepth Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.064Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.498Z",
   "description": "Depth of penetration (sinking) into a support surface.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-skin-PressureUlcer.json b/lib/resources/standard_health_record/StructureDefinition-shr-skin-PressureUlcer.json
old mode 100755
new mode 100644
index 0913fce..d410240
--- a/lib/resources/standard_health_record/StructureDefinition-shr-skin-PressureUlcer.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-skin-PressureUlcer.json
@@ -12,8 +12,10 @@
       "value": "shr.skin.PressureUlcer"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR PressureUlcer Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.067Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.502Z",
   "description": "A single pressure ulcer, tracked over a period of time. Multiple PressureUlcerAssessments (at different times) may be associated with a single PressureUlcer.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "sct-concept",
@@ -107,7 +108,7 @@
             "severity": "error",
             "human": "If condition is abated, then clinicalStatus must be either inactive, resolved, or remission",
             "expression": "abatement.empty() or (abatement as boolean).not()  or clinicalStatus='resolved' or clinicalStatus='remission' or clinicalStatus='inactive'",
-            "xpath": "xpath: not(f:abatementBoolean='true' or (not(exists(f:abatementBoolean)) and exists(*[starts-with(local-name(.), 'abatement')])) or f:clinicalStatus/@value=('resolved', 'remission', 'inactive')"
+            "xpath": "not(f:abatementBoolean='true' or (not(exists(f:abatementBoolean)) and exists(*[starts-with(local-name(.), 'abatement')])) or f:clinicalStatus/@value=('resolved', 'remission', 'inactive'))"
           },
           {
             "key": "con-3",
@@ -145,7 +146,7 @@
         "path": "Condition.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -184,7 +185,7 @@
         "path": "Condition.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -205,7 +206,7 @@
         "path": "Condition.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -225,6 +226,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -239,7 +248,7 @@
         "path": "Condition.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -273,7 +282,7 @@
         "path": "Condition.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -302,16 +311,19 @@
         "id": "Condition:shr-skin-PressureUlcer.extension",
         "path": "Condition.extension",
         "slicing": {
-          "id": "258",
+          "id": "248",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -340,6 +352,7 @@
         "path": "Condition.extension",
         "sliceName": "generalizedlikelihood",
         "definition": "Quantitative or qualitative measure of likelihood.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -372,6 +385,7 @@
         "path": "Condition.extension",
         "sliceName": "supportingevidencequality",
         "definition": "An assessment of the quality and/or quantity of the source information that supports judgment.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -404,6 +418,7 @@
         "path": "Condition.extension",
         "sliceName": "includeonproblemlist",
         "definition": "Whether or not to include this problem on the subject's current problem list.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -436,6 +451,7 @@
         "path": "Condition.extension",
         "sliceName": "whenclinicallyrecognized",
         "definition": "The time at which a condition or problem was first identified in a healthcare context.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -468,6 +484,7 @@
         "path": "Condition.extension",
         "sliceName": "preexisting",
         "definition": "If the problem or condition existed before the current episode of care.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -500,6 +517,7 @@
         "path": "Condition.extension",
         "sliceName": "criticality",
         "definition": "A clinical judgment of potential clinical harm, or seriousness, of a condition. When the worst case result is assessed to have a life-threatening or organ system threatening potential, it is considered to be of high criticality.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -532,6 +550,7 @@
         "path": "Condition.extension",
         "sliceName": "causativefactor",
         "definition": "The cause the irritation or inflammation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -563,16 +582,19 @@
         "id": "Condition:shr-skin-PressureUlcer.modifierExtension",
         "path": "Condition.modifierExtension",
         "slicing": {
-          "id": "259",
+          "id": "249",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -602,6 +624,7 @@
         "path": "Condition.modifierExtension",
         "sliceName": "nonoccurrencemodifier",
         "definition": "When true, indicates either that the event or action documented in the entry did not occur, or the the thing documented is absent or does not exist.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -659,6 +682,7 @@
         "path": "Condition.clinicalStatus",
         "short": "active | recurrence | inactive | remission | resolved",
         "definition": "The clinical status of the condition.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the condition as not currently valid or of concern.",
         "min": 1,
         "max": "1",
         "type": [
@@ -666,9 +690,19 @@
             "code": "code"
           }
         ],
+        "condition": [
+          "con-3",
+          "con-4"
+        ],
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ConditionClinicalStatus"
+            }
+          ],
           "strength": "required",
           "description": "The clinical status of the condition or diagnosis.",
           "valueSetReference": {
@@ -684,6 +718,10 @@
             "identity": "v2",
             "map": "PRB-14 / DG1-6"
           },
+          {
+            "identity": "rim",
+            "map": "Observation ACT\n.inboundRelationship[typeCode=COMP].source[classCode=OBS, code=\"clinicalStatus\", moodCode=EVN].value"
+          },
           {
             "identity": "w5",
             "map": "status"
@@ -695,7 +733,7 @@
         "path": "Condition.verificationStatus",
         "short": "provisional | differential | confirmed | refuted | entered-in-error | unknown",
         "definition": "The verification status to support the clinical status of the condition.",
-        "comments": "verificationStatus is not required.  For example, when a patient has abdominal pain in the ED, there is not likely going to be a verification status.",
+        "comment": "verificationStatus is not required.  For example, when a patient has abdominal pain in the ED, there is not likely going to be a verification status.\n\nThis element is labeled as a modifier because the status contains the code refuted and entered-in-error that mark the Condition as not currently valid.",
         "min": 0,
         "max": "1",
         "type": [
@@ -704,9 +742,18 @@
           }
         ],
         "defaultValueCode": "unknown",
+        "condition": [
+          "con-3"
+        ],
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ConditionVerificationStatus"
+            }
+          ],
           "strength": "required",
           "description": "The verification status to support or decline the clinical status of the condition or diagnosis.",
           "valueSetReference": {
@@ -724,7 +771,7 @@
           },
           {
             "identity": "rim",
-            "map": ".code (pre or post-coordinated in)  Can use valueNegationInd for refuted"
+            "map": "Observation ACT\n.inboundRelationship[typeCode=COMP].source[classCode=OBS, code=\"verificationStatus\", moodCode=EVN].value"
           },
           {
             "identity": "sct-attr",
@@ -741,7 +788,7 @@
         "path": "Condition.category",
         "short": "problem-list-item | encounter-diagnosis",
         "definition": "A category assigned to the condition.",
-        "comments": "The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts.",
+        "comment": "The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts.",
         "min": 0,
         "max": "*",
         "type": [
@@ -753,7 +800,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-problem-ProblemCategoryVS"
+            "reference": "http://standardhealthrecord.org/shr/problem/vs/ProblemCategoryVS"
           }
         },
         "mapping": [
@@ -780,7 +827,7 @@
         "path": "Condition.severity",
         "short": "Subjective severity of condition",
         "definition": "A subjective assessment of the severity of the condition as evaluated by the clinician.",
-        "comments": "Coding of the severity with a terminology is preferred, where possible.",
+        "comment": "Coding of the severity with a terminology is preferred, where possible.",
         "min": 0,
         "max": "1",
         "type": [
@@ -790,6 +837,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ConditionSeverity"
+            }
+          ],
           "strength": "preferred",
           "description": "A subjective assessment of the severity of the condition as evaluated by the clinician.",
           "valueSetReference": {
@@ -824,6 +877,10 @@
         "path": "Condition.code",
         "short": "Identification of the condition, problem or diagnosis",
         "definition": "Identification of the condition, problem or diagnosis.",
+        "requirements": "0..1 to account for primarily narrative only resources.",
+        "alias": [
+          "type"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -834,6 +891,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ConditionKind"
+            }
+          ],
           "strength": "example",
           "description": "Identification of the condition or diagnosis.",
           "valueSetReference": {
@@ -868,7 +931,7 @@
         "path": "Condition.bodySite",
         "short": "Anatomical location, if relevant",
         "definition": "The anatomical location where this condition manifests itself.",
-        "comments": "Only used if not implicit in code found in Condition.code. If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [body-site-instance](extension-body-site-instance.html).  May be a summary code, or a reference to a very precise definition of the location, or both.",
+        "comment": "Only used if not implicit in code found in Condition.code. If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [body-site-instance](extension-body-site-instance.html).  May be a summary code, or a reference to a very precise definition of the location, or both.",
         "min": 0,
         "max": "*",
         "type": [
@@ -881,7 +944,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-skin-PressureUlcerBodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/skin/vs/PressureUlcerBodySiteVS"
           }
         },
         "mapping": [
@@ -905,6 +968,9 @@
         "short": "Who has the condition?",
         "definition": "Indicates the patient or group who the condition record is associated with.",
         "requirements": "Group is typically used for veterinary or public health use cases.",
+        "alias": [
+          "patient"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -936,9 +1002,12 @@
       {
         "id": "Condition:shr-skin-PressureUlcer.context",
         "path": "Condition.context",
-        "short": "Encounter when condition first asserted",
+        "short": "Encounter or episode when condition first asserted",
         "definition": "Encounter during which the condition was first asserted.",
-        "comments": "This record indicates the encounter this particular record is associated with.  In the case of a \"new\" diagnosis reflecting ongoing/revised information about the condition, this might be distinct from the first encounter in which the underlying condition was first \"known\".",
+        "comment": "This record indicates the encounter this particular record is associated with.  In the case of a \"new\" diagnosis reflecting ongoing/revised information about the condition, this might be distinct from the first encounter in which the underlying condition was first \"known\".",
+        "alias": [
+          "encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -951,6 +1020,7 @@
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -971,7 +1041,7 @@
         "path": "Condition.onset[x]",
         "short": "Estimated or actual date,  date-time, or age",
         "definition": "Estimated or actual date or date-time  the condition began, in the opinion of the clinician.",
-        "comments": "Age is generally used when the patient reports an age at which the Condition began to occur.",
+        "comment": "Age is generally used when the patient reports an age at which the Condition began to occur.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1012,7 +1082,7 @@
         "path": "Condition.abatement[x]",
         "short": "If/when in resolution/remission",
         "definition": "The date or estimated date that the condition resolved or went into remission. This is called \"abatement\" because of the many overloaded connotations associated with \"remission\" or \"resolution\" - Conditions are never really resolved, but they can abate.",
-        "comments": "There is no explicit distinction between resolution and remission because in many cases the distinction is not clear. Age is generally used when the patient reports an age at which the Condition abated.  If there is no abatement element, it is unknown whether the condition has resolved or entered remission; applications and users should generally assume that the condition is still valid.  When abatementString exists, it implies the condition is abated.",
+        "comment": "There is no explicit distinction between resolution and remission because in many cases the distinction is not clear. Age is generally used when the patient reports an age at which the Condition abated.  If there is no abatement element, it is unknown whether the condition has resolved or entered remission; applications and users should generally assume that the condition is still valid.  When abatementString exists, it implies the condition is abated.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1035,6 +1105,9 @@
             "code": "string"
           }
         ],
+        "condition": [
+          "con-4"
+        ],
         "mapping": [
           {
             "identity": "rim",
@@ -1051,14 +1124,15 @@
         "path": "Condition.assertedDate",
         "short": "Date record was believed accurate",
         "definition": "The date on which the existance of the Condition was first asserted or acknowledged.",
-        "comments": "The assertedDate represents the date when this particular Condition record was created in the EHR, not the date of the most recent update in terms of when severity, abatement, etc. were specified.  The date of the last record modification can be retrieved from the resource metadata.",
+        "comment": "The assertedDate represents the date when this particular Condition record was created in the EHR, not the date of the most recent update in terms of when severity, abatement, etc. were specified.  The date of the last record modification can be retrieved from the resource metadata.",
         "min": 1,
         "max": "1",
         "type": [
           {
-            "code": "date"
+            "code": "dateTime"
           }
         ],
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -1179,7 +1253,7 @@
         "path": "Condition.stage.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1208,7 +1282,7 @@
         "path": "Condition.stage.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1254,7 +1328,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-problem-GradeOrStageVS"
+            "reference": "http://standardhealthrecord.org/shr/problem/vs/GradeOrStageVS"
           }
         },
         "mapping": [
@@ -1308,7 +1382,7 @@
         "path": "Condition.evidence",
         "short": "Supporting evidence",
         "definition": "Supporting Evidence / manifestations that are the basis on which this condition is suspected or confirmed.",
-        "comments": "The evidence may be a simple list of coded symptoms/manifestations, or references to observations or formal assessments, or both.",
+        "comment": "The evidence may be a simple list of coded symptoms/manifestations, or references to observations or formal assessments, or both.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1372,7 +1446,7 @@
         "path": "Condition.evidence.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1401,7 +1475,7 @@
         "path": "Condition.evidence.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1434,7 +1508,7 @@
         "short": "Manifestation/symptom",
         "definition": "A manifestation or symptom that led to the recording of this condition.",
         "min": 0,
-        "max": "1",
+        "max": "*",
         "type": [
           {
             "code": "CodeableConcept",
@@ -1444,10 +1518,11 @@
         "condition": [
           "con-2"
         ],
+        "isSummary": true,
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-ManifestationVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/ManifestationVS"
           }
         },
         "mapping": [
@@ -1458,6 +1533,10 @@
           {
             "identity": "rim",
             "map": "[code=\"diagnosis\"].value"
+          },
+          {
+            "identity": "w5",
+            "map": "why"
           }
         ]
       },
@@ -1477,10 +1556,15 @@
         "condition": [
           "con-2"
         ],
+        "isSummary": true,
         "mapping": [
           {
             "identity": "rim",
             "map": ".self"
+          },
+          {
+            "identity": "w5",
+            "map": "why"
           }
         ]
       },
@@ -1663,7 +1747,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-problem-ProblemCategoryVS"
+            "reference": "http://standardhealthrecord.org/shr/problem/vs/ProblemCategoryVS"
           }
         }
       },
@@ -1680,6 +1764,8 @@
       {
         "id": "Condition:shr-skin-PressureUlcer.code",
         "path": "Condition.code",
+        "min": 1,
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept",
@@ -1699,7 +1785,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-skin-PressureUlcerBodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/skin/vs/PressureUlcerBodySiteVS"
           }
         }
       },
@@ -1743,7 +1829,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-problem-GradeOrStageVS"
+            "reference": "http://standardhealthrecord.org/shr/problem/vs/GradeOrStageVS"
           }
         }
       },
@@ -1763,7 +1849,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-ManifestationVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/ManifestationVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-skin-PressureUlcerBodySite.json b/lib/resources/standard_health_record/StructureDefinition-shr-skin-PressureUlcerBodySite.json
old mode 100755
new mode 100644
index d600325..fb47869
--- a/lib/resources/standard_health_record/StructureDefinition-shr-skin-PressureUlcerBodySite.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-skin-PressureUlcerBodySite.json
@@ -3,7 +3,7 @@
   "id": "shr-skin-PressureUlcerBodySite",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR PressureUlcerBodySite Profile</b></p>\n  <p>The site of a pressure ulcer.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.skin.PressureUlcerBodySite maps to BodySite:\n  CodeableConcept maps to code\n  Laterality maps to modifier (slice on = coding.code)\n  Directionality maps to modifier\n  PortionTotality maps to modifier\n  Description maps to description\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR PressureUlcerBodySite Profile</b></p>\n  <p>The site of a pressure ulcer.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.skin.PressureUlcerBodySite maps to BodySite:\n  CodeableConcept maps to code\n  Laterality maps to qualifier (slice on = coding.code)\n  Directionality maps to qualifier\n  PortionTotality maps to qualifier\n  Description maps to description\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-skin-PressureUlcerBodySite",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.skin.PressureUlcerBodySite"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR PressureUlcerBodySite Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.083Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,10 +27,14 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.505Z",
   "description": "The site of a pressure ulcer.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "rim",
+      "uri": "http://hl7.org/v3",
+      "name": "RIM Mapping"
+    },
     {
       "identity": "openehr",
       "uri": "http://openehr.org",
@@ -43,11 +49,6 @@
       "identity": "v2",
       "uri": "http://hl7.org/v2",
       "name": "HL7 v2 Mapping"
-    },
-    {
-      "identity": "rim",
-      "uri": "http://hl7.org/v3",
-      "name": "RIM Mapping"
     }
   ],
   "kind": "resource",
@@ -106,9 +107,13 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "rim",
+            "map": "ActSIte"
+          },
           {
             "identity": "openehr",
-            "map": "Archetype ID   openEHR-EHR-CLUSTER.anatomical_location.v1      Concept name   Anatomical Location      Concept description   Record details about an anatomical location.      Keywords   location, site, anatomical      Copyright   © openEHR Foundation      Purpose   To record details about anatomical location.      Misuse   Not for specifiying unilateral/bilateral occurence - this is related to an evaluation which perhaps includes multiple locations.      Author   Author name: Heather Leslie Organisation: Ocean Informatics Email: heather.leslie@oceaninformatics.com Date of Origination: 2008-11-10       Translator   Norwegian Bokmål: Lars Bitsch-Larsen, Haukeland University Hospital of Bergen, Norway, MD, DEAA, MBA, spec in anesthesia, spec in tropical medicine. Arabic (Syria): Mona Saleh       Other contributors   Heather Leslie, Ocean Informatics, Australia (Editor) Ian McNicoll, freshEHR Clinical Informatics, United Kingdom (Editor) Dunmail Hodkinson, Black Pear Software Ltd, UK      References   Use cases: - 5LICS, midclavicular line - L forearm, 2cm anterior to the cubital fossa - Right iliac fossa - 5 cm below L tibial tuberosity - 2 cm medial to R nipple - 4 cm below R costal margin in midclavicular line - R femur - midline nose - medial aspect of R great toe nail."
+            "map": "Archetype ID   openEHR-EHR-CLUSTER.anatomical_location.v1      Concept name   Anatomical Location      Concept description   Record details about an anatomical location.      Keywords   location, site, anatomical      Copyright   © openEHR Foundation      Purpose   To record details about anatomical location.      Misuse   Not for specifiying unilateral/bilateral occurrence - this is related to an evaluation which perhaps includes multiple locations.      Author   Author name: Heather Leslie Organization: Ocean Informatics Email: heather.leslie@oceaninformatics.com Date of Origination: 2008-11-10       Translator   Norwegian Bokmål: Lars Bitsch-Larsen, Haukeland University Hospital of Bergen, Norway, MD, DEAA, MBA, spec in anesthesia, spec in tropical medicine. Arabic (Syria): Mona Saleh       Other contributors   Heather Leslie, Ocean Informatics, Australia (Editor) Ian McNicoll, freshEHR Clinical Informatics, United Kingdom (Editor) Dunmail Hodkinson, Black Pear Software Ltd, UK      References   Use cases: - 5LICS, midclavicular line - L forearm, 2cm anterior to the cubital fossa - Right iliac fossa - 5 cm below L tibial tuberosity - 2 cm medial to R nipple - 4 cm below R costal margin in midclavicular line - R femur - midline nose - medial aspect of R great toe nail."
           },
           {
             "identity": "w5",
@@ -121,7 +126,7 @@
         "path": "BodySite.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -160,7 +165,7 @@
         "path": "BodySite.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -181,7 +186,7 @@
         "path": "BodySite.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -201,6 +206,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -215,7 +228,7 @@
         "path": "BodySite.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -249,7 +262,7 @@
         "path": "BodySite.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -279,7 +292,7 @@
         "path": "BodySite.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -308,7 +321,7 @@
         "path": "BodySite.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -333,21 +346,6 @@
           }
         ]
       },
-      {
-        "id": "BodySite:shr-skin-PressureUlcerBodySite.patient",
-        "path": "BodySite.patient",
-        "short": "Patient",
-        "definition": "The person to which the body site belongs.",
-        "min": 1,
-        "max": "1",
-        "type": [
-          {
-            "code": "Reference",
-            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient"
-          }
-        ],
-        "isSummary": true
-      },
       {
         "id": "BodySite:shr-skin-PressureUlcerBodySite.identifier",
         "path": "BodySite.identifier",
@@ -362,9 +360,45 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "rim",
+            "map": ".id"
+          },
           {
             "identity": "openehr",
             "map": "Specific location  Cluster Optional (0..1) Cardinality: Mandatory, repeating, unordered (1..*)"
+          },
+          {
+            "identity": "w5",
+            "map": "id"
+          }
+        ]
+      },
+      {
+        "id": "BodySite:shr-skin-PressureUlcerBodySite.active",
+        "path": "BodySite.active",
+        "short": "Whether this body site record is in active use",
+        "definition": "Whether this body site is in active use.",
+        "comment": "This element is labeled as a modifier because it may be used to mark that the resource was created in error.",
+        "requirements": "Need to be able to mark a body site entry as not to be used because it was created in error.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "boolean"
+          }
+        ],
+        "defaultValueBoolean": true,
+        "isModifier": true,
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "statusCode"
+          },
+          {
+            "identity": "w5",
+            "map": "status"
           }
         ]
       },
@@ -385,7 +419,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-skin-PressureUlcerBodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/skin/vs/PressureUlcerBodySiteVS"
           }
         },
         "mapping": [
@@ -393,25 +427,36 @@
             "identity": "v2",
             "map": "OBX-20"
           },
+          {
+            "identity": "rim",
+            "map": ".targetSiteCode"
+          },
           {
             "identity": "openehr",
             "map": "Name of location"
+          },
+          {
+            "identity": "w5",
+            "map": "what"
           }
         ]
       },
       {
-        "id": "BodySite:shr-skin-PressureUlcerBodySite.modifier",
-        "path": "BodySite.modifier",
+        "id": "BodySite:shr-skin-PressureUlcerBodySite.qualifier",
+        "path": "BodySite.qualifier",
         "slicing": {
-          "id": "260",
+          "id": "250",
           "discriminator": [
-            "coding.code"
+            {
+              "type": "value",
+              "path": "coding.code"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Modification to location code",
-        "definition": "Modifier to refine the anatomical location.  These include modifiers for laterality, relative location, directionality, number, and plane.",
+        "definition": "Qualifier to refine the anatomical location.  These include qualifiers for laterality, relative location, directionality, number, and plane.",
         "min": 0,
         "max": "*",
         "type": [
@@ -420,6 +465,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySiteQualifier"
+            }
+          ],
           "strength": "example",
           "description": "Concepts modifying the anatomic location",
           "valueSetReference": {
@@ -431,18 +482,26 @@
             "identity": "v2",
             "map": "No distinct element defined in V2.x. The IHE Radiology Technical Framework directs the use of OBR-15-specimen source to contain laterality for imaging studies."
           },
+          {
+            "identity": "rim",
+            "map": ".targetSiteCode"
+          },
           {
             "identity": "openehr",
             "map": "Combines Side, Numerical identifier, Anatomical plane,and Aspect"
+          },
+          {
+            "identity": "w5",
+            "map": "what"
           }
         ]
       },
       {
-        "id": "BodySite:shr-skin-PressureUlcerBodySite.modifier:shr-core-Laterality",
-        "path": "BodySite.modifier",
+        "id": "BodySite:shr-skin-PressureUlcerBodySite.qualifier:shr-core-Laterality",
+        "path": "BodySite.qualifier",
         "sliceName": "shr-core-Laterality",
         "short": "Modification to location code",
-        "definition": "Modifier to refine the anatomical location.  These include modifiers for laterality, relative location, directionality, number, and plane.",
+        "definition": "Qualifier to refine the anatomical location.  These include qualifiers for laterality, relative location, directionality, number, and plane.",
         "min": 0,
         "max": "1",
         "type": [
@@ -454,7 +513,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-LateralityVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/LateralityVS"
           }
         },
         "mapping": [
@@ -462,18 +521,26 @@
             "identity": "v2",
             "map": "No distinct element defined in V2.x. The IHE Radiology Technical Framework directs the use of OBR-15-specimen source to contain laterality for imaging studies."
           },
+          {
+            "identity": "rim",
+            "map": ".targetSiteCode"
+          },
           {
             "identity": "openehr",
             "map": "Combines Side, Numerical identifier, Anatomical plane,and Aspect"
+          },
+          {
+            "identity": "w5",
+            "map": "what"
           }
         ]
       },
       {
-        "id": "BodySite:shr-skin-PressureUlcerBodySite.modifier:shr-core-Directionality",
-        "path": "BodySite.modifier",
+        "id": "BodySite:shr-skin-PressureUlcerBodySite.qualifier:shr-core-Directionality",
+        "path": "BodySite.qualifier",
         "sliceName": "shr-core-Directionality",
         "short": "Modification to location code",
-        "definition": "Modifier to refine the anatomical location.  These include modifiers for laterality, relative location, directionality, number, and plane.",
+        "definition": "Qualifier to refine the anatomical location.  These include qualifiers for laterality, relative location, directionality, number, and plane.",
         "min": 0,
         "max": "0",
         "type": [
@@ -485,7 +552,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-DirectionalityVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/DirectionalityVS"
           }
         },
         "mapping": [
@@ -493,18 +560,26 @@
             "identity": "v2",
             "map": "No distinct element defined in V2.x. The IHE Radiology Technical Framework directs the use of OBR-15-specimen source to contain laterality for imaging studies."
           },
+          {
+            "identity": "rim",
+            "map": ".targetSiteCode"
+          },
           {
             "identity": "openehr",
             "map": "Combines Side, Numerical identifier, Anatomical plane,and Aspect"
+          },
+          {
+            "identity": "w5",
+            "map": "what"
           }
         ]
       },
       {
-        "id": "BodySite:shr-skin-PressureUlcerBodySite.modifier:shr-core-PortionTotality",
-        "path": "BodySite.modifier",
+        "id": "BodySite:shr-skin-PressureUlcerBodySite.qualifier:shr-core-PortionTotality",
+        "path": "BodySite.qualifier",
         "sliceName": "shr-core-PortionTotality",
         "short": "Modification to location code",
-        "definition": "Modifier to refine the anatomical location.  These include modifiers for laterality, relative location, directionality, number, and plane.",
+        "definition": "Qualifier to refine the anatomical location.  These include qualifiers for laterality, relative location, directionality, number, and plane.",
         "min": 0,
         "max": "0",
         "type": [
@@ -516,7 +591,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-PortionTotalityVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/PortionTotalityVS"
           }
         },
         "mapping": [
@@ -524,18 +599,26 @@
             "identity": "v2",
             "map": "No distinct element defined in V2.x. The IHE Radiology Technical Framework directs the use of OBR-15-specimen source to contain laterality for imaging studies."
           },
+          {
+            "identity": "rim",
+            "map": ".targetSiteCode"
+          },
           {
             "identity": "openehr",
             "map": "Combines Side, Numerical identifier, Anatomical plane,and Aspect"
+          },
+          {
+            "identity": "w5",
+            "map": "what"
           }
         ]
       },
       {
         "id": "BodySite:shr-skin-PressureUlcerBodySite.description",
         "path": "BodySite.description",
-        "short": "The Description of anatomical location",
-        "definition": "Description of anatomical location.",
-        "comments": "This Description  could include any visual markings used to orientate the viewer e.g. external reference points, special sutures, ink markings.",
+        "short": "Anatomical location description",
+        "definition": "A summary, charactarization or explanation of the anatomic location.",
+        "comment": "This description could include any visual markings used to orientate the viewer e.g. external reference points, special sutures, ink markings.",
         "min": 0,
         "max": "1",
         "type": [
@@ -545,9 +628,17 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "rim",
+            "map": ".text"
+          },
           {
             "identity": "openehr",
             "map": "Description of anatomical location/Visual markings/orientation"
+          },
+          {
+            "identity": "w5",
+            "map": "what"
           }
         ]
       },
@@ -564,9 +655,42 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "rim",
+            "map": "outboundRelationship[typeCode=COMP].target"
+          },
           {
             "identity": "openehr",
             "map": "Image"
+          },
+          {
+            "identity": "w5",
+            "map": "what"
+          }
+        ]
+      },
+      {
+        "id": "BodySite:shr-skin-PressureUlcerBodySite.patient",
+        "path": "BodySite.patient",
+        "short": "Who this is about",
+        "definition": "The person to which the body site belongs.",
+        "min": 1,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".scoper or .scoper.playsRole"
+          },
+          {
+            "identity": "w5",
+            "map": "who.focus"
           }
         ]
       }
@@ -594,25 +718,28 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-skin-PressureUlcerBodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/skin/vs/PressureUlcerBodySiteVS"
           }
         }
       },
       {
-        "id": "BodySite:shr-skin-PressureUlcerBodySite.modifier",
-        "path": "BodySite.modifier",
+        "id": "BodySite:shr-skin-PressureUlcerBodySite.qualifier",
+        "path": "BodySite.qualifier",
         "slicing": {
-          "id": "260",
+          "id": "250",
           "discriminator": [
-            "coding.code"
+            {
+              "type": "value",
+              "path": "coding.code"
+            }
           ],
           "ordered": false,
           "rules": "open"
         }
       },
       {
-        "id": "BodySite:shr-skin-PressureUlcerBodySite.modifier:shr-core-Laterality",
-        "path": "BodySite.modifier",
+        "id": "BodySite:shr-skin-PressureUlcerBodySite.qualifier:shr-core-Laterality",
+        "path": "BodySite.qualifier",
         "sliceName": "shr-core-Laterality",
         "min": 0,
         "max": "1",
@@ -625,13 +752,13 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-LateralityVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/LateralityVS"
           }
         }
       },
       {
-        "id": "BodySite:shr-skin-PressureUlcerBodySite.modifier:shr-core-Directionality",
-        "path": "BodySite.modifier",
+        "id": "BodySite:shr-skin-PressureUlcerBodySite.qualifier:shr-core-Directionality",
+        "path": "BodySite.qualifier",
         "sliceName": "shr-core-Directionality",
         "min": 0,
         "max": "0",
@@ -644,13 +771,13 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-DirectionalityVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/DirectionalityVS"
           }
         }
       },
       {
-        "id": "BodySite:shr-skin-PressureUlcerBodySite.modifier:shr-core-PortionTotality",
-        "path": "BodySite.modifier",
+        "id": "BodySite:shr-skin-PressureUlcerBodySite.qualifier:shr-core-PortionTotality",
+        "path": "BodySite.qualifier",
         "sliceName": "shr-core-PortionTotality",
         "min": 0,
         "max": "0",
@@ -663,7 +790,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-PortionTotalityVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/PortionTotalityVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-skin-PressureUlcerManifestation.json b/lib/resources/standard_health_record/StructureDefinition-shr-skin-PressureUlcerManifestation.json
old mode 100755
new mode 100644
index 8f91ad0..c0fe017
--- a/lib/resources/standard_health_record/StructureDefinition-shr-skin-PressureUlcerManifestation.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-skin-PressureUlcerManifestation.json
@@ -3,7 +3,7 @@
   "id": "shr-skin-PressureUlcerManifestation",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR PressureUlcerManifestation Profile</b></p>\n  <p>Observation regarding the properties and severity of a single pressure ulcer.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.skin.PressureUlcerManifestation maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR PressureUlcerManifestation Profile</b></p>\n  <p>Observation regarding the properties and severity of a single pressure ulcer.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.skin.PressureUlcerManifestation maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-skin-PressureUlcerManifestation",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.skin.PressureUlcerManifestation"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR PressureUlcerManifestation Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.108Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.519Z",
   "description": "Observation regarding the properties and severity of a single pressure ulcer.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR PressureUlcerManifestation Profile",
         "definition": "Observation regarding the properties and severity of a single pressure ulcer.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-skin-PressureUlcerManifestation.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "269",
+          "id": "259",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -398,6 +435,7 @@
         "path": "Observation.extension",
         "sliceName": "severity",
         "definition": "Degree of severity of a symptom, disorder, or problem.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -430,6 +468,7 @@
         "path": "Observation.extension",
         "sliceName": "bodysite",
         "definition": "Location on or in the body.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -462,6 +501,7 @@
         "path": "Observation.extension",
         "sliceName": "visibleinternalstructure",
         "definition": "An internal body structure visible from outside the body, for example, due to injury.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -494,6 +534,7 @@
         "path": "Observation.extension",
         "sliceName": "woundsize",
         "definition": "The estimated or measured dimensions of a wound.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -526,6 +567,7 @@
         "path": "Observation.extension",
         "sliceName": "woundtunnelling",
         "definition": "A discharging blind-ended track that extends from the surface of an organ to an underlying area or abscess cavity. The track is invariably lined with granulation tissue. In chronic cases this may be augmented with epithelial tissue.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -558,6 +600,7 @@
         "path": "Observation.extension",
         "sliceName": "woundundermining",
         "definition": "Assessment of deep tissue (subcutaneous fat and muscle) damage around the wound margin. Tunneling is just under the skin surface and doesn't involve deep tissue, and sinus tracts are a narrow tract that are away from the wound margins and go downward into the wound.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -590,6 +633,7 @@
         "path": "Observation.extension",
         "sliceName": "woundbedandedge",
         "definition": "SHR WoundBedAndEdge Extension",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -622,6 +666,7 @@
         "path": "Observation.extension",
         "sliceName": "woundexudate",
         "definition": "A mass of cells and fluid that has seeped out of a wound.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -654,6 +699,7 @@
         "path": "Observation.extension",
         "sliceName": "changeflag",
         "definition": "Indicator of significant change (delta) from the last or previous measurement.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -685,16 +731,19 @@
         "id": "Observation:shr-skin-PressureUlcerManifestation.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "270",
+          "id": "260",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -724,6 +773,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -754,8 +804,8 @@
       {
         "id": "Observation:shr-skin-PressureUlcerManifestation.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -764,7 +814,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -779,6 +834,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-skin-PressureUlcerManifestation.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-skin-PressureUlcerManifestation.status",
         "extension": [
@@ -790,6 +902,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -801,6 +914,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -808,6 +927,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -827,8 +954,8 @@
         "path": "Observation.category",
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 0,
         "max": "*",
         "type": [
@@ -838,8 +965,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -861,6 +994,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -881,10 +1017,18 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-ManifestationVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/ManifestationVS"
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -893,6 +1037,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -904,7 +1052,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -928,6 +1076,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -943,20 +1095,32 @@
         ]
       },
       {
-        "id": "Observation:shr-skin-PressureUlcerManifestation.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-skin-PressureUlcerManifestation.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -976,8 +1140,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -991,6 +1158,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -1010,7 +1181,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -1062,6 +1233,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -1081,8 +1256,8 @@
         "path": "Observation.value[x]",
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1095,6 +1270,9 @@
           {
             "code": "string"
           },
+          {
+            "code": "boolean"
+          },
           {
             "code": "Range"
           },
@@ -1122,6 +1300,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1129,6 +1315,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1137,7 +1327,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1150,6 +1340,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1157,6 +1353,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -1184,6 +1384,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1191,6 +1397,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1198,6 +1408,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1215,6 +1429,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -1230,8 +1448,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1240,6 +1457,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -1247,6 +1470,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -1254,6 +1481,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1262,7 +1493,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1273,6 +1504,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1295,7 +1532,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1305,6 +1542,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1312,6 +1553,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1320,7 +1565,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1334,6 +1579,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1341,6 +1590,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1349,7 +1602,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1418,7 +1671,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1447,7 +1700,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1529,30 +1782,82 @@
         ]
       },
       {
-        "id": "Observation:shr-skin-PressureUlcerManifestation.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-skin-PressureUlcerManifestation.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-skin-PressureUlcerManifestation.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1608,8 +1913,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1671,7 +1976,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1700,7 +2005,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1732,7 +2037,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1742,6 +2047,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1792,7 +2103,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1855,7 +2166,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1884,7 +2195,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1926,6 +2237,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1933,6 +2250,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1952,8 +2273,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1990,6 +2311,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1997,6 +2322,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -2005,7 +2334,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -2018,6 +2347,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -2040,7 +2375,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -2053,6 +2388,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -2060,6 +2401,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -2067,6 +2412,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -2075,7 +2424,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -2323,7 +2672,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-ManifestationVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/ManifestationVS"
           }
         }
       },
@@ -2352,12 +2701,16 @@
         ]
       },
       {
-        "id": "Observation:shr-skin-PressureUlcerManifestation.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-skin-PressureUlcerManifestation.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-skin-PressureUlcerNotPresent.json b/lib/resources/standard_health_record/StructureDefinition-shr-skin-PressureUlcerNotPresent.json
old mode 100755
new mode 100644
index 37a6081..872662b
--- a/lib/resources/standard_health_record/StructureDefinition-shr-skin-PressureUlcerNotPresent.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-skin-PressureUlcerNotPresent.json
@@ -12,8 +12,10 @@
       "value": "shr.skin.PressureUlcerNotPresent"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR PressureUlcerNotPresent Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.089Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.509Z",
   "description": "A statement that there is no pressure ulcer at a given body site. If body site is omitted, or if the body site is a coding representing the entire body, then the inference is that no pressure ulcers is present anywhere on the body.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "sct-concept",
@@ -107,7 +108,7 @@
             "severity": "error",
             "human": "If condition is abated, then clinicalStatus must be either inactive, resolved, or remission",
             "expression": "abatement.empty() or (abatement as boolean).not()  or clinicalStatus='resolved' or clinicalStatus='remission' or clinicalStatus='inactive'",
-            "xpath": "xpath: not(f:abatementBoolean='true' or (not(exists(f:abatementBoolean)) and exists(*[starts-with(local-name(.), 'abatement')])) or f:clinicalStatus/@value=('resolved', 'remission', 'inactive')"
+            "xpath": "not(f:abatementBoolean='true' or (not(exists(f:abatementBoolean)) and exists(*[starts-with(local-name(.), 'abatement')])) or f:clinicalStatus/@value=('resolved', 'remission', 'inactive'))"
           },
           {
             "key": "con-3",
@@ -145,7 +146,7 @@
         "path": "Condition.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -184,7 +185,7 @@
         "path": "Condition.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -205,7 +206,7 @@
         "path": "Condition.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -225,6 +226,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -239,7 +248,7 @@
         "path": "Condition.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -273,7 +282,7 @@
         "path": "Condition.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -302,16 +311,19 @@
         "id": "Condition:shr-skin-PressureUlcerNotPresent.extension",
         "path": "Condition.extension",
         "slicing": {
-          "id": "261",
+          "id": "251",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -340,6 +352,7 @@
         "path": "Condition.extension",
         "sliceName": "generalizedlikelihood",
         "definition": "Quantitative or qualitative measure of likelihood.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -372,6 +385,7 @@
         "path": "Condition.extension",
         "sliceName": "supportingevidencequality",
         "definition": "An assessment of the quality and/or quantity of the source information that supports judgment.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -404,6 +418,7 @@
         "path": "Condition.extension",
         "sliceName": "causativefactor",
         "definition": "The cause the irritation or inflammation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -435,16 +450,19 @@
         "id": "Condition:shr-skin-PressureUlcerNotPresent.modifierExtension",
         "path": "Condition.modifierExtension",
         "slicing": {
-          "id": "262",
+          "id": "252",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -474,6 +492,7 @@
         "path": "Condition.modifierExtension",
         "sliceName": "nonoccurrencemodifier",
         "definition": "When true, indicates either that the event or action documented in the entry did not occur, or the the thing documented is absent or does not exist.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -534,7 +553,10 @@
         "slicing": {
           "id": "10",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -634,7 +656,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -714,7 +735,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -900,6 +920,7 @@
         "path": "Condition.clinicalStatus",
         "short": "active | recurrence | inactive | remission | resolved",
         "definition": "The clinical status of the condition.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the condition as not currently valid or of concern.",
         "min": 1,
         "max": "1",
         "type": [
@@ -907,9 +928,19 @@
             "code": "code"
           }
         ],
+        "condition": [
+          "con-3",
+          "con-4"
+        ],
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ConditionClinicalStatus"
+            }
+          ],
           "strength": "required",
           "description": "The clinical status of the condition or diagnosis.",
           "valueSetReference": {
@@ -925,6 +956,10 @@
             "identity": "v2",
             "map": "PRB-14 / DG1-6"
           },
+          {
+            "identity": "rim",
+            "map": "Observation ACT\n.inboundRelationship[typeCode=COMP].source[classCode=OBS, code=\"clinicalStatus\", moodCode=EVN].value"
+          },
           {
             "identity": "w5",
             "map": "status"
@@ -936,7 +971,7 @@
         "path": "Condition.verificationStatus",
         "short": "provisional | differential | confirmed | refuted | entered-in-error | unknown",
         "definition": "The verification status to support the clinical status of the condition.",
-        "comments": "verificationStatus is not required.  For example, when a patient has abdominal pain in the ED, there is not likely going to be a verification status.",
+        "comment": "verificationStatus is not required.  For example, when a patient has abdominal pain in the ED, there is not likely going to be a verification status.\n\nThis element is labeled as a modifier because the status contains the code refuted and entered-in-error that mark the Condition as not currently valid.",
         "min": 0,
         "max": "1",
         "type": [
@@ -945,9 +980,18 @@
           }
         ],
         "defaultValueCode": "unknown",
+        "condition": [
+          "con-3"
+        ],
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ConditionVerificationStatus"
+            }
+          ],
           "strength": "required",
           "description": "The verification status to support or decline the clinical status of the condition or diagnosis.",
           "valueSetReference": {
@@ -965,7 +1009,7 @@
           },
           {
             "identity": "rim",
-            "map": ".code (pre or post-coordinated in)  Can use valueNegationInd for refuted"
+            "map": "Observation ACT\n.inboundRelationship[typeCode=COMP].source[classCode=OBS, code=\"verificationStatus\", moodCode=EVN].value"
           },
           {
             "identity": "sct-attr",
@@ -982,7 +1026,7 @@
         "path": "Condition.category",
         "short": "problem-list-item | encounter-diagnosis",
         "definition": "A category assigned to the condition.",
-        "comments": "The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts.",
+        "comment": "The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts.",
         "min": 0,
         "max": "*",
         "type": [
@@ -994,7 +1038,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-problem-ProblemCategoryVS"
+            "reference": "http://standardhealthrecord.org/shr/problem/vs/ProblemCategoryVS"
           }
         },
         "mapping": [
@@ -1021,7 +1065,7 @@
         "path": "Condition.severity",
         "short": "Subjective severity of condition",
         "definition": "A subjective assessment of the severity of the condition as evaluated by the clinician.",
-        "comments": "Coding of the severity with a terminology is preferred, where possible.",
+        "comment": "Coding of the severity with a terminology is preferred, where possible.",
         "min": 0,
         "max": "0",
         "type": [
@@ -1031,6 +1075,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ConditionSeverity"
+            }
+          ],
           "strength": "preferred",
           "description": "A subjective assessment of the severity of the condition as evaluated by the clinician.",
           "valueSetReference": {
@@ -1065,6 +1115,10 @@
         "path": "Condition.code",
         "short": "Identification of the condition, problem or diagnosis",
         "definition": "Identification of the condition, problem or diagnosis.",
+        "requirements": "0..1 to account for primarily narrative only resources.",
+        "alias": [
+          "type"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -1075,6 +1129,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ConditionKind"
+            }
+          ],
           "strength": "example",
           "description": "Identification of the condition or diagnosis.",
           "valueSetReference": {
@@ -1109,7 +1169,7 @@
         "path": "Condition.bodySite",
         "short": "Anatomical location, if relevant",
         "definition": "The anatomical location where this condition manifests itself.",
-        "comments": "Only used if not implicit in code found in Condition.code. If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [body-site-instance](extension-body-site-instance.html).  May be a summary code, or a reference to a very precise definition of the location, or both.",
+        "comment": "Only used if not implicit in code found in Condition.code. If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [body-site-instance](extension-body-site-instance.html).  May be a summary code, or a reference to a very precise definition of the location, or both.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1122,7 +1182,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-skin-PressureUlcerBodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/skin/vs/PressureUlcerBodySiteVS"
           }
         },
         "mapping": [
@@ -1146,6 +1206,9 @@
         "short": "Who has the condition?",
         "definition": "Indicates the patient or group who the condition record is associated with.",
         "requirements": "Group is typically used for veterinary or public health use cases.",
+        "alias": [
+          "patient"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -1177,9 +1240,12 @@
       {
         "id": "Condition:shr-skin-PressureUlcerNotPresent.context",
         "path": "Condition.context",
-        "short": "Encounter when condition first asserted",
+        "short": "Encounter or episode when condition first asserted",
         "definition": "Encounter during which the condition was first asserted.",
-        "comments": "This record indicates the encounter this particular record is associated with.  In the case of a \"new\" diagnosis reflecting ongoing/revised information about the condition, this might be distinct from the first encounter in which the underlying condition was first \"known\".",
+        "comment": "This record indicates the encounter this particular record is associated with.  In the case of a \"new\" diagnosis reflecting ongoing/revised information about the condition, this might be distinct from the first encounter in which the underlying condition was first \"known\".",
+        "alias": [
+          "encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -1192,6 +1258,7 @@
             "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -1212,7 +1279,7 @@
         "path": "Condition.onset[x]",
         "short": "Estimated or actual date,  date-time, or age",
         "definition": "Estimated or actual date or date-time  the condition began, in the opinion of the clinician.",
-        "comments": "Age is generally used when the patient reports an age at which the Condition began to occur.",
+        "comment": "Age is generally used when the patient reports an age at which the Condition began to occur.",
         "min": 0,
         "max": "0",
         "type": [
@@ -1253,7 +1320,7 @@
         "path": "Condition.abatement[x]",
         "short": "If/when in resolution/remission",
         "definition": "The date or estimated date that the condition resolved or went into remission. This is called \"abatement\" because of the many overloaded connotations associated with \"remission\" or \"resolution\" - Conditions are never really resolved, but they can abate.",
-        "comments": "There is no explicit distinction between resolution and remission because in many cases the distinction is not clear. Age is generally used when the patient reports an age at which the Condition abated.  If there is no abatement element, it is unknown whether the condition has resolved or entered remission; applications and users should generally assume that the condition is still valid.  When abatementString exists, it implies the condition is abated.",
+        "comment": "There is no explicit distinction between resolution and remission because in many cases the distinction is not clear. Age is generally used when the patient reports an age at which the Condition abated.  If there is no abatement element, it is unknown whether the condition has resolved or entered remission; applications and users should generally assume that the condition is still valid.  When abatementString exists, it implies the condition is abated.",
         "min": 0,
         "max": "0",
         "type": [
@@ -1276,6 +1343,9 @@
             "code": "string"
           }
         ],
+        "condition": [
+          "con-4"
+        ],
         "mapping": [
           {
             "identity": "rim",
@@ -1292,14 +1362,15 @@
         "path": "Condition.assertedDate",
         "short": "Date record was believed accurate",
         "definition": "The date on which the existance of the Condition was first asserted or acknowledged.",
-        "comments": "The assertedDate represents the date when this particular Condition record was created in the EHR, not the date of the most recent update in terms of when severity, abatement, etc. were specified.  The date of the last record modification can be retrieved from the resource metadata.",
+        "comment": "The assertedDate represents the date when this particular Condition record was created in the EHR, not the date of the most recent update in terms of when severity, abatement, etc. were specified.  The date of the last record modification can be retrieved from the resource metadata.",
         "min": 1,
         "max": "1",
         "type": [
           {
-            "code": "date"
+            "code": "dateTime"
           }
         ],
+        "isSummary": true,
         "mapping": [
           {
             "identity": "v2",
@@ -1420,7 +1491,7 @@
         "path": "Condition.stage.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1449,7 +1520,7 @@
         "path": "Condition.stage.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1495,7 +1566,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-problem-GradeOrStageVS"
+            "reference": "http://standardhealthrecord.org/shr/problem/vs/GradeOrStageVS"
           }
         },
         "mapping": [
@@ -1549,7 +1620,7 @@
         "path": "Condition.evidence",
         "short": "Supporting evidence",
         "definition": "Supporting Evidence / manifestations that are the basis on which this condition is suspected or confirmed.",
-        "comments": "The evidence may be a simple list of coded symptoms/manifestations, or references to observations or formal assessments, or both.",
+        "comment": "The evidence may be a simple list of coded symptoms/manifestations, or references to observations or formal assessments, or both.",
         "min": 0,
         "max": "0",
         "type": [
@@ -1613,7 +1684,7 @@
         "path": "Condition.evidence.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1642,7 +1713,7 @@
         "path": "Condition.evidence.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1675,7 +1746,7 @@
         "short": "Manifestation/symptom",
         "definition": "A manifestation or symptom that led to the recording of this condition.",
         "min": 0,
-        "max": "1",
+        "max": "*",
         "type": [
           {
             "code": "CodeableConcept",
@@ -1685,10 +1756,11 @@
         "condition": [
           "con-2"
         ],
+        "isSummary": true,
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-ManifestationVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/ManifestationVS"
           }
         },
         "mapping": [
@@ -1699,6 +1771,10 @@
           {
             "identity": "rim",
             "map": "[code=\"diagnosis\"].value"
+          },
+          {
+            "identity": "w5",
+            "map": "why"
           }
         ]
       },
@@ -1718,10 +1794,15 @@
         "condition": [
           "con-2"
         ],
+        "isSummary": true,
         "mapping": [
           {
             "identity": "rim",
             "map": ".self"
+          },
+          {
+            "identity": "w5",
+            "map": "why"
           }
         ]
       },
@@ -1841,7 +1922,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-problem-ProblemCategoryVS"
+            "reference": "http://standardhealthrecord.org/shr/problem/vs/ProblemCategoryVS"
           }
         }
       },
@@ -1860,6 +1941,8 @@
       {
         "id": "Condition:shr-skin-PressureUlcerNotPresent.code",
         "path": "Condition.code",
+        "min": 1,
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept",
@@ -1879,7 +1962,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-skin-PressureUlcerBodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/skin/vs/PressureUlcerBodySiteVS"
           }
         }
       },
@@ -1937,7 +2020,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-problem-GradeOrStageVS"
+            "reference": "http://standardhealthrecord.org/shr/problem/vs/GradeOrStageVS"
           }
         }
       },
@@ -1959,7 +2042,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-ManifestationVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/ManifestationVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-skin-SupportSurface.json b/lib/resources/standard_health_record/StructureDefinition-shr-skin-SupportSurface.json
old mode 100755
new mode 100644
index f5f1048..de2146b
--- a/lib/resources/standard_health_record/StructureDefinition-shr-skin-SupportSurface.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-skin-SupportSurface.json
@@ -3,7 +3,7 @@
   "id": "shr-skin-SupportSurface",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR SupportSurface Profile</b></p>\n  <p>A specific instance of a support surface used to distribute pressure and support a patient. The value is coding of the type of support surface.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.skin.SupportSurface maps to Device:\n  CodeableConcept maps to type\n  DeviceUdi maps to udiCarrier.value\n  VendorModelNumber maps to model\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR SupportSurface Profile</b></p>\n  <p>A specific instance of a support surface used to distribute pressure and support a patient. The value is coding of the type of support surface.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.skin.SupportSurface maps to Device:\n  CodeableConcept maps to type\n  DeviceUdi maps to udi.carrierHRF\n  VendorModelNumber maps to model\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-skin-SupportSurface",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.skin.SupportSurface"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR SupportSurface Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.054Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,16 +27,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.495Z",
   "description": "A specific instance of a support surface used to distribute pressure and support a patient. The value is coding of the type of support surface.",
   "purpose": "Allows institutions to track their devices.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
-    {
-      "identity": "udi",
-      "uri": "http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/UniqueDeviceIdentification/default.htm",
-      "name": "UDI Mapping"
-    },
     {
       "identity": "rim",
       "uri": "http://hl7.org/v3",
@@ -44,6 +40,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "udi",
+      "uri": "http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/UniqueDeviceIdentification/default.htm",
+      "name": "UDI Mapping"
     }
   ],
   "kind": "resource",
@@ -99,10 +100,6 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
-          {
-            "identity": "udi",
-            "map": "N/A"
-          },
           {
             "identity": "rim",
             "map": "Device"
@@ -118,7 +115,7 @@
         "path": "Device.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -157,7 +154,7 @@
         "path": "Device.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +175,7 @@
         "path": "Device.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -198,6 +195,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -212,7 +217,7 @@
         "path": "Device.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -246,7 +251,7 @@
         "path": "Device.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -275,16 +280,19 @@
         "id": "Device:shr-skin-SupportSurface.extension",
         "path": "Device.extension",
         "slicing": {
-          "id": "254",
+          "id": "244",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -313,6 +321,7 @@
         "path": "Device.extension",
         "sliceName": "supportsurfacecategory",
         "definition": "The category of support surface.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -345,6 +354,7 @@
         "path": "Device.extension",
         "sliceName": "supportsurfacebodyposition",
         "definition": "What body positions the surface can be used for, specifically, sitting or lying.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -377,6 +387,7 @@
         "path": "Device.extension",
         "sliceName": "supportsurfacecomponent",
         "definition": "A physical material, structure, or system used alone or in combination with other components to fashion a support surface.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -409,7 +420,7 @@
         "path": "Device.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -439,7 +450,7 @@
         "path": "Device.identifier",
         "short": "Instance identifier",
         "definition": "Unique instance identifiers assigned to a device by manufacturers other organizations or owners.",
-        "comments": "The barcode string from a barcode present on a device label or package may identify the instance, include names given to the device in local usage, or may identify the type of device. If the identifier identifies the type of device, Device.type element should be used.  For [UDI](device.html#5.11.3.2.2),  this element corresponds to the variable portion of the UDI that identifies the serial number of a specific device. See [UDI mappings](device-mappings.html#udi) for a complete mapping of UDI parts to Device.",
+        "comment": "The barcode string from a barcode present on a device label or package may identify the instance, include names given to the device in local usage, or may identify the type of device. If the identifier identifies the type of device, Device.type element should be used.  For [UDI](device.html#5.11.3.2.2),  this element corresponds to the variable portion of the UDI that identifies the serial number of a specific device. See [UDI mappings](device-mappings.html#udi) for a complete mapping of UDI parts to Device.",
         "alias": [
           "Serial Number"
         ],
@@ -453,7 +464,7 @@
         "mapping": [
           {
             "identity": "udi",
-            "map": "The serial number which is a component of the the production identifier (PI), a conditional, variable portion of a UDI.   The identifier.type code should be set to “SNO”(Serial Number) and the system left empty."
+            "map": "The serial number which is a component of the production identifier (PI), a conditional, variable portion of a UDI.   The identifier.type code should be set to “SNO”(Serial Number) and the system left empty."
           },
           {
             "identity": "rim",
@@ -466,42 +477,332 @@
         ]
       },
       {
-        "id": "Device:shr-skin-SupportSurface.udiCarrier",
-        "path": "Device.udiCarrier",
+        "id": "Device:shr-skin-SupportSurface.udi",
+        "path": "Device.udi",
         "short": "Unique Device Identifier (UDI) Barcode string",
-        "definition": "[Unique device identifier (UDI)](device.html#5.11.3.2.2) barcode or rfid string assigned to device label or package.",
-        "comments": "The udiCarrier string may identify an unique instance of a device, or it may only identify the type of the device. The Human Readable format (HRF) is required in FHIR. AIDC identifiers cannot be conveyed in FHIR, Because of limitations on character sets in XML and the need to round-trip JSON data through XML.  See [UDI mappings](device-mappings.html#udi) for a complete mapping of UDI parts to Device.",
+        "definition": "[Unique device identifier (UDI)](device.html#5.11.3.2.2) assigned to device label or package.",
+        "comment": "UDI may identify an unique instance of a device, or it may only identify the type of the device.  See [UDI mappings](device-mappings.html#udi) for a complete mapping of UDI parts to Device.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "BackboneElement"
+          }
+        ],
+        "constraint": [
+          {
+            "key": "ele-1",
+            "severity": "error",
+            "human": "All FHIR elements must have a @value or children",
+            "expression": "children().count() > id.count()",
+            "xpath": "@value|f:*|h:div",
+            "source": "Element"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": ".id and .code"
+          },
+          {
+            "identity": "w5",
+            "map": "id"
+          }
+        ]
+      },
+      {
+        "id": "Device:shr-skin-SupportSurface.udi.id",
+        "path": "Device.udi.id",
+        "representation": [
+          "xmlAttr"
+        ],
+        "short": "xml:id (or equivalent in JSON)",
+        "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
+        "min": 0,
+        "max": "1",
+        "base": {
+          "path": "Element.id",
+          "min": 0,
+          "max": "1"
+        },
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "Device:shr-skin-SupportSurface.udi.extension",
+        "path": "Device.udi.extension",
+        "short": "Additional Content defined by implementations",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
-          "UDI",
-          "Barcode String"
+          "extensions",
+          "user content"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "Element.extension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "n/a"
+          }
+        ]
+      },
+      {
+        "id": "Device:shr-skin-SupportSurface.udi.modifierExtension",
+        "path": "Device.udi.modifierExtension",
+        "short": "Extensions that cannot be ignored",
+        "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "alias": [
+          "extensions",
+          "user content",
+          "modifiers"
+        ],
+        "min": 0,
+        "max": "*",
+        "base": {
+          "path": "BackboneElement.modifierExtension",
+          "min": 0,
+          "max": "*"
+        },
+        "type": [
+          {
+            "code": "Extension"
+          }
+        ],
+        "isModifier": true,
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "N/A"
+          }
+        ]
+      },
+      {
+        "id": "Device:shr-skin-SupportSurface.udi.deviceIdentifier",
+        "path": "Device.udi.deviceIdentifier",
+        "short": "Mandatory fixed portion of UDI",
+        "definition": "The device identifier (DI) is a mandatory, fixed portion of a UDI that identifies the labeler and the specific version or model of a device.",
+        "alias": [
+          "DI"
         ],
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "Identifier"
+            "code": "string"
           }
         ],
+        "isSummary": true,
         "mapping": [
           {
             "identity": "udi",
-            "map": "The full UDI carrier - The Human Readable Form (HRF) representation of the barcode string as printed on the packaging of the device.  The  'type' component should be set to “UDI” and the 'system' component to the the appropriate repository url.  the additional URL is needed to identify the authoritative source for UDI generation within the jurisdiction.  All UDIs are globally unique within a single namespace. with the appropriate repository uri as the system.  This allows a recipient of a UDI to know which database will contain the UDI-associated metadata.  For example,  UDIs of devices managed in the U.S. by the FDA, the value is  http://hl7.org/fhir/NamingSystem/fda-udi.  Because of limitations on character sets in XML and the need to round-trip JSON data through XML, AIDC identifiers cannot be conveyed in FHIR."
+            "map": "The device identifier (DI), a mandatory, fixed portion of a UDI that identifies the labeler and the specific version or model of a device."
           },
           {
             "identity": "rim",
-            "map": ".id[where root is root for UDI]"
+            "map": "Role.id.extension"
           },
           {
             "identity": "w5",
-            "map": "id"
+            "map": "what"
+          }
+        ]
+      },
+      {
+        "id": "Device:shr-skin-SupportSurface.udi.name",
+        "path": "Device.udi.name",
+        "short": "Device Name as appears on UDI label",
+        "definition": "Name of device as used in labeling or catalog.",
+        "comment": "Use the `Device.type`  for a generic type or kind of device name.  Note the [GUDID](http://www.fda.gov/medicaldevices/deviceregulationandguidance/uniquedeviceidentification/globaludidatabasegudid/default.htm) lists the name as the 'Brand Name'.",
+        "alias": [
+          "Brand Name"
+        ],
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "udi",
+            "map": "Propietary/Trade Name of the medical Device as used in the labeling or catalog"
+          },
+          {
+            "identity": "rim",
+            "map": ".displayName"
+          },
+          {
+            "identity": "w5",
+            "map": "what"
+          }
+        ]
+      },
+      {
+        "id": "Device:shr-skin-SupportSurface.udi.jurisdiction",
+        "path": "Device.udi.jurisdiction",
+        "short": "Regional UDI authority",
+        "definition": "The identity of the authoritative source for UDI generation within a  jurisdiction.  All UDIs are globally unique within a single namespace. with the appropriate repository uri as the system.  For example,  UDIs of devices managed in the U.S. by the FDA, the value is  http://hl7.org/fhir/NamingSystem/fda-udi.",
+        "requirements": "Allows a recipient of a UDI to know which database will contain the UDI-associated metadata.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "uri"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "Role.scoper"
+          }
+        ]
+      },
+      {
+        "id": "Device:shr-skin-SupportSurface.udi.carrierHRF",
+        "path": "Device.udi.carrierHRF",
+        "short": "UDI Human Readable Barcode String",
+        "definition": "The full UDI carrier as the human readable form (HRF) representation of the barcode string as printed on the packaging of the device.",
+        "comment": "If separate barcodes for DI and PI are present, concatenate the string with DI first and in order of human readable expression on label.",
+        "alias": [
+          "Human Readable Form"
+        ],
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "string"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "udi",
+            "map": "A unique device identifier (UDI) on a device label in plain text"
+          },
+          {
+            "identity": "rim",
+            "map": "Role.id.extension"
+          }
+        ]
+      },
+      {
+        "id": "Device:shr-skin-SupportSurface.udi.carrierAIDC",
+        "path": "Device.udi.carrierAIDC",
+        "short": "UDI Machine Readable Barcode String",
+        "definition": "The full UDI carrier of the Automatic Identification and Data Capture (AIDC) technology representation of the barcode string as printed on the packaging of the device - E.g a barcode or RFID.   Because of limitations on character sets in XML and the need to round-trip JSON data through XML, AIDC Formats *SHALL* be base64 encoded.",
+        "comment": "The AIDC form of UDIs should be scanned or otherwise used for the identification of the device whenever possible to minimize errors in records resulting from manual transcriptions. If separate barcodes for DI and PI are present, concatenate the string with DI first and in order of human readable expression on label.",
+        "alias": [
+          "Automatic Identification and Data Capture"
+        ],
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "base64Binary"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "udi",
+            "map": "A unique device identifier (UDI) on a device label a form that uses automatic identification and data capture (AIDC) technology."
+          },
+          {
+            "identity": "rim",
+            "map": "Role.id.extension"
+          }
+        ]
+      },
+      {
+        "id": "Device:shr-skin-SupportSurface.udi.issuer",
+        "path": "Device.udi.issuer",
+        "short": "UDI Issuing Organization",
+        "definition": "Organization that is charged with issuing UDIs for devices.  For example, the US FDA issuers include :\n1) GS1: \nhttp://hl7.org/fhir/NamingSystem/gs1-di, \n2) HIBCC:\nhttp://hl7.org/fhir/NamingSystem/hibcc-dI, \n3) ICCBBA for blood containers:\nhttp://hl7.org/fhir/NamingSystem/iccbba-blood-di, \n4) ICCBA for other devices:\nhttp://hl7.org/fhir/NamingSystem/iccbba-other-di.",
+        "alias": [
+          "Barcode System"
+        ],
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "uri"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "udi",
+            "map": "All UDIs are to be issued under a system operated by an Jurisdiction-accredited issuing agency.\nGS1 DIs: \n http://hl7.org/fhir/NamingSystem/gs1\nHIBCC DIs:\n http://hl7.org/fhir/NamingSystem/hibcc\nICCBBA DIs for blood containers:\n http://hl7.org/fhir/NamingSystem/iccbba-blood\nICCBA DIs for other devices:\n http://hl7.org/fhir/NamingSystem/iccbba-other"
+          },
+          {
+            "identity": "rim",
+            "map": "Role.id.root"
+          }
+        ]
+      },
+      {
+        "id": "Device:shr-skin-SupportSurface.udi.entryType",
+        "path": "Device.udi.entryType",
+        "short": "barcode | rfid | manual +",
+        "definition": "A coded entry to indicate how the data was entered.",
+        "requirements": "Supports a way to distinguish hand entered from machine read data.",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "code"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "UDIEntryType"
+            }
+          ],
+          "strength": "required",
+          "description": "Codes to identify how UDI data was entered",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/udi-entry-type"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "NA"
           }
         ]
       },
       {
         "id": "Device:shr-skin-SupportSurface.status",
         "path": "Device.status",
-        "short": "available | not-available | entered-in-error",
+        "short": "active | inactive | entered-in-error | unknown",
         "definition": "Status of the Device availability.",
+        "comment": "This element is labeled as a modifier because the status contains the codes inactive and entered-in-error that mark the device (record)as not currently valid.",
         "min": 0,
         "max": "1",
         "type": [
@@ -512,17 +813,19 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "FHIRDeviceStatus"
+            }
+          ],
           "strength": "required",
           "description": "The availability status of the device.",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/devicestatus"
+            "reference": "http://hl7.org/fhir/ValueSet/device-status"
           }
         },
         "mapping": [
-          {
-            "identity": "udi",
-            "map": "N/A"
-          },
           {
             "identity": "rim",
             "map": ".statusCode"
@@ -538,7 +841,6 @@
         "path": "Device.type",
         "short": "What kind of device this is",
         "definition": "Code or identifier to identify a kind of device.",
-        "comments": "There can be different code values thath may correspond to different granularities of the same concept.  These can be represented as translations using  the [codeableConcept](datatypes.html#codeableconcept) datatype.  For [UDI](device.html#5.11.3.2.2), this element corresponds to the UDI device identifier (DI) part. See [UDI mappings](device-mappings.html#udi) for a complete mapping of UDI parts to Device.",
         "min": 1,
         "max": "1",
         "type": [
@@ -550,13 +852,13 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-skin-SupportSurfaceVS"
+            "reference": "http://standardhealthrecord.org/shr/skin/vs/SupportSurfaceVS"
           }
         },
         "mapping": [
           {
             "identity": "udi",
-            "map": "The device identifier (DI), a mandatory, fixed portion of a UDI that identifies the labeler and the specific version or model of a devicet.  The system uri should be included. Possible URIs include\nGS1 DIs: \n http://hl7.org/fhir/NamingSystem/gs1-di\nHIBCC DIs:\n http://hl7.org/fhir/NamingSystem/hibcc-di\nICCBBA DIs for blood containers:\n http://hl7.org/fhir/NamingSystem/iccbba-blood-di\nICCBA DIs for other devices:\n http://hl7.org/fhir/NamingSystem/iccbba-other-di"
+            "map": "Type description using GMDN or other code system"
           },
           {
             "identity": "rim",
@@ -573,7 +875,6 @@
         "path": "Device.lotNumber",
         "short": "Lot number of manufacture",
         "definition": "Lot number assigned by the manufacturer.",
-        "comments": "Alphanumeric. For [UDI](device.html#5.11.3.2.2), this element corresponds to the variable portion of a UDI that identifies the lot or batch number within which a physical instance of a device was manufactured. See [UDI mappings](device-mappings.html#udi) for a complete mapping of UDI parts to Device.",
         "min": 0,
         "max": "1",
         "type": [
@@ -584,7 +885,7 @@
         "mapping": [
           {
             "identity": "udi",
-            "map": "The lot or batch number within which a device was manufactured - which is a component of the the production identifier (PI), a conditional, variable portion of a UDI."
+            "map": "The lot or batch number within which a device was manufactured - which is a component of the production identifier (PI), a conditional, variable portion of a UDI."
           },
           {
             "identity": "rim",
@@ -628,7 +929,6 @@
         "path": "Device.manufactureDate",
         "short": "Date when the device was made",
         "definition": "The date and time when the device was manufactured.",
-        "comments": "For [UDI](device.html#5.11.3.2.2), this element corresponds to the variable portion of a UDI that identifies the date a physical instance of a device was manufactured. See [UDI mappings](device-mappings.html#udi) for a complete mapping of UDI parts to Device.",
         "min": 0,
         "max": "1",
         "type": [
@@ -639,7 +939,7 @@
         "mapping": [
           {
             "identity": "udi",
-            "map": "The date a specific device was manufactured - which is a component of the the production identifier (PI), a conditional, variable portion of a UDI.  For FHIR, The datetime syntax must converted to YYYY-MM-DD[THH:MM:SS].  If hour is present, the minutes and seconds should both be set to “00”."
+            "map": "The date a specific device was manufactured - which is a component of the production identifier (PI), a conditional, variable portion of a UDI.  For FHIR, The datetime syntax must converted to YYYY-MM-DD[THH:MM:SS].  If hour is present, the minutes and seconds should both be set to “00”."
           },
           {
             "identity": "rim",
@@ -656,7 +956,6 @@
         "path": "Device.expirationDate",
         "short": "Date and time of expiry of this device (if applicable)",
         "definition": "The date and time beyond which this device is no longer valid or should not be used (if applicable).",
-        "comments": "For [UDI](device.html#5.11.3.2.2), this element corresponds to the variable portion of a UDI that identifies the expiration date of a physical instance of a device. See [UDI mappings](device-mappings.html#udi) for a complete mapping of UDI parts to Device.",
         "min": 0,
         "max": "1",
         "type": [
@@ -667,7 +966,7 @@
         "mapping": [
           {
             "identity": "udi",
-            "map": "the expiration date of a specific device -  which is a component of the the production identifier (PI), a conditional, variable portion of a UDI.  For FHIR, The datetime syntax must converted to YYYY-MM-DD[THH:MM:SS].  If hour is present, the minutes and seconds should both be set to “00”."
+            "map": "the expiration date of a specific device -  which is a component of the production identifier (PI), a conditional, variable portion of a UDI.  For FHIR, The datetime syntax must converted to YYYY-MM-DD[THH:MM:SS].  If hour is present, the minutes and seconds should both be set to “00”."
           },
           {
             "identity": "rim",
@@ -692,10 +991,6 @@
           }
         ],
         "mapping": [
-          {
-            "identity": "udi",
-            "map": "N/A"
-          },
           {
             "identity": "rim",
             "map": ".playedRole[typeCode=MANU].code"
@@ -719,10 +1014,6 @@
           }
         ],
         "mapping": [
-          {
-            "identity": "udi",
-            "map": "N/A"
-          },
           {
             "identity": "rim",
             "map": ".softwareName (included as part)"
@@ -748,10 +1039,6 @@
           }
         ],
         "mapping": [
-          {
-            "identity": "udi",
-            "map": "N/A"
-          },
           {
             "identity": "rim",
             "map": ".playedRole[typeCode=USED].scoper.playedRole[typeCode=PAT]"
@@ -776,10 +1063,6 @@
           }
         ],
         "mapping": [
-          {
-            "identity": "udi",
-            "map": "N/A"
-          },
           {
             "identity": "rim",
             "map": ".playedRole[typeCode=OWN].scoper"
@@ -795,7 +1078,7 @@
         "path": "Device.contact",
         "short": "Details for human/organization for support",
         "definition": "Contact details for an organization or a particular human that is responsible for the device.",
-        "comments": "used for troubleshooting etc.",
+        "comment": "used for troubleshooting etc.",
         "min": 0,
         "max": "*",
         "type": [
@@ -804,10 +1087,6 @@
           }
         ],
         "mapping": [
-          {
-            "identity": "udi",
-            "map": "N/A"
-          },
           {
             "identity": "rim",
             "map": ".scopedRole[typeCode=CON].player"
@@ -833,10 +1112,6 @@
           }
         ],
         "mapping": [
-          {
-            "identity": "udi",
-            "map": "N/A"
-          },
           {
             "identity": "rim",
             "map": ".playedRole[typeCode=LOCE].scoper"
@@ -852,7 +1127,7 @@
         "path": "Device.url",
         "short": "Network address to contact device",
         "definition": "A network address on which the device may be contacted directly.",
-        "comments": "If the device is running a FHIR server, the network address should  be the Base URL from which a conformance statement may be retrieved.",
+        "comment": "If the device is running a FHIR server, the network address should  be the Base URL from which a conformance statement may be retrieved.",
         "min": 0,
         "max": "1",
         "type": [
@@ -861,10 +1136,6 @@
           }
         ],
         "mapping": [
-          {
-            "identity": "udi",
-            "map": "N/A"
-          },
           {
             "identity": "rim",
             "map": ".telecom"
@@ -888,15 +1159,44 @@
           }
         ],
         "mapping": [
-          {
-            "identity": "udi",
-            "map": "N/A"
-          },
           {
             "identity": "rim",
             "map": ".text"
           }
         ]
+      },
+      {
+        "id": "Device:shr-skin-SupportSurface.safety",
+        "path": "Device.safety",
+        "short": "Safety Characteristics of Device",
+        "definition": "Provides additional safety characteristics about a medical device.  For example devices containing latex.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "isSummary": true,
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "DeviceSafety"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes used to identify medical devices safety characterics. These codes are derived in part from the [United States Food and Drug Administration recommendations](http://www.fda.gov/downloads/medicaldevices/deviceregulationandguidance/guidancedocuments/ucm107708.pdf) and are provided here as a suggestive example.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/device-safety"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "rim",
+            "map": "NA"
+          }
+        ]
       }
     ]
   },
@@ -970,7 +1270,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-skin-SupportSurfaceVS"
+            "reference": "http://standardhealthrecord.org/shr/skin/vs/SupportSurfaceVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-skin-SupportSurfaceBodyPosition-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-skin-SupportSurfaceBodyPosition-extension.json
old mode 100755
new mode 100644
index 891f73d..ad11e16
--- a/lib/resources/standard_health_record/StructureDefinition-shr-skin-SupportSurfaceBodyPosition-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-skin-SupportSurfaceBodyPosition-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.skin.SupportSurfaceBodyPosition"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR SupportSurfaceBodyPosition Extension",
   "title": "SHR SupportSurfaceBodyPosition Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.055Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.496Z",
   "description": "What body positions the surface can be used for, specifically, sitting or lying.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -170,7 +170,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-skin-SupportSurfaceBodyPositionVS"
+            "reference": "http://standardhealthrecord.org/shr/skin/vs/SupportSurfaceBodyPositionVS"
           }
         },
         "mapping": [
@@ -221,7 +221,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-skin-SupportSurfaceBodyPositionVS"
+            "reference": "http://standardhealthrecord.org/shr/skin/vs/SupportSurfaceBodyPositionVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-skin-SupportSurfaceCategory-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-skin-SupportSurfaceCategory-extension.json
old mode 100755
new mode 100644
index 8e3f7b3..72b265a
--- a/lib/resources/standard_health_record/StructureDefinition-shr-skin-SupportSurfaceCategory-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-skin-SupportSurfaceCategory-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.skin.SupportSurfaceCategory"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR SupportSurfaceCategory Extension",
   "title": "SHR SupportSurfaceCategory Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.054Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.496Z",
   "description": "The category of support surface.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -170,7 +170,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-skin-SupportSurfaceCategoryVS"
+            "reference": "http://standardhealthrecord.org/shr/skin/vs/SupportSurfaceCategoryVS"
           }
         },
         "mapping": [
@@ -221,7 +221,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-skin-SupportSurfaceCategoryVS"
+            "reference": "http://standardhealthrecord.org/shr/skin/vs/SupportSurfaceCategoryVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-skin-SupportSurfaceComponent-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-skin-SupportSurfaceComponent-extension.json
old mode 100755
new mode 100644
index 5bb648c..d1bab62
--- a/lib/resources/standard_health_record/StructureDefinition-shr-skin-SupportSurfaceComponent-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-skin-SupportSurfaceComponent-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.skin.SupportSurfaceComponent"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR SupportSurfaceComponent Extension",
   "title": "SHR SupportSurfaceComponent Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.055Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.496Z",
   "description": "A physical material, structure, or system used alone or in combination with other components to fashion a support surface.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -170,7 +170,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-skin-SupportSurfaceComponentVS"
+            "reference": "http://standardhealthrecord.org/shr/skin/vs/SupportSurfaceComponentVS"
           }
         },
         "mapping": [
@@ -221,7 +221,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-skin-SupportSurfaceComponentVS"
+            "reference": "http://standardhealthrecord.org/shr/skin/vs/SupportSurfaceComponentVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-skin-SupportSurfaceEmployed.json b/lib/resources/standard_health_record/StructureDefinition-shr-skin-SupportSurfaceEmployed.json
old mode 100755
new mode 100644
index 7d85c36..17b9afb
--- a/lib/resources/standard_health_record/StructureDefinition-shr-skin-SupportSurfaceEmployed.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-skin-SupportSurfaceEmployed.json
@@ -12,8 +12,10 @@
       "value": "shr.skin.SupportSurfaceEmployed"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR SupportSurfaceEmployed Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.057Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,9 +27,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.497Z",
   "description": "A paricular instance of the use of a support surface in patient care.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
     {
       "identity": "quick",
@@ -113,7 +114,7 @@
         "path": "DeviceUseStatement.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -152,7 +153,7 @@
         "path": "DeviceUseStatement.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -173,7 +174,7 @@
         "path": "DeviceUseStatement.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -193,6 +194,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -207,7 +216,7 @@
         "path": "DeviceUseStatement.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -241,7 +250,7 @@
         "path": "DeviceUseStatement.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -270,16 +279,19 @@
         "id": "DeviceUseStatement:shr-skin-SupportSurfaceEmployed.extension",
         "path": "DeviceUseStatement.extension",
         "slicing": {
-          "id": "255",
+          "id": "245",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -308,6 +320,7 @@
         "path": "DeviceUseStatement.extension",
         "sliceName": "deviceusestatus",
         "definition": "A code representing the patient or other source's judgment about the state of the device used that this statement is about. Generally this will be active or completed.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -340,6 +353,7 @@
         "path": "DeviceUseStatement.extension",
         "sliceName": "implanted",
         "definition": "Whether this device is implanted in the body.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -421,7 +435,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -472,6 +485,7 @@
         "path": "DeviceUseStatement.extension",
         "sliceName": "immersiondepth",
         "definition": "Depth of penetration (sinking) into a support surface.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -503,16 +517,19 @@
         "id": "DeviceUseStatement:shr-skin-SupportSurfaceEmployed.modifierExtension",
         "path": "DeviceUseStatement.modifierExtension",
         "slicing": {
-          "id": "256",
+          "id": "246",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -542,6 +559,7 @@
         "path": "DeviceUseStatement.modifierExtension",
         "sliceName": "nonoccurrencemodifier",
         "definition": "When true, indicates either that the event or action documented in the entry did not occur, or the the thing documented is absent or does not exist.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -570,228 +588,300 @@
         ]
       },
       {
-        "id": "DeviceUseStatement:shr-skin-SupportSurfaceEmployed.bodySite",
-        "path": "DeviceUseStatement.bodySite",
-        "short": "Target body site",
-        "definition": "Indicates the site on the subject's body where the device was used ( i.e. the target site).",
-        "requirements": "Knowing where the device is targeted is important for tracking if multiple sites are possible. If more information than just a code is required, use the extension [http://hl7.org/fhir/StructureDefinition/body-site-instance](null.html).",
+        "id": "DeviceUseStatement:shr-skin-SupportSurfaceEmployed.identifier",
+        "path": "DeviceUseStatement.identifier",
+        "short": "External identifier for this record",
+        "definition": "An external identifier for this statement such as an IRI.",
         "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Identifier"
+          }
+        ],
+        "mapping": [
+          {
+            "identity": "quick",
+            "map": "ClinicalStatement.identifier"
+          },
+          {
+            "identity": "w5",
+            "map": "id"
+          }
+        ]
+      },
+      {
+        "id": "DeviceUseStatement:shr-skin-SupportSurfaceEmployed.status",
+        "path": "DeviceUseStatement.status",
+        "short": "active | completed | entered-in-error +",
+        "definition": "A code representing the patient or other source's judgment about the state of the device used that this statement is about.  Generally this will be active or completed.",
+        "comment": "DeviceUseStatment is a statement at a point in time.  The status is only representative at the point when it was asserted.  The value set for contains codes that assert the status of the use  by the patient (for example, stopped or on hold) as well as codes that assert the status of the resource itself (for example, entered in error).\n\nThis element is labeled as a modifier because the status contains the codes that mark the statement as not currently valid.",
+        "min": 1,
         "max": "1",
         "type": [
           {
-            "code": "CodeableConcept"
+            "code": "code"
           }
         ],
+        "isModifier": true,
         "isSummary": true,
         "binding": {
-          "strength": "example",
-          "description": "Codes describing anatomical locations. May include laterality.",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "DeviceUseStatementStatus"
+            }
+          ],
+          "strength": "required",
+          "description": "A coded concept indicating the current status of a the Device Usage",
           "valueSetReference": {
-            "reference": "http://hl7.org/fhir/ValueSet/body-site"
+            "reference": "http://hl7.org/fhir/ValueSet/device-statement-status"
           }
         },
         "mapping": [
           {
             "identity": "rim",
-            "map": "targetSiteCode"
+            "map": ".statusCode"
+          },
+          {
+            "identity": "quick",
+            "map": "…status"
+          },
+          {
+            "identity": "w5",
+            "map": "status"
           }
         ]
       },
       {
-        "id": "DeviceUseStatement:shr-skin-SupportSurfaceEmployed.whenUsed",
-        "path": "DeviceUseStatement.whenUsed",
-        "short": "Period device was used",
-        "definition": "The time period over which the device was used.",
-        "min": 0,
+        "id": "DeviceUseStatement:shr-skin-SupportSurfaceEmployed.subject",
+        "path": "DeviceUseStatement.subject",
+        "short": "Patient using device",
+        "definition": "The patient who used the device.",
+        "min": 1,
         "max": "1",
         "type": [
           {
-            "code": "Period",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-PeriodOfUse"
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-demographics-PersonOfRecord"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Group"
           }
         ],
-        "isSummary": true,
         "mapping": [
           {
             "identity": "quick",
-            "map": "Performance.performanceTime"
+            "map": "ClinicalStatement.subject"
           },
           {
             "identity": "w5",
-            "map": "when.done"
+            "map": "who.focus"
           }
         ]
       },
       {
-        "id": "DeviceUseStatement:shr-skin-SupportSurfaceEmployed.device",
-        "path": "DeviceUseStatement.device",
-        "short": "Reference to device used",
-        "definition": "The details of the device used.",
-        "min": 1,
+        "id": "DeviceUseStatement:shr-skin-SupportSurfaceEmployed.whenUsed",
+        "path": "DeviceUseStatement.whenUsed",
+        "short": "Period device was used",
+        "definition": "The time period over which the device was used.",
+        "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-skin-SupportSurface"
+            "code": "Period",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-PeriodOfUse"
           }
         ],
-        "isSummary": true,
         "mapping": [
           {
             "identity": "quick",
-            "map": "DeviceUse.device"
+            "map": "Performance.performanceTime"
           },
           {
             "identity": "w5",
-            "map": "who.actor"
+            "map": "when.done"
           }
         ]
       },
       {
-        "id": "DeviceUseStatement:shr-skin-SupportSurfaceEmployed.identifier",
-        "path": "DeviceUseStatement.identifier",
-        "short": "External identifier for this record",
-        "definition": "An external identifier for this statement such as an IRI.",
+        "id": "DeviceUseStatement:shr-skin-SupportSurfaceEmployed.timing[x]",
+        "path": "DeviceUseStatement.timing[x]",
+        "short": "How often  the device was used",
+        "definition": "How often the device was used.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
-            "code": "Identifier"
+            "code": "Timing"
+          },
+          {
+            "code": "Period"
+          },
+          {
+            "code": "dateTime"
           }
         ],
-        "isSummary": true,
         "mapping": [
           {
             "identity": "quick",
-            "map": "ClinicalStatement.identifier"
+            "map": "DeviceUse.applicationSchedule"
           },
           {
             "identity": "w5",
-            "map": "id"
+            "map": "when.done"
           }
         ]
       },
       {
-        "id": "DeviceUseStatement:shr-skin-SupportSurfaceEmployed.indication",
-        "path": "DeviceUseStatement.indication",
-        "short": "Why device was used",
-        "definition": "Reason or justification for the use of the device.",
+        "id": "DeviceUseStatement:shr-skin-SupportSurfaceEmployed.recordedOn",
+        "path": "DeviceUseStatement.recordedOn",
+        "short": "When statement was recorded",
+        "definition": "The time at which the statement was made/recorded.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
-            "code": "CodeableConcept",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
+            "code": "dateTime"
           }
         ],
-        "isSummary": true,
         "mapping": [
           {
             "identity": "quick",
-            "map": "Action.indication.reason"
+            "map": "ClinicalStatement.statementDateTime"
           },
           {
             "identity": "w5",
-            "map": "why"
+            "map": "when.recorded"
           }
         ]
       },
       {
-        "id": "DeviceUseStatement:shr-skin-SupportSurfaceEmployed.notes",
-        "path": "DeviceUseStatement.notes",
-        "short": "Addition details (comments, instructions)",
-        "definition": "Details about the device statement that were not represented at all or sufficiently in one of the attributes provided in a class. These may include for example a comment, an instruction, or a note associated with the statement.",
+        "id": "DeviceUseStatement:shr-skin-SupportSurfaceEmployed.source",
+        "path": "DeviceUseStatement.source",
+        "short": "Who made the statement",
+        "definition": "Who reported the device was being used by the patient.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
-            "code": "string"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
           }
         ],
-        "isSummary": true,
         "mapping": [
           {
-            "identity": "quick",
-            "map": "ClinicalStatement.additionalText"
+            "identity": "w5",
+            "map": "who.actor"
           }
         ]
       },
       {
-        "id": "DeviceUseStatement:shr-skin-SupportSurfaceEmployed.recordedOn",
-        "path": "DeviceUseStatement.recordedOn",
-        "short": "When statement was recorded",
-        "definition": "The time at which the statement was made/recorded.",
-        "min": 0,
+        "id": "DeviceUseStatement:shr-skin-SupportSurfaceEmployed.device",
+        "path": "DeviceUseStatement.device",
+        "short": "Reference to device used",
+        "definition": "The details of the device used.",
+        "min": 1,
         "max": "1",
         "type": [
           {
-            "code": "dateTime"
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-skin-SupportSurface"
           }
         ],
-        "isSummary": true,
         "mapping": [
           {
             "identity": "quick",
-            "map": "ClinicalStatement.statementDateTime"
+            "map": "DeviceUse.device"
           },
           {
             "identity": "w5",
-            "map": "when.recorded"
+            "map": "who.actor"
           }
         ]
       },
       {
-        "id": "DeviceUseStatement:shr-skin-SupportSurfaceEmployed.subject",
-        "path": "DeviceUseStatement.subject",
-        "short": "Patient using device",
-        "definition": "The patient who used the device.",
-        "min": 1,
-        "max": "1",
+        "id": "DeviceUseStatement:shr-skin-SupportSurfaceEmployed.indication",
+        "path": "DeviceUseStatement.indication",
+        "short": "Why device was used",
+        "definition": "Reason or justification for the use of the device.",
+        "min": 0,
+        "max": "*",
         "type": [
           {
-            "code": "Reference",
-            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-demographics-PersonOfRecord"
+            "code": "CodeableConcept",
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
           }
         ],
-        "isSummary": true,
         "mapping": [
           {
             "identity": "quick",
-            "map": "ClinicalStatement.subject"
+            "map": "Action.indication.reason"
           },
           {
             "identity": "w5",
-            "map": "who.focus"
+            "map": "why"
           }
         ]
       },
       {
-        "id": "DeviceUseStatement:shr-skin-SupportSurfaceEmployed.timing[x]",
-        "path": "DeviceUseStatement.timing[x]",
-        "short": "How often  the device was used",
-        "definition": "How often the device was used.",
+        "id": "DeviceUseStatement:shr-skin-SupportSurfaceEmployed.bodySite",
+        "path": "DeviceUseStatement.bodySite",
+        "short": "Target body site",
+        "definition": "Indicates the site on the subject's body where the device was used ( i.e. the target site).",
+        "requirements": "Knowing where the device is targeted is important for tracking if multiple sites are possible. If more information than just a code is required, use the extension [http://hl7.org/fhir/StructureDefinition/body-site-instance](null.html).",
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "Timing"
-          },
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes describing anatomical locations. May include laterality.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/body-site"
+          }
+        },
+        "mapping": [
           {
-            "code": "Period"
-          },
+            "identity": "rim",
+            "map": "targetSiteCode"
+          }
+        ]
+      },
+      {
+        "id": "DeviceUseStatement:shr-skin-SupportSurfaceEmployed.note",
+        "path": "DeviceUseStatement.note",
+        "short": "Addition details (comments, instructions)",
+        "definition": "Details about the device statement that were not represented at all or sufficiently in one of the attributes provided in a class. These may include for example a comment, an instruction, or a note associated with the statement.",
+        "min": 0,
+        "max": "*",
+        "type": [
           {
-            "code": "dateTime"
+            "code": "Annotation"
           }
         ],
-        "isSummary": true,
         "mapping": [
           {
             "identity": "quick",
-            "map": "DeviceUse.applicationSchedule"
-          },
-          {
-            "identity": "w5",
-            "map": "when.done"
+            "map": "ClinicalStatement.additionalText"
           }
         ]
       }
@@ -870,6 +960,20 @@
         "isModifier": true,
         "isSummary": false
       },
+      {
+        "id": "DeviceUseStatement:shr-skin-SupportSurfaceEmployed.subject",
+        "path": "DeviceUseStatement.subject",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-demographics-PersonOfRecord"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Group"
+          }
+        ]
+      },
       {
         "id": "DeviceUseStatement:shr-skin-SupportSurfaceEmployed.whenUsed",
         "path": "DeviceUseStatement.whenUsed",
@@ -899,16 +1003,6 @@
             "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"
           }
         ]
-      },
-      {
-        "id": "DeviceUseStatement:shr-skin-SupportSurfaceEmployed.subject",
-        "path": "DeviceUseStatement.subject",
-        "type": [
-          {
-            "code": "Reference",
-            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-demographics-PersonOfRecord"
-          }
-        ]
       }
     ]
   }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-skin-VisibleInternalStructure-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-skin-VisibleInternalStructure-extension.json
old mode 100755
new mode 100644
index 56efb1e..1d0bf5f
--- a/lib/resources/standard_health_record/StructureDefinition-shr-skin-VisibleInternalStructure-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-skin-VisibleInternalStructure-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.skin.VisibleInternalStructure"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR VisibleInternalStructure Extension",
   "title": "SHR VisibleInternalStructure Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.120Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.520Z",
   "description": "An internal body structure visible from outside the body, for example, due to injury.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -170,7 +170,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-skin-VisibleInternalStructureVS"
+            "reference": "http://standardhealthrecord.org/shr/skin/vs/VisibleInternalStructureVS"
           }
         },
         "mapping": [
@@ -221,7 +221,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-skin-VisibleInternalStructureVS"
+            "reference": "http://standardhealthrecord.org/shr/skin/vs/VisibleInternalStructureVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-skin-WoundBedAndEdge-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-skin-WoundBedAndEdge-extension.json
old mode 100755
new mode 100644
index aaa9f90..201df29
--- a/lib/resources/standard_health_record/StructureDefinition-shr-skin-WoundBedAndEdge-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-skin-WoundBedAndEdge-extension.json
@@ -3,7 +3,7 @@
   "id": "shr-skin-WoundBedAndEdge-extension",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR WoundBedAndEdge Extension</b></p>\n  <p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR WoundBedAndEdge Extension</b></p>\n  <p/>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-skin-WoundBedAndEdge-extension",
   "identifier": [
@@ -12,9 +12,11 @@
       "value": "shr.skin.WoundBedAndEdge"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR WoundBedAndEdge Extension",
   "title": "SHR WoundBedAndEdge Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.121Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,8 +28,7 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.521Z",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -104,9 +105,12 @@
         "id": "Extension:woundbedandedge.extension",
         "path": "Extension.extension",
         "slicing": {
-          "id": "267",
+          "id": "257",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -160,7 +164,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-skin-WoundEdgeAppearance-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-skin-WoundEdgeAppearance-extension.json
old mode 100755
new mode 100644
index be2895d..505c5c9
--- a/lib/resources/standard_health_record/StructureDefinition-shr-skin-WoundEdgeAppearance-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-skin-WoundEdgeAppearance-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.skin.WoundEdgeAppearance"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR WoundEdgeAppearance Extension",
   "title": "SHR WoundEdgeAppearance Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.121Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.521Z",
   "description": "Evaluation of the state of the tissue at the edge of the wound.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -170,7 +170,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-skin-WoundEdgeAppearanceVS"
+            "reference": "http://standardhealthrecord.org/shr/skin/vs/WoundEdgeAppearanceVS"
           }
         },
         "mapping": [
@@ -221,7 +221,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-skin-WoundEdgeAppearanceVS"
+            "reference": "http://standardhealthrecord.org/shr/skin/vs/WoundEdgeAppearanceVS"
           }
         }
       }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-skin-WoundExudate-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-skin-WoundExudate-extension.json
old mode 100755
new mode 100644
index 7f1e8dc..7571dc6
--- a/lib/resources/standard_health_record/StructureDefinition-shr-skin-WoundExudate-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-skin-WoundExudate-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.skin.WoundExudate"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR WoundExudate Extension",
   "title": "SHR WoundExudate Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.121Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.521Z",
   "description": "A mass of cells and fluid that has seeped out of a wound.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -105,9 +106,12 @@
         "id": "Extension:woundexudate.extension",
         "path": "Extension.extension",
         "slicing": {
-          "id": "268",
+          "id": "258",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -161,7 +165,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-skin-WoundSize-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-skin-WoundSize-extension.json
old mode 100755
new mode 100644
index 221909d..410e8f1
--- a/lib/resources/standard_health_record/StructureDefinition-shr-skin-WoundSize-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-skin-WoundSize-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.skin.WoundSize"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR WoundSize Extension",
   "title": "SHR WoundSize Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.120Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.520Z",
   "description": "The estimated or measured dimensions of a wound.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -105,9 +106,12 @@
         "id": "Extension:woundsize.extension",
         "path": "Extension.extension",
         "slicing": {
-          "id": "263",
+          "id": "253",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -291,7 +295,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-skin-WoundTunnelling-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-skin-WoundTunnelling-extension.json
old mode 100755
new mode 100644
index f4acf4b..41d43d6
--- a/lib/resources/standard_health_record/StructureDefinition-shr-skin-WoundTunnelling-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-skin-WoundTunnelling-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.skin.WoundTunnelling"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR WoundTunnelling Extension",
   "title": "SHR WoundTunnelling Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.120Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.521Z",
   "description": "A discharging blind-ended track that extends from the surface of an organ to an underlying area or abscess cavity. The track is invariably lined with granulation tissue. In chronic cases this may be augmented with epithelial tissue.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -105,9 +106,12 @@
         "id": "Extension:woundtunnelling.extension",
         "path": "Extension.extension",
         "slicing": {
-          "id": "265",
+          "id": "255",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -213,7 +217,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-skin-WoundUndermining-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-skin-WoundUndermining-extension.json
old mode 100755
new mode 100644
index 1f2cb1a..075d4ef
--- a/lib/resources/standard_health_record/StructureDefinition-shr-skin-WoundUndermining-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-skin-WoundUndermining-extension.json
@@ -3,7 +3,7 @@
   "id": "shr-skin-WoundUndermining-extension",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR WoundUndermining Extension</b></p>\n  <p>Assessment of deep tissue (subcutaneous fat and muscle) damage around the wound margin. Tunneling is just under the skin surface and doesn&#039;t involve deep tissue, and sinus tracts are a narrow tract that are away from the wound margins and go downward into the wound.</p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR WoundUndermining Extension</b></p>\n  <p>Assessment of deep tissue (subcutaneous fat and muscle) damage around the wound margin. Tunneling is just under the skin surface and doesn't involve deep tissue, and sinus tracts are a narrow tract that are away from the wound margins and go downward into the wound.</p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-skin-WoundUndermining-extension",
   "identifier": [
@@ -12,9 +12,11 @@
       "value": "shr.skin.WoundUndermining"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR WoundUndermining Extension",
   "title": "SHR WoundUndermining Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.121Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.521Z",
   "description": "Assessment of deep tissue (subcutaneous fat and muscle) damage around the wound margin. Tunneling is just under the skin surface and doesn't involve deep tissue, and sinus tracts are a narrow tract that are away from the wound margins and go downward into the wound.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -105,9 +106,12 @@
         "id": "Extension:woundundermining.extension",
         "path": "Extension.extension",
         "slicing": {
-          "id": "266",
+          "id": "256",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -187,7 +191,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-vital-BloodPressure.json b/lib/resources/standard_health_record/StructureDefinition-shr-vital-BloodPressure.json
old mode 100755
new mode 100644
index 4391b5c..901d27b
--- a/lib/resources/standard_health_record/StructureDefinition-shr-vital-BloodPressure.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-vital-BloodPressure.json
@@ -3,7 +3,7 @@
   "id": "shr-vital-BloodPressure",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR BloodPressure Profile</b></p>\n  <p>The force of circulating blood on the walls of the arteries.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.vital.BloodPressure maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  BodySite maps to bodySite\n  BodyPosition maps to http://hl7.org/fhir/StructureDefinition/observation-bodyPosition\n  Device maps to device\n  TBD &quot;Specimen&quot; maps to specimen\n  Interpretation maps to interpretation\n  ReferenceRange maps to referenceRange\n  ChangeFlag maps to http://hl7.org/fhir/StructureDefinition/observation-delta\n  Quantity maps to value[x].Quantity\n  SystolicPressure maps to component (slice on = code)\n  SystolicPressure.Quantity maps to component.value[x].Quantity\n  SystolicPressure.ObservationCode maps to component.code\n  DiastolicPressure maps to component\n  DiastolicPressure.Quantity maps to component.value[x].Quantity\n  DiastolicPressure.ObservationCode maps to component.code\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR BloodPressure Profile</b></p>\n  <p>The force of circulating blood on the walls of the arteries.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.vital.BloodPressure maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  BodySite maps to bodySite\n  BodyPosition maps to http://hl7.org/fhir/StructureDefinition/observation-bodyPosition\n  Device maps to device\n  &lt;TBD &quot;Specimen&quot;&gt; maps to specimen\n  Interpretation maps to interpretation\n  ReferenceRange maps to referenceRange\n  ChangeFlag maps to http://hl7.org/fhir/StructureDefinition/observation-delta\n  TestRequest maps to basedOn\n  Quantity maps to value[x].Quantity\n  SystolicPressure maps to component (slice on = code)\n  SystolicPressure.Quantity maps to component.value[x].Quantity\n  SystolicPressure.ObservationCode maps to component.code\n  DiastolicPressure maps to component\n  DiastolicPressure.Quantity maps to component.value[x].Quantity\n  DiastolicPressure.ObservationCode maps to component.code\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-vital-BloodPressure",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.vital.BloodPressure"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR BloodPressure Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.620Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.623Z",
   "description": "The force of circulating blood on the walls of the arteries.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR BloodPressure Profile",
         "definition": "The force of circulating blood on the walls of the arteries.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-vital-BloodPressure.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "316",
+          "id": "306",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "bodyposition",
         "definition": "The position or physical attitude of the body.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "changeflag",
         "definition": "Indicator of significant change (delta) from the last or previous measurement.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -398,6 +435,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -430,6 +468,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -511,7 +550,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -553,7 +591,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-vital-BloodPressureQualifierVS"
+            "reference": "http://standardhealthrecord.org/shr/vital/vs/BloodPressureQualifierVS"
           }
         },
         "mapping": [
@@ -563,43 +601,12 @@
           }
         ]
       },
-      {
-        "id": "Observation:shr-vital-BloodPressure.extension:testrequest",
-        "path": "Observation.extension",
-        "sliceName": "testrequest",
-        "definition": "A record of a request (order) for a test to be performed.",
-        "alias": [
-          "extensions",
-          "user content"
-        ],
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "DomainResource.extension",
-          "min": 0,
-          "max": "*"
-        },
-        "type": [
-          {
-            "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest-extension"
-          }
-        ],
-        "mustSupport": false,
-        "isModifier": false,
-        "isSummary": false,
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "N/A"
-          }
-        ]
-      },
       {
         "id": "Observation:shr-vital-BloodPressure.extension:headtiltangle",
         "path": "Observation.extension",
         "sliceName": "headtiltangle",
         "definition": "The angle at which the head is tilted relative to a level position while physiologic tests are taken.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -631,16 +638,19 @@
         "id": "Observation:shr-vital-BloodPressure.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "317",
+          "id": "307",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -670,6 +680,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -700,8 +711,8 @@
       {
         "id": "Observation:shr-vital-BloodPressure.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -710,7 +721,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -725,6 +741,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-vital-BloodPressure.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-vital-BloodPressure.status",
         "extension": [
@@ -736,6 +809,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -747,6 +821,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -754,6 +834,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -772,17 +860,20 @@
         "id": "Observation:shr-vital-BloodPressure.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "312",
+          "id": "302",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 1,
         "max": "*",
         "type": [
@@ -792,8 +883,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -810,9 +907,9 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-BloodPressure.category:vital-sign",
+        "id": "Observation:shr-vital-BloodPressure.category:vital-signs",
         "path": "Observation.category",
-        "sliceName": "vital-sign",
+        "sliceName": "vital-signs",
         "min": 1,
         "max": "1",
         "type": [
@@ -825,7 +922,7 @@
           "coding": [
             {
               "system": "http://hl7.org/fhir/observation-category",
-              "code": "vital-sign"
+              "code": "vital-signs"
             }
           ]
         }
@@ -836,6 +933,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -854,6 +954,12 @@
         },
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -861,6 +967,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -869,6 +983,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -880,7 +998,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -904,6 +1022,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -919,20 +1041,32 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-BloodPressure.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-vital-BloodPressure.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -952,8 +1086,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -967,6 +1104,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -986,7 +1127,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -1038,6 +1179,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -1057,8 +1202,8 @@
         "path": "Observation.value[x]",
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "0",
         "type": [
@@ -1072,6 +1217,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1079,6 +1232,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1087,7 +1244,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1100,6 +1257,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1107,6 +1270,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -1137,10 +1304,14 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-TestInterpretationVS"
+            "reference": "http://standardhealthrecord.org/shr/lab/vs/TestInterpretationVS"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1148,6 +1319,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1165,6 +1340,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -1180,8 +1359,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1193,10 +1371,14 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-vital-BloodPressureBodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/vital/vs/BloodPressureBodySiteVS"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -1204,6 +1386,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1212,7 +1398,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1225,7 +1411,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-vital-BloodPressureMethodVS"
+            "reference": "http://standardhealthrecord.org/shr/vital/vs/BloodPressureMethodVS"
           }
         },
         "mapping": [
@@ -1244,7 +1430,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1254,6 +1440,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1261,6 +1451,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1269,7 +1463,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1283,6 +1477,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1290,6 +1488,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1298,7 +1500,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "1",
@@ -1367,7 +1569,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1396,7 +1598,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1478,30 +1680,82 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-BloodPressure.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-vital-BloodPressure.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-vital-BloodPressure.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1557,8 +1811,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1620,7 +1874,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1649,7 +1903,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1681,7 +1935,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1691,6 +1945,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1740,16 +2000,19 @@
         "id": "Observation:shr-vital-BloodPressure.component",
         "path": "Observation.component",
         "slicing": {
-          "id": "313",
+          "id": "303",
           "discriminator": [
-            "code"
+            {
+              "type": "value",
+              "path": "code"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1812,7 +2075,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1841,7 +2104,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1883,6 +2146,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1890,6 +2159,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1909,8 +2182,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1947,6 +2220,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1954,6 +2231,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1962,7 +2243,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1975,6 +2256,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1997,7 +2284,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -2010,6 +2297,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -2017,6 +2310,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -2024,6 +2321,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -2032,7 +2333,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -2054,7 +2355,7 @@
         "sliceName": "shr-vital-SystolicPressure",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 1,
         "max": "1",
@@ -2117,7 +2418,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -2146,7 +2447,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -2197,6 +2498,12 @@
         },
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -2204,6 +2511,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -2222,18 +2533,21 @@
         "id": "Observation:shr-vital-BloodPressure.component:shr-vital-SystolicPressure.value[x]",
         "path": "Observation.component.value[x]",
         "slicing": {
-          "id": "314",
+          "id": "304",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
-        "min": 0,
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
+        "min": 1,
         "max": "1",
         "type": [
           {
@@ -2243,6 +2557,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -2250,6 +2568,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -2259,7 +2581,7 @@
         "sliceName": "shr-core-Quantity",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "min": 0,
+        "min": 1,
         "max": "1",
         "type": [
           {
@@ -2278,7 +2600,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -2291,6 +2613,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -2313,7 +2641,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -2326,6 +2654,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -2333,6 +2667,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -2340,6 +2678,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -2348,7 +2690,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -2370,7 +2712,7 @@
         "sliceName": "shr-vital-DiastolicPressure",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 1,
         "max": "1",
@@ -2433,7 +2775,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -2462,7 +2804,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -2513,6 +2855,12 @@
         },
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -2520,6 +2868,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -2538,18 +2890,21 @@
         "id": "Observation:shr-vital-BloodPressure.component:shr-vital-DiastolicPressure.value[x]",
         "path": "Observation.component.value[x]",
         "slicing": {
-          "id": "315",
+          "id": "305",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
-        "min": 0,
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
+        "min": 1,
         "max": "1",
         "type": [
           {
@@ -2559,6 +2914,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -2566,6 +2925,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -2575,7 +2938,7 @@
         "sliceName": "shr-core-Quantity",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "min": 0,
+        "min": 1,
         "max": "1",
         "type": [
           {
@@ -2594,7 +2957,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -2607,6 +2970,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -2629,7 +2998,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -2642,6 +3011,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -2649,6 +3024,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -2656,6 +3035,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -2664,7 +3047,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -2756,26 +3139,10 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-vital-BloodPressureQualifierVS"
+            "reference": "http://standardhealthrecord.org/shr/vital/vs/BloodPressureQualifierVS"
           }
         }
       },
-      {
-        "id": "Observation:shr-vital-BloodPressure.extension:testrequest",
-        "path": "Observation.extension",
-        "sliceName": "testrequest",
-        "min": 0,
-        "max": "1",
-        "type": [
-          {
-            "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest-extension"
-          }
-        ],
-        "mustSupport": false,
-        "isModifier": false,
-        "isSummary": false
-      },
       {
         "id": "Observation:shr-vital-BloodPressure.extension:headtiltangle",
         "path": "Observation.extension",
@@ -2808,13 +3175,52 @@
         "isModifier": true,
         "isSummary": false
       },
+      {
+        "id": "Observation:shr-vital-BloodPressure.basedOn",
+        "path": "Observation.basedOn",
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-vital-BloodPressure.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "312",
+          "id": "302",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -2829,9 +3235,9 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-BloodPressure.category:vital-sign",
+        "id": "Observation:shr-vital-BloodPressure.category:vital-signs",
         "path": "Observation.category",
-        "sliceName": "vital-sign",
+        "sliceName": "vital-signs",
         "min": 1,
         "max": "1",
         "type": [
@@ -2844,7 +3250,7 @@
           "coding": [
             {
               "system": "http://hl7.org/fhir/observation-category",
-              "code": "vital-sign"
+              "code": "vital-signs"
             }
           ]
         }
@@ -2892,12 +3298,16 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-BloodPressure.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-vital-BloodPressure.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
@@ -2966,7 +3376,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-TestInterpretationVS"
+            "reference": "http://standardhealthrecord.org/shr/lab/vs/TestInterpretationVS"
           }
         }
       },
@@ -2982,7 +3392,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-vital-BloodPressureBodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/vital/vs/BloodPressureBodySiteVS"
           }
         }
       },
@@ -2998,7 +3408,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-vital-BloodPressureMethodVS"
+            "reference": "http://standardhealthrecord.org/shr/vital/vs/BloodPressureMethodVS"
           }
         }
       },
@@ -3026,9 +3436,12 @@
         "id": "Observation:shr-vital-BloodPressure.component",
         "path": "Observation.component",
         "slicing": {
-          "id": "313",
+          "id": "303",
           "discriminator": [
-            "code"
+            {
+              "type": "value",
+              "path": "code"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -3063,13 +3476,18 @@
         "id": "Observation:shr-vital-BloodPressure.component:shr-vital-SystolicPressure.value[x]",
         "path": "Observation.component.value[x]",
         "slicing": {
-          "id": "314",
+          "id": "304",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
+        "min": 1,
+        "max": "1",
         "type": [
           {
             "code": "Quantity",
@@ -3120,13 +3538,18 @@
         "id": "Observation:shr-vital-BloodPressure.component:shr-vital-DiastolicPressure.value[x]",
         "path": "Observation.component.value[x]",
         "slicing": {
-          "id": "315",
+          "id": "305",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
+        "min": 1,
+        "max": "1",
         "type": [
           {
             "code": "Quantity",
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-vital-BodyHeight.json b/lib/resources/standard_health_record/StructureDefinition-shr-vital-BodyHeight.json
old mode 100755
new mode 100644
index cde1f88..86caa1b
--- a/lib/resources/standard_health_record/StructureDefinition-shr-vital-BodyHeight.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-vital-BodyHeight.json
@@ -3,7 +3,7 @@
   "id": "shr-vital-BodyHeight",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR BodyHeight Profile</b></p>\n  <p>The distance from the sole to the crown of the head.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.vital.BodyHeight maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  BodySite maps to bodySite\n  BodyPosition maps to http://hl7.org/fhir/StructureDefinition/observation-bodyPosition\n  Device maps to device\n  TBD &quot;Specimen&quot; maps to specimen\n  Interpretation maps to interpretation\n  ReferenceRange maps to referenceRange\n  ChangeFlag maps to http://hl7.org/fhir/StructureDefinition/observation-delta\n  Quantity maps to value[x].Quantity\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR BodyHeight Profile</b></p>\n  <p>The distance from the sole to the crown of the head.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.vital.BodyHeight maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  BodySite maps to bodySite\n  BodyPosition maps to http://hl7.org/fhir/StructureDefinition/observation-bodyPosition\n  Device maps to device\n  &lt;TBD &quot;Specimen&quot;&gt; maps to specimen\n  Interpretation maps to interpretation\n  ReferenceRange maps to referenceRange\n  ChangeFlag maps to http://hl7.org/fhir/StructureDefinition/observation-delta\n  TestRequest maps to basedOn\n  Quantity maps to value[x].Quantity\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-vital-BodyHeight",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.vital.BodyHeight"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR BodyHeight Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.361Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.570Z",
   "description": "The distance from the sole to the crown of the head.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR BodyHeight Profile",
         "definition": "The distance from the sole to the crown of the head.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-vital-BodyHeight.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "292",
+          "id": "282",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "bodyposition",
         "definition": "The position or physical attitude of the body.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "changeflag",
         "definition": "Indicator of significant change (delta) from the last or previous measurement.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -398,6 +435,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -430,6 +468,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -511,7 +550,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -553,7 +591,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-vital-BodyHeightQualifierVS"
+            "reference": "http://standardhealthrecord.org/shr/vital/vs/BodyHeightQualifierVS"
           }
         },
         "mapping": [
@@ -563,52 +601,23 @@
           }
         ]
       },
-      {
-        "id": "Observation:shr-vital-BodyHeight.extension:testrequest",
-        "path": "Observation.extension",
-        "sliceName": "testrequest",
-        "definition": "A record of a request (order) for a test to be performed.",
-        "alias": [
-          "extensions",
-          "user content"
-        ],
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "DomainResource.extension",
-          "min": 0,
-          "max": "*"
-        },
-        "type": [
-          {
-            "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest-extension"
-          }
-        ],
-        "mustSupport": false,
-        "isModifier": false,
-        "isSummary": false,
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "N/A"
-          }
-        ]
-      },
       {
         "id": "Observation:shr-vital-BodyHeight.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "293",
+          "id": "283",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -638,6 +647,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -668,8 +678,8 @@
       {
         "id": "Observation:shr-vital-BodyHeight.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -678,7 +688,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -693,6 +708,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-vital-BodyHeight.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-vital-BodyHeight.status",
         "extension": [
@@ -704,6 +776,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -715,6 +788,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -722,6 +801,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -740,17 +827,20 @@
         "id": "Observation:shr-vital-BodyHeight.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "290",
+          "id": "280",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 1,
         "max": "*",
         "type": [
@@ -760,8 +850,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -778,9 +874,9 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-BodyHeight.category:vital-sign",
+        "id": "Observation:shr-vital-BodyHeight.category:vital-signs",
         "path": "Observation.category",
-        "sliceName": "vital-sign",
+        "sliceName": "vital-signs",
         "min": 1,
         "max": "1",
         "type": [
@@ -793,7 +889,7 @@
           "coding": [
             {
               "system": "http://hl7.org/fhir/observation-category",
-              "code": "vital-sign"
+              "code": "vital-signs"
             }
           ]
         }
@@ -804,6 +900,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -822,6 +921,12 @@
         },
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -829,6 +934,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -837,6 +950,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -848,7 +965,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -872,6 +989,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -887,20 +1008,32 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-BodyHeight.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-vital-BodyHeight.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -920,8 +1053,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -935,6 +1071,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -954,7 +1094,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -1006,6 +1146,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -1024,17 +1168,20 @@
         "id": "Observation:shr-vital-BodyHeight.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "291",
+          "id": "281",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 1,
         "max": "1",
         "type": [
@@ -1048,6 +1195,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1055,6 +1210,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1083,7 +1242,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1096,6 +1255,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1103,6 +1268,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -1133,10 +1302,14 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-TestInterpretationVS"
+            "reference": "http://standardhealthrecord.org/shr/lab/vs/TestInterpretationVS"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1144,6 +1317,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1161,6 +1338,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -1176,8 +1357,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1189,10 +1369,14 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -1200,6 +1384,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1208,7 +1396,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1219,6 +1407,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1241,7 +1435,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1251,6 +1445,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1258,6 +1456,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1266,7 +1468,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1280,6 +1482,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1287,6 +1493,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1295,7 +1505,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "1",
@@ -1364,7 +1574,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1393,7 +1603,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1475,30 +1685,82 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-BodyHeight.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-vital-BodyHeight.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-vital-BodyHeight.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1554,8 +1816,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1617,7 +1879,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1646,7 +1908,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1678,7 +1940,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1688,6 +1950,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1738,7 +2006,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1801,7 +2069,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1830,7 +2098,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1872,6 +2140,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1879,6 +2153,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1898,8 +2176,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1936,6 +2214,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1943,6 +2225,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1951,7 +2237,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1964,6 +2250,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1986,7 +2278,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1999,6 +2291,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -2006,6 +2304,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -2013,6 +2315,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -2021,7 +2327,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -2113,49 +2419,72 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-vital-BodyHeightQualifierVS"
+            "reference": "http://standardhealthrecord.org/shr/vital/vs/BodyHeightQualifierVS"
           }
         }
       },
       {
-        "id": "Observation:shr-vital-BodyHeight.extension:testrequest",
-        "path": "Observation.extension",
-        "sliceName": "testrequest",
+        "id": "Observation:shr-vital-BodyHeight.modifierExtension:observationnonoccurrencemodifier",
+        "path": "Observation.modifierExtension",
+        "sliceName": "observationnonoccurrencemodifier",
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest-extension"
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-observation-ObservationNonOccurrenceModifier-extension"
           }
         ],
-        "mustSupport": false,
-        "isModifier": false,
+        "mustSupport": true,
+        "isModifier": true,
         "isSummary": false
       },
       {
-        "id": "Observation:shr-vital-BodyHeight.modifierExtension:observationnonoccurrencemodifier",
-        "path": "Observation.modifierExtension",
-        "sliceName": "observationnonoccurrencemodifier",
+        "id": "Observation:shr-vital-BodyHeight.basedOn",
+        "path": "Observation.basedOn",
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-observation-ObservationNonOccurrenceModifier-extension"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
           }
-        ],
-        "mustSupport": true,
-        "isModifier": true,
-        "isSummary": false
+        ]
       },
       {
         "id": "Observation:shr-vital-BodyHeight.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "290",
+          "id": "280",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -2170,9 +2499,9 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-BodyHeight.category:vital-sign",
+        "id": "Observation:shr-vital-BodyHeight.category:vital-signs",
         "path": "Observation.category",
-        "sliceName": "vital-sign",
+        "sliceName": "vital-signs",
         "min": 1,
         "max": "1",
         "type": [
@@ -2185,7 +2514,7 @@
           "coding": [
             {
               "system": "http://hl7.org/fhir/observation-category",
-              "code": "vital-sign"
+              "code": "vital-signs"
             }
           ]
         }
@@ -2233,12 +2562,16 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-BodyHeight.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-vital-BodyHeight.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
@@ -2287,9 +2620,12 @@
         "id": "Observation:shr-vital-BodyHeight.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "291",
+          "id": "281",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -2329,7 +2665,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-TestInterpretationVS"
+            "reference": "http://standardhealthrecord.org/shr/lab/vs/TestInterpretationVS"
           }
         }
       },
@@ -2345,7 +2681,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-vital-BodyLength.json b/lib/resources/standard_health_record/StructureDefinition-shr-vital-BodyLength.json
old mode 100755
new mode 100644
index d29fcc4..b067ab2
--- a/lib/resources/standard_health_record/StructureDefinition-shr-vital-BodyLength.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-vital-BodyLength.json
@@ -3,7 +3,7 @@
   "id": "shr-vital-BodyLength",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR BodyLength Profile</b></p>\n  <p>The distance from the sole of the foot to the crown of the head, lying down (typically 0-2 years).</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.vital.BodyLength maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  BodySite maps to bodySite\n  BodyPosition maps to http://hl7.org/fhir/StructureDefinition/observation-bodyPosition\n  Device maps to device\n  TBD &quot;Specimen&quot; maps to specimen\n  Interpretation maps to interpretation\n  ReferenceRange maps to referenceRange\n  ChangeFlag maps to http://hl7.org/fhir/StructureDefinition/observation-delta\n  Quantity maps to value[x].Quantity\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR BodyLength Profile</b></p>\n  <p>The distance from the sole of the foot to the crown of the head, lying down (typically 0-2 years).</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.vital.BodyLength maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  BodySite maps to bodySite\n  BodyPosition maps to http://hl7.org/fhir/StructureDefinition/observation-bodyPosition\n  Device maps to device\n  &lt;TBD &quot;Specimen&quot;&gt; maps to specimen\n  Interpretation maps to interpretation\n  ReferenceRange maps to referenceRange\n  ChangeFlag maps to http://hl7.org/fhir/StructureDefinition/observation-delta\n  TestRequest maps to basedOn\n  Quantity maps to value[x].Quantity\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-vital-BodyLength",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.vital.BodyLength"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR BodyLength Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.448Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.580Z",
   "description": "The distance from the sole of the foot to the crown of the head, lying down (typically 0-2 years).",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR BodyLength Profile",
         "definition": "The distance from the sole of the foot to the crown of the head, lying down (typically 0-2 years).",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-vital-BodyLength.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "296",
+          "id": "286",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "bodyposition",
         "definition": "The position or physical attitude of the body.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "changeflag",
         "definition": "Indicator of significant change (delta) from the last or previous measurement.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -398,6 +435,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -430,6 +468,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -511,7 +550,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -553,7 +591,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-vital-BodyHeightQualifierVS"
+            "reference": "http://standardhealthrecord.org/shr/vital/vs/BodyHeightQualifierVS"
           }
         },
         "mapping": [
@@ -563,52 +601,23 @@
           }
         ]
       },
-      {
-        "id": "Observation:shr-vital-BodyLength.extension:testrequest",
-        "path": "Observation.extension",
-        "sliceName": "testrequest",
-        "definition": "A record of a request (order) for a test to be performed.",
-        "alias": [
-          "extensions",
-          "user content"
-        ],
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "DomainResource.extension",
-          "min": 0,
-          "max": "*"
-        },
-        "type": [
-          {
-            "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest-extension"
-          }
-        ],
-        "mustSupport": false,
-        "isModifier": false,
-        "isSummary": false,
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "N/A"
-          }
-        ]
-      },
       {
         "id": "Observation:shr-vital-BodyLength.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "297",
+          "id": "287",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -638,6 +647,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -668,8 +678,8 @@
       {
         "id": "Observation:shr-vital-BodyLength.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -678,7 +688,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -693,6 +708,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-vital-BodyLength.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-vital-BodyLength.status",
         "extension": [
@@ -704,6 +776,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -715,6 +788,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -722,6 +801,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -740,17 +827,20 @@
         "id": "Observation:shr-vital-BodyLength.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "294",
+          "id": "284",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 1,
         "max": "*",
         "type": [
@@ -760,8 +850,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -778,9 +874,9 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-BodyLength.category:vital-sign",
+        "id": "Observation:shr-vital-BodyLength.category:vital-signs",
         "path": "Observation.category",
-        "sliceName": "vital-sign",
+        "sliceName": "vital-signs",
         "min": 1,
         "max": "1",
         "type": [
@@ -793,7 +889,7 @@
           "coding": [
             {
               "system": "http://hl7.org/fhir/observation-category",
-              "code": "vital-sign"
+              "code": "vital-signs"
             }
           ]
         }
@@ -804,6 +900,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -822,6 +921,12 @@
         },
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -829,6 +934,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -837,6 +950,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -848,7 +965,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -872,6 +989,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -887,20 +1008,32 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-BodyLength.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-vital-BodyLength.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -920,8 +1053,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -935,6 +1071,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -954,7 +1094,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -1006,6 +1146,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -1024,17 +1168,20 @@
         "id": "Observation:shr-vital-BodyLength.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "295",
+          "id": "285",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 1,
         "max": "1",
         "type": [
@@ -1048,6 +1195,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1055,6 +1210,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1083,7 +1242,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1096,6 +1255,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1103,6 +1268,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -1133,10 +1302,14 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-TestInterpretationVS"
+            "reference": "http://standardhealthrecord.org/shr/lab/vs/TestInterpretationVS"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1144,6 +1317,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1161,6 +1338,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -1176,8 +1357,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1189,10 +1369,14 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -1200,6 +1384,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1208,7 +1396,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1219,6 +1407,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1241,7 +1435,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1251,6 +1445,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1258,6 +1456,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1266,7 +1468,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1280,6 +1482,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1287,6 +1493,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1295,7 +1505,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "1",
@@ -1364,7 +1574,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1393,7 +1603,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1475,30 +1685,82 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-BodyLength.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-vital-BodyLength.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-vital-BodyLength.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1554,8 +1816,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1617,7 +1879,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1646,7 +1908,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1678,7 +1940,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1688,6 +1950,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1738,7 +2006,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1801,7 +2069,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1830,7 +2098,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1872,6 +2140,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1879,6 +2153,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1898,8 +2176,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1936,6 +2214,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1943,6 +2225,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1951,7 +2237,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1964,6 +2250,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1986,7 +2278,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1999,6 +2291,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -2006,6 +2304,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -2013,6 +2315,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -2021,7 +2327,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -2113,49 +2419,72 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-vital-BodyHeightQualifierVS"
+            "reference": "http://standardhealthrecord.org/shr/vital/vs/BodyHeightQualifierVS"
           }
         }
       },
       {
-        "id": "Observation:shr-vital-BodyLength.extension:testrequest",
-        "path": "Observation.extension",
-        "sliceName": "testrequest",
+        "id": "Observation:shr-vital-BodyLength.modifierExtension:observationnonoccurrencemodifier",
+        "path": "Observation.modifierExtension",
+        "sliceName": "observationnonoccurrencemodifier",
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest-extension"
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-observation-ObservationNonOccurrenceModifier-extension"
           }
         ],
-        "mustSupport": false,
-        "isModifier": false,
+        "mustSupport": true,
+        "isModifier": true,
         "isSummary": false
       },
       {
-        "id": "Observation:shr-vital-BodyLength.modifierExtension:observationnonoccurrencemodifier",
-        "path": "Observation.modifierExtension",
-        "sliceName": "observationnonoccurrencemodifier",
+        "id": "Observation:shr-vital-BodyLength.basedOn",
+        "path": "Observation.basedOn",
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-observation-ObservationNonOccurrenceModifier-extension"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
           }
-        ],
-        "mustSupport": true,
-        "isModifier": true,
-        "isSummary": false
+        ]
       },
       {
         "id": "Observation:shr-vital-BodyLength.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "294",
+          "id": "284",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -2170,9 +2499,9 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-BodyLength.category:vital-sign",
+        "id": "Observation:shr-vital-BodyLength.category:vital-signs",
         "path": "Observation.category",
-        "sliceName": "vital-sign",
+        "sliceName": "vital-signs",
         "min": 1,
         "max": "1",
         "type": [
@@ -2185,7 +2514,7 @@
           "coding": [
             {
               "system": "http://hl7.org/fhir/observation-category",
-              "code": "vital-sign"
+              "code": "vital-signs"
             }
           ]
         }
@@ -2233,12 +2562,16 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-BodyLength.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-vital-BodyLength.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
@@ -2287,9 +2620,12 @@
         "id": "Observation:shr-vital-BodyLength.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "295",
+          "id": "285",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -2329,7 +2665,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-TestInterpretationVS"
+            "reference": "http://standardhealthrecord.org/shr/lab/vs/TestInterpretationVS"
           }
         }
       },
@@ -2345,7 +2681,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-vital-BodyMassIndex.json b/lib/resources/standard_health_record/StructureDefinition-shr-vital-BodyMassIndex.json
old mode 100755
new mode 100644
index 3abb53f..841dcd3
--- a/lib/resources/standard_health_record/StructureDefinition-shr-vital-BodyMassIndex.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-vital-BodyMassIndex.json
@@ -3,7 +3,7 @@
   "id": "shr-vital-BodyMassIndex",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR BodyMassIndex Profile</b></p>\n  <p>A general indicator of the body fat an individual is carrying based upon the ratio of weight to height.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.vital.BodyMassIndex maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  BodySite maps to bodySite\n  BodyPosition maps to http://hl7.org/fhir/StructureDefinition/observation-bodyPosition\n  Device maps to device\n  TBD &quot;Specimen&quot; maps to specimen\n  Interpretation maps to interpretation\n  ReferenceRange maps to referenceRange\n  ChangeFlag maps to http://hl7.org/fhir/StructureDefinition/observation-delta\n  Quantity maps to value[x].Quantity\n  BodyWeight maps to component (slice on = code)\n  BodyWeight.Quantity maps to component.value[x].Quantity\n  BodyWeight.ObservationCode maps to component.code\n  BodyWeight.Interpretation maps to component.interpretation\n  BodyWeight.ReferenceRange maps to component.referenceRange\n  BodyHeight maps to component\n  BodyHeight.Quantity maps to component.value[x].Quantity\n  BodyHeight.ObservationCode maps to component.code\n  BodyHeight.Interpretation maps to component.interpretation\n  BodyHeight.ReferenceRange maps to component.referenceRange\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR BodyMassIndex Profile</b></p>\n  <p>A general indicator of the body fat an individual is carrying based upon the ratio of weight to height.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.vital.BodyMassIndex maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  BodySite maps to bodySite\n  BodyPosition maps to http://hl7.org/fhir/StructureDefinition/observation-bodyPosition\n  Device maps to device\n  &lt;TBD &quot;Specimen&quot;&gt; maps to specimen\n  Interpretation maps to interpretation\n  ReferenceRange maps to referenceRange\n  ChangeFlag maps to http://hl7.org/fhir/StructureDefinition/observation-delta\n  TestRequest maps to basedOn\n  Quantity maps to value[x].Quantity\n  BodyWeight maps to component (slice on = code)\n  BodyWeight.Quantity maps to component.value[x].Quantity\n  BodyWeight.ObservationCode maps to component.code\n  BodyWeight.Interpretation maps to component.interpretation\n  BodyWeight.ReferenceRange maps to component.referenceRange\n  BodyHeight maps to component\n  BodyHeight.Quantity maps to component.value[x].Quantity\n  BodyHeight.ObservationCode maps to component.code\n  BodyHeight.Interpretation maps to component.interpretation\n  BodyHeight.ReferenceRange maps to component.referenceRange\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-vital-BodyMassIndex",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.vital.BodyMassIndex"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR BodyMassIndex Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.570Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.605Z",
   "description": "A general indicator of the body fat an individual is carrying based upon the ratio of weight to height.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR BodyMassIndex Profile",
         "definition": "A general indicator of the body fat an individual is carrying based upon the ratio of weight to height.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-vital-BodyMassIndex.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "310",
+          "id": "300",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "bodyposition",
         "definition": "The position or physical attitude of the body.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "changeflag",
         "definition": "Indicator of significant change (delta) from the last or previous measurement.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -398,6 +435,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -430,6 +468,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -457,52 +496,23 @@
           }
         ]
       },
-      {
-        "id": "Observation:shr-vital-BodyMassIndex.extension:testrequest",
-        "path": "Observation.extension",
-        "sliceName": "testrequest",
-        "definition": "A record of a request (order) for a test to be performed.",
-        "alias": [
-          "extensions",
-          "user content"
-        ],
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "DomainResource.extension",
-          "min": 0,
-          "max": "*"
-        },
-        "type": [
-          {
-            "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest-extension"
-          }
-        ],
-        "mustSupport": false,
-        "isModifier": false,
-        "isSummary": false,
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "N/A"
-          }
-        ]
-      },
       {
         "id": "Observation:shr-vital-BodyMassIndex.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "311",
+          "id": "301",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -532,6 +542,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -562,8 +573,8 @@
       {
         "id": "Observation:shr-vital-BodyMassIndex.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -572,7 +583,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -587,6 +603,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-vital-BodyMassIndex.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-vital-BodyMassIndex.status",
         "extension": [
@@ -598,6 +671,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -609,6 +683,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -616,6 +696,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -634,17 +722,20 @@
         "id": "Observation:shr-vital-BodyMassIndex.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "306",
+          "id": "296",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 1,
         "max": "*",
         "type": [
@@ -654,8 +745,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -672,9 +769,9 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-BodyMassIndex.category:vital-sign",
+        "id": "Observation:shr-vital-BodyMassIndex.category:vital-signs",
         "path": "Observation.category",
-        "sliceName": "vital-sign",
+        "sliceName": "vital-signs",
         "min": 1,
         "max": "1",
         "type": [
@@ -687,7 +784,7 @@
           "coding": [
             {
               "system": "http://hl7.org/fhir/observation-category",
-              "code": "vital-sign"
+              "code": "vital-signs"
             }
           ]
         }
@@ -698,6 +795,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -716,6 +816,12 @@
         },
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -723,6 +829,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -731,6 +845,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -742,7 +860,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -766,6 +884,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -781,20 +903,32 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-BodyMassIndex.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-vital-BodyMassIndex.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -814,8 +948,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -829,6 +966,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -848,7 +989,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -900,6 +1041,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -919,8 +1064,8 @@
         "path": "Observation.value[x]",
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -934,6 +1079,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -941,6 +1094,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -949,7 +1106,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -962,6 +1119,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -969,6 +1132,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -999,10 +1166,14 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-TestInterpretationVS"
+            "reference": "http://standardhealthrecord.org/shr/lab/vs/TestInterpretationVS"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1010,6 +1181,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1027,6 +1202,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -1042,8 +1221,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1055,10 +1233,14 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -1066,6 +1248,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1074,7 +1260,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1085,6 +1271,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1107,7 +1299,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1117,6 +1309,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1124,6 +1320,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1132,7 +1332,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1146,6 +1346,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1153,6 +1357,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1161,7 +1369,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "1",
@@ -1230,7 +1438,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1259,7 +1467,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1341,30 +1549,82 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-BodyMassIndex.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-vital-BodyMassIndex.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-vital-BodyMassIndex.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1420,8 +1680,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1483,7 +1743,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1512,7 +1772,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1544,7 +1804,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1554,6 +1814,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1603,16 +1869,19 @@
         "id": "Observation:shr-vital-BodyMassIndex.component",
         "path": "Observation.component",
         "slicing": {
-          "id": "307",
+          "id": "297",
           "discriminator": [
-            "code"
+            {
+              "type": "value",
+              "path": "code"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1675,7 +1944,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1704,7 +1973,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1746,6 +2015,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1753,6 +2028,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1772,8 +2051,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1810,6 +2089,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1817,6 +2100,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1825,7 +2112,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1838,6 +2125,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1860,7 +2153,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1873,6 +2166,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1880,6 +2179,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1887,6 +2190,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1895,7 +2202,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1917,7 +2224,7 @@
         "sliceName": "shr-vital-BodyWeight",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "1",
@@ -1980,7 +2287,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -2009,7 +2316,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -2060,6 +2367,12 @@
         },
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -2067,6 +2380,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -2085,17 +2402,20 @@
         "id": "Observation:shr-vital-BodyMassIndex.component:shr-vital-BodyWeight.value[x]",
         "path": "Observation.component.value[x]",
         "slicing": {
-          "id": "308",
+          "id": "298",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -2106,6 +2426,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -2113,6 +2437,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -2141,7 +2469,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -2154,6 +2482,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -2176,7 +2510,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -2192,10 +2526,14 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-TestInterpretationVS"
+            "reference": "http://standardhealthrecord.org/shr/lab/vs/TestInterpretationVS"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -2203,6 +2541,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -2211,10 +2553,10 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "BackboneElement"
@@ -2263,7 +2605,7 @@
         "path": "Observation.component.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -2292,7 +2634,7 @@
         "path": "Observation.component.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -2374,30 +2716,82 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-BodyMassIndex.component:shr-vital-BodyWeight.referenceRange.meaning",
-        "path": "Observation.component.referenceRange.meaning",
+        "id": "Observation:shr-vital-BodyMassIndex.component:shr-vital-BodyWeight.referenceRange.type",
+        "path": "Observation.component.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-vital-BodyMassIndex.component:shr-vital-BodyWeight.referenceRange.appliesTo",
+        "path": "Observation.component.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -2454,7 +2848,7 @@
         "sliceName": "shr-vital-BodyHeight",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "1",
@@ -2517,7 +2911,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -2546,7 +2940,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -2597,6 +2991,12 @@
         },
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -2604,6 +3004,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -2622,17 +3026,20 @@
         "id": "Observation:shr-vital-BodyMassIndex.component:shr-vital-BodyHeight.value[x]",
         "path": "Observation.component.value[x]",
         "slicing": {
-          "id": "309",
+          "id": "299",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -2643,6 +3050,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -2650,6 +3061,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -2678,7 +3093,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -2691,6 +3106,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -2713,7 +3134,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -2729,10 +3150,14 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-TestInterpretationVS"
+            "reference": "http://standardhealthrecord.org/shr/lab/vs/TestInterpretationVS"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -2740,6 +3165,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -2748,10 +3177,10 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "BackboneElement"
@@ -2800,7 +3229,7 @@
         "path": "Observation.component.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -2829,7 +3258,7 @@
         "path": "Observation.component.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -2911,30 +3340,82 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-BodyMassIndex.component:shr-vital-BodyHeight.referenceRange.meaning",
-        "path": "Observation.component.referenceRange.meaning",
+        "id": "Observation:shr-vital-BodyMassIndex.component:shr-vital-BodyHeight.referenceRange.type",
+        "path": "Observation.component.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-vital-BodyMassIndex.component:shr-vital-BodyHeight.referenceRange.appliesTo",
+        "path": "Observation.component.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -3060,44 +3541,67 @@
         "isSummary": false
       },
       {
-        "id": "Observation:shr-vital-BodyMassIndex.extension:testrequest",
-        "path": "Observation.extension",
-        "sliceName": "testrequest",
+        "id": "Observation:shr-vital-BodyMassIndex.modifierExtension:observationnonoccurrencemodifier",
+        "path": "Observation.modifierExtension",
+        "sliceName": "observationnonoccurrencemodifier",
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest-extension"
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-observation-ObservationNonOccurrenceModifier-extension"
           }
         ],
-        "mustSupport": false,
-        "isModifier": false,
+        "mustSupport": true,
+        "isModifier": true,
         "isSummary": false
       },
       {
-        "id": "Observation:shr-vital-BodyMassIndex.modifierExtension:observationnonoccurrencemodifier",
-        "path": "Observation.modifierExtension",
-        "sliceName": "observationnonoccurrencemodifier",
+        "id": "Observation:shr-vital-BodyMassIndex.basedOn",
+        "path": "Observation.basedOn",
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-observation-ObservationNonOccurrenceModifier-extension"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
           }
-        ],
-        "mustSupport": true,
-        "isModifier": true,
-        "isSummary": false
+        ]
       },
       {
         "id": "Observation:shr-vital-BodyMassIndex.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "306",
+          "id": "296",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -3112,9 +3616,9 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-BodyMassIndex.category:vital-sign",
+        "id": "Observation:shr-vital-BodyMassIndex.category:vital-signs",
         "path": "Observation.category",
-        "sliceName": "vital-sign",
+        "sliceName": "vital-signs",
         "min": 1,
         "max": "1",
         "type": [
@@ -3127,7 +3631,7 @@
           "coding": [
             {
               "system": "http://hl7.org/fhir/observation-category",
-              "code": "vital-sign"
+              "code": "vital-signs"
             }
           ]
         }
@@ -3175,12 +3679,16 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-BodyMassIndex.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-vital-BodyMassIndex.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
@@ -3247,7 +3755,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-TestInterpretationVS"
+            "reference": "http://standardhealthrecord.org/shr/lab/vs/TestInterpretationVS"
           }
         }
       },
@@ -3263,7 +3771,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
           }
         }
       },
@@ -3301,9 +3809,12 @@
         "id": "Observation:shr-vital-BodyMassIndex.component",
         "path": "Observation.component",
         "slicing": {
-          "id": "307",
+          "id": "297",
           "discriminator": [
-            "code"
+            {
+              "type": "value",
+              "path": "code"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -3338,9 +3849,12 @@
         "id": "Observation:shr-vital-BodyMassIndex.component:shr-vital-BodyWeight.value[x]",
         "path": "Observation.component.value[x]",
         "slicing": {
-          "id": "308",
+          "id": "298",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -3378,10 +3892,16 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-TestInterpretationVS"
+            "reference": "http://standardhealthrecord.org/shr/lab/vs/TestInterpretationVS"
           }
         }
       },
+      {
+        "id": "Observation:shr-vital-BodyMassIndex.component:shr-vital-BodyWeight.referenceRange",
+        "path": "Observation.component.referenceRange",
+        "min": 0,
+        "max": "1"
+      },
       {
         "id": "Observation:shr-vital-BodyMassIndex.component:shr-vital-BodyHeight",
         "path": "Observation.component",
@@ -3411,9 +3931,12 @@
         "id": "Observation:shr-vital-BodyMassIndex.component:shr-vital-BodyHeight.value[x]",
         "path": "Observation.component.value[x]",
         "slicing": {
-          "id": "309",
+          "id": "299",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -3451,9 +3974,15 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-TestInterpretationVS"
+            "reference": "http://standardhealthrecord.org/shr/lab/vs/TestInterpretationVS"
           }
         }
+      },
+      {
+        "id": "Observation:shr-vital-BodyMassIndex.component:shr-vital-BodyHeight.referenceRange",
+        "path": "Observation.component.referenceRange",
+        "min": 0,
+        "max": "1"
       }
     ]
   }
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-vital-BodyTemperature.json b/lib/resources/standard_health_record/StructureDefinition-shr-vital-BodyTemperature.json
old mode 100755
new mode 100644
index 0628579..ab667fe
--- a/lib/resources/standard_health_record/StructureDefinition-shr-vital-BodyTemperature.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-vital-BodyTemperature.json
@@ -3,7 +3,7 @@
   "id": "shr-vital-BodyTemperature",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR BodyTemperature Profile</b></p>\n  <p>The measure of the level of heat in a human or animal.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.vital.BodyTemperature maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  BodySite maps to bodySite\n  BodyPosition maps to http://hl7.org/fhir/StructureDefinition/observation-bodyPosition\n  Device maps to device\n  TBD &quot;Specimen&quot; maps to specimen\n  Interpretation maps to interpretation\n  ReferenceRange maps to referenceRange\n  ChangeFlag maps to http://hl7.org/fhir/StructureDefinition/observation-delta\n  Quantity maps to value[x].Quantity\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR BodyTemperature Profile</b></p>\n  <p>The measure of the level of heat in a human or animal.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.vital.BodyTemperature maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  BodySite maps to bodySite\n  BodyPosition maps to http://hl7.org/fhir/StructureDefinition/observation-bodyPosition\n  Device maps to device\n  &lt;TBD &quot;Specimen&quot;&gt; maps to specimen\n  Interpretation maps to interpretation\n  ReferenceRange maps to referenceRange\n  ChangeFlag maps to http://hl7.org/fhir/StructureDefinition/observation-delta\n  TestRequest maps to basedOn\n  Quantity maps to value[x].Quantity\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-vital-BodyTemperature",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.vital.BodyTemperature"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR BodyTemperature Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.305Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.562Z",
   "description": "The measure of the level of heat in a human or animal.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR BodyTemperature Profile",
         "definition": "The measure of the level of heat in a human or animal.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-vital-BodyTemperature.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "288",
+          "id": "278",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "bodyposition",
         "definition": "The position or physical attitude of the body.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "changeflag",
         "definition": "Indicator of significant change (delta) from the last or previous measurement.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -398,6 +435,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -430,6 +468,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -511,7 +550,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -553,7 +591,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-vital-BodyTemperatureQualifierVS"
+            "reference": "http://standardhealthrecord.org/shr/vital/vs/BodyTemperatureQualifierVS"
           }
         },
         "mapping": [
@@ -563,52 +601,23 @@
           }
         ]
       },
-      {
-        "id": "Observation:shr-vital-BodyTemperature.extension:testrequest",
-        "path": "Observation.extension",
-        "sliceName": "testrequest",
-        "definition": "A record of a request (order) for a test to be performed.",
-        "alias": [
-          "extensions",
-          "user content"
-        ],
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "DomainResource.extension",
-          "min": 0,
-          "max": "*"
-        },
-        "type": [
-          {
-            "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest-extension"
-          }
-        ],
-        "mustSupport": false,
-        "isModifier": false,
-        "isSummary": false,
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "N/A"
-          }
-        ]
-      },
       {
         "id": "Observation:shr-vital-BodyTemperature.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "289",
+          "id": "279",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -638,6 +647,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -668,8 +678,8 @@
       {
         "id": "Observation:shr-vital-BodyTemperature.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -678,7 +688,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -693,6 +708,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-vital-BodyTemperature.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-vital-BodyTemperature.status",
         "extension": [
@@ -704,6 +776,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -715,6 +788,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -722,6 +801,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -740,17 +827,20 @@
         "id": "Observation:shr-vital-BodyTemperature.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "286",
+          "id": "276",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 1,
         "max": "*",
         "type": [
@@ -760,8 +850,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -778,9 +874,9 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-BodyTemperature.category:vital-sign",
+        "id": "Observation:shr-vital-BodyTemperature.category:vital-signs",
         "path": "Observation.category",
-        "sliceName": "vital-sign",
+        "sliceName": "vital-signs",
         "min": 1,
         "max": "1",
         "type": [
@@ -793,7 +889,7 @@
           "coding": [
             {
               "system": "http://hl7.org/fhir/observation-category",
-              "code": "vital-sign"
+              "code": "vital-signs"
             }
           ]
         }
@@ -804,6 +900,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -822,6 +921,12 @@
         },
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -829,6 +934,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -837,6 +950,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -848,7 +965,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -872,6 +989,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -887,20 +1008,32 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-BodyTemperature.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-vital-BodyTemperature.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -920,8 +1053,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -935,6 +1071,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -954,7 +1094,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -1006,6 +1146,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -1024,17 +1168,20 @@
         "id": "Observation:shr-vital-BodyTemperature.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "287",
+          "id": "277",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 1,
         "max": "1",
         "type": [
@@ -1048,6 +1195,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1055,6 +1210,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1083,7 +1242,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1096,6 +1255,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1103,6 +1268,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -1133,10 +1302,14 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-TestInterpretationVS"
+            "reference": "http://standardhealthrecord.org/shr/lab/vs/TestInterpretationVS"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1144,6 +1317,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1161,6 +1338,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -1176,8 +1357,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1189,10 +1369,14 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-vital-BodyTemperatureBodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/vital/vs/BodyTemperatureBodySiteVS"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -1200,6 +1384,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1208,7 +1396,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1219,6 +1407,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1241,7 +1435,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1251,6 +1445,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1258,6 +1456,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1266,7 +1468,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1280,6 +1482,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1287,6 +1493,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1295,7 +1505,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "1",
@@ -1364,7 +1574,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1393,7 +1603,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1475,30 +1685,82 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-BodyTemperature.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-vital-BodyTemperature.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-vital-BodyTemperature.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1554,8 +1816,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1617,7 +1879,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1646,7 +1908,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1678,7 +1940,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1688,6 +1950,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1738,7 +2006,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1801,7 +2069,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1830,7 +2098,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1872,6 +2140,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1879,6 +2153,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1898,8 +2176,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1936,6 +2214,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1943,6 +2225,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1951,7 +2237,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1964,6 +2250,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1986,7 +2278,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1999,6 +2291,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -2006,6 +2304,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -2013,6 +2315,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -2021,7 +2327,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -2113,49 +2419,72 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-vital-BodyTemperatureQualifierVS"
+            "reference": "http://standardhealthrecord.org/shr/vital/vs/BodyTemperatureQualifierVS"
           }
         }
       },
       {
-        "id": "Observation:shr-vital-BodyTemperature.extension:testrequest",
-        "path": "Observation.extension",
-        "sliceName": "testrequest",
+        "id": "Observation:shr-vital-BodyTemperature.modifierExtension:observationnonoccurrencemodifier",
+        "path": "Observation.modifierExtension",
+        "sliceName": "observationnonoccurrencemodifier",
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest-extension"
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-observation-ObservationNonOccurrenceModifier-extension"
           }
         ],
-        "mustSupport": false,
-        "isModifier": false,
+        "mustSupport": true,
+        "isModifier": true,
         "isSummary": false
       },
       {
-        "id": "Observation:shr-vital-BodyTemperature.modifierExtension:observationnonoccurrencemodifier",
-        "path": "Observation.modifierExtension",
-        "sliceName": "observationnonoccurrencemodifier",
+        "id": "Observation:shr-vital-BodyTemperature.basedOn",
+        "path": "Observation.basedOn",
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-observation-ObservationNonOccurrenceModifier-extension"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
           }
-        ],
-        "mustSupport": true,
-        "isModifier": true,
-        "isSummary": false
+        ]
       },
       {
         "id": "Observation:shr-vital-BodyTemperature.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "286",
+          "id": "276",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -2170,9 +2499,9 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-BodyTemperature.category:vital-sign",
+        "id": "Observation:shr-vital-BodyTemperature.category:vital-signs",
         "path": "Observation.category",
-        "sliceName": "vital-sign",
+        "sliceName": "vital-signs",
         "min": 1,
         "max": "1",
         "type": [
@@ -2185,7 +2514,7 @@
           "coding": [
             {
               "system": "http://hl7.org/fhir/observation-category",
-              "code": "vital-sign"
+              "code": "vital-signs"
             }
           ]
         }
@@ -2233,12 +2562,16 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-BodyTemperature.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-vital-BodyTemperature.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
@@ -2287,9 +2620,12 @@
         "id": "Observation:shr-vital-BodyTemperature.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "287",
+          "id": "277",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -2329,7 +2665,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-TestInterpretationVS"
+            "reference": "http://standardhealthrecord.org/shr/lab/vs/TestInterpretationVS"
           }
         }
       },
@@ -2345,7 +2681,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-vital-BodyTemperatureBodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/vital/vs/BodyTemperatureBodySiteVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-vital-BodyWeight.json b/lib/resources/standard_health_record/StructureDefinition-shr-vital-BodyWeight.json
old mode 100755
new mode 100644
index 0d995c3..cef18ba
--- a/lib/resources/standard_health_record/StructureDefinition-shr-vital-BodyWeight.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-vital-BodyWeight.json
@@ -3,7 +3,7 @@
   "id": "shr-vital-BodyWeight",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR BodyWeight Profile</b></p>\n  <p>The mass or quantity of heaviness of an individual. Does not include estimates of fetal bodyweight.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.vital.BodyWeight maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  BodySite maps to bodySite\n  BodyPosition maps to http://hl7.org/fhir/StructureDefinition/observation-bodyPosition\n  Device maps to device\n  TBD &quot;Specimen&quot; maps to specimen\n  Interpretation maps to interpretation\n  ReferenceRange maps to referenceRange\n  ChangeFlag maps to http://hl7.org/fhir/StructureDefinition/observation-delta\n  Quantity maps to value[x].Quantity\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR BodyWeight Profile</b></p>\n  <p>The mass or quantity of heaviness of an individual. Does not include estimates of fetal bodyweight.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.vital.BodyWeight maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  BodySite maps to bodySite\n  BodyPosition maps to http://hl7.org/fhir/StructureDefinition/observation-bodyPosition\n  Device maps to device\n  &lt;TBD &quot;Specimen&quot;&gt; maps to specimen\n  Interpretation maps to interpretation\n  ReferenceRange maps to referenceRange\n  ChangeFlag maps to http://hl7.org/fhir/StructureDefinition/observation-delta\n  TestRequest maps to basedOn\n  Quantity maps to value[x].Quantity\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-vital-BodyWeight",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.vital.BodyWeight"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR BodyWeight Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.498Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.590Z",
   "description": "The mass or quantity of heaviness of an individual. Does not include estimates of fetal bodyweight.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR BodyWeight Profile",
         "definition": "The mass or quantity of heaviness of an individual. Does not include estimates of fetal bodyweight.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-vital-BodyWeight.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "300",
+          "id": "290",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "bodyposition",
         "definition": "The position or physical attitude of the body.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "changeflag",
         "definition": "Indicator of significant change (delta) from the last or previous measurement.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -398,6 +435,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -430,6 +468,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -511,7 +550,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -553,7 +591,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-vital-BodyWeightQualifierVS"
+            "reference": "http://standardhealthrecord.org/shr/vital/vs/BodyWeightQualifierVS"
           }
         },
         "mapping": [
@@ -563,52 +601,23 @@
           }
         ]
       },
-      {
-        "id": "Observation:shr-vital-BodyWeight.extension:testrequest",
-        "path": "Observation.extension",
-        "sliceName": "testrequest",
-        "definition": "A record of a request (order) for a test to be performed.",
-        "alias": [
-          "extensions",
-          "user content"
-        ],
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "DomainResource.extension",
-          "min": 0,
-          "max": "*"
-        },
-        "type": [
-          {
-            "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest-extension"
-          }
-        ],
-        "mustSupport": false,
-        "isModifier": false,
-        "isSummary": false,
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "N/A"
-          }
-        ]
-      },
       {
         "id": "Observation:shr-vital-BodyWeight.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "301",
+          "id": "291",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -638,6 +647,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -668,8 +678,8 @@
       {
         "id": "Observation:shr-vital-BodyWeight.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -678,7 +688,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -693,6 +708,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-vital-BodyWeight.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-vital-BodyWeight.status",
         "extension": [
@@ -704,6 +776,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -715,6 +788,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -722,6 +801,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -740,17 +827,20 @@
         "id": "Observation:shr-vital-BodyWeight.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "298",
+          "id": "288",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 1,
         "max": "*",
         "type": [
@@ -760,8 +850,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -778,9 +874,9 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-BodyWeight.category:vital-sign",
+        "id": "Observation:shr-vital-BodyWeight.category:vital-signs",
         "path": "Observation.category",
-        "sliceName": "vital-sign",
+        "sliceName": "vital-signs",
         "min": 1,
         "max": "1",
         "type": [
@@ -793,7 +889,7 @@
           "coding": [
             {
               "system": "http://hl7.org/fhir/observation-category",
-              "code": "vital-sign"
+              "code": "vital-signs"
             }
           ]
         }
@@ -804,6 +900,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -822,6 +921,12 @@
         },
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -829,6 +934,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -837,6 +950,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -848,7 +965,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -872,6 +989,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -887,20 +1008,32 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-BodyWeight.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-vital-BodyWeight.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -920,8 +1053,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -935,6 +1071,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -954,7 +1094,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -1006,6 +1146,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -1024,17 +1168,20 @@
         "id": "Observation:shr-vital-BodyWeight.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "299",
+          "id": "289",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 1,
         "max": "1",
         "type": [
@@ -1048,6 +1195,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1055,6 +1210,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1083,7 +1242,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1096,6 +1255,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1103,6 +1268,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -1133,10 +1302,14 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-TestInterpretationVS"
+            "reference": "http://standardhealthrecord.org/shr/lab/vs/TestInterpretationVS"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1144,6 +1317,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1161,6 +1338,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -1176,8 +1357,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1189,10 +1369,14 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -1200,6 +1384,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1208,7 +1396,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1219,6 +1407,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1241,7 +1435,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1251,6 +1445,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1258,6 +1456,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1266,7 +1468,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1280,6 +1482,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1287,6 +1493,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1295,7 +1505,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "1",
@@ -1364,7 +1574,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1393,7 +1603,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1475,30 +1685,82 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-BodyWeight.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-vital-BodyWeight.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-vital-BodyWeight.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1554,8 +1816,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1617,7 +1879,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1646,7 +1908,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1678,7 +1940,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1688,6 +1950,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1738,7 +2006,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1801,7 +2069,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1830,7 +2098,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1872,6 +2140,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1879,6 +2153,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1898,8 +2176,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1936,6 +2214,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1943,6 +2225,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1951,7 +2237,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1964,6 +2250,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1986,7 +2278,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1999,6 +2291,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -2006,6 +2304,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -2013,6 +2315,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -2021,7 +2327,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -2113,49 +2419,72 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-vital-BodyWeightQualifierVS"
+            "reference": "http://standardhealthrecord.org/shr/vital/vs/BodyWeightQualifierVS"
           }
         }
       },
       {
-        "id": "Observation:shr-vital-BodyWeight.extension:testrequest",
-        "path": "Observation.extension",
-        "sliceName": "testrequest",
+        "id": "Observation:shr-vital-BodyWeight.modifierExtension:observationnonoccurrencemodifier",
+        "path": "Observation.modifierExtension",
+        "sliceName": "observationnonoccurrencemodifier",
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest-extension"
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-observation-ObservationNonOccurrenceModifier-extension"
           }
         ],
-        "mustSupport": false,
-        "isModifier": false,
+        "mustSupport": true,
+        "isModifier": true,
         "isSummary": false
       },
       {
-        "id": "Observation:shr-vital-BodyWeight.modifierExtension:observationnonoccurrencemodifier",
-        "path": "Observation.modifierExtension",
-        "sliceName": "observationnonoccurrencemodifier",
+        "id": "Observation:shr-vital-BodyWeight.basedOn",
+        "path": "Observation.basedOn",
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-observation-ObservationNonOccurrenceModifier-extension"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
           }
-        ],
-        "mustSupport": true,
-        "isModifier": true,
-        "isSummary": false
+        ]
       },
       {
         "id": "Observation:shr-vital-BodyWeight.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "298",
+          "id": "288",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -2170,9 +2499,9 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-BodyWeight.category:vital-sign",
+        "id": "Observation:shr-vital-BodyWeight.category:vital-signs",
         "path": "Observation.category",
-        "sliceName": "vital-sign",
+        "sliceName": "vital-signs",
         "min": 1,
         "max": "1",
         "type": [
@@ -2185,7 +2514,7 @@
           "coding": [
             {
               "system": "http://hl7.org/fhir/observation-category",
-              "code": "vital-sign"
+              "code": "vital-signs"
             }
           ]
         }
@@ -2233,12 +2562,16 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-BodyWeight.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-vital-BodyWeight.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
@@ -2287,9 +2620,12 @@
         "id": "Observation:shr-vital-BodyWeight.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "299",
+          "id": "289",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -2329,7 +2665,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-TestInterpretationVS"
+            "reference": "http://standardhealthrecord.org/shr/lab/vs/TestInterpretationVS"
           }
         }
       },
@@ -2345,7 +2681,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-vital-DiastolicPressure.json b/lib/resources/standard_health_record/StructureDefinition-shr-vital-DiastolicPressure.json
old mode 100755
new mode 100644
index 9390d5c..3cde403
--- a/lib/resources/standard_health_record/StructureDefinition-shr-vital-DiastolicPressure.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-vital-DiastolicPressure.json
@@ -3,7 +3,7 @@
   "id": "shr-vital-DiastolicPressure",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR DiastolicPressure Profile</b></p>\n  <p>The blood pressure after the contraction of the heart while the chambers of the heart refill with blood, when the pressure is lowest.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.vital.DiastolicPressure maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR DiastolicPressure Profile</b></p>\n  <p>The blood pressure after the contraction of the heart while the chambers of the heart refill with blood, when the pressure is lowest.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.vital.DiastolicPressure maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-vital-DiastolicPressure",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.vital.DiastolicPressure"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR DiastolicPressure Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.694Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.639Z",
   "description": "The blood pressure after the contraction of the heart while the chambers of the heart refill with blood, when the pressure is lowest.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR DiastolicPressure Profile",
         "definition": "The blood pressure after the contraction of the heart while the chambers of the heart refill with blood, when the pressure is lowest.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-vital-DiastolicPressure.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "320",
+          "id": "310",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "quantity",
         "definition": "A quantity with Units.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -370,6 +406,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -402,6 +439,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -433,16 +471,19 @@
         "id": "Observation:shr-vital-DiastolicPressure.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "321",
+          "id": "311",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -472,6 +513,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -502,8 +544,8 @@
       {
         "id": "Observation:shr-vital-DiastolicPressure.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -512,7 +554,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -527,6 +574,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-vital-DiastolicPressure.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-vital-DiastolicPressure.status",
         "extension": [
@@ -538,6 +642,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -549,6 +654,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -556,6 +667,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -575,8 +694,8 @@
         "path": "Observation.category",
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 0,
         "max": "*",
         "type": [
@@ -586,8 +705,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -609,6 +734,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -627,6 +755,12 @@
         },
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -634,6 +768,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -642,6 +784,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -653,7 +799,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -677,6 +823,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -692,20 +842,32 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-DiastolicPressure.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-vital-DiastolicPressure.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -725,8 +887,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -740,6 +905,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -759,7 +928,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -811,6 +980,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -830,8 +1003,8 @@
         "path": "Observation.value[x]",
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -844,6 +1017,9 @@
           {
             "code": "string"
           },
+          {
+            "code": "boolean"
+          },
           {
             "code": "Range"
           },
@@ -871,6 +1047,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -878,6 +1062,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -886,7 +1074,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -899,6 +1087,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -906,6 +1100,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -933,6 +1131,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -940,6 +1144,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -947,6 +1155,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -964,6 +1176,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -979,8 +1195,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -989,6 +1204,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -996,6 +1217,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -1003,6 +1228,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1011,7 +1240,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1022,6 +1251,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1044,7 +1279,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1054,6 +1289,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1061,6 +1300,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1069,7 +1312,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1083,6 +1326,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1090,6 +1337,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1098,7 +1349,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1167,7 +1418,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1196,7 +1447,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1278,30 +1529,82 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-DiastolicPressure.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-vital-DiastolicPressure.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-vital-DiastolicPressure.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1357,8 +1660,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1420,7 +1723,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1449,7 +1752,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1481,7 +1784,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1491,6 +1794,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1541,7 +1850,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1604,7 +1913,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1633,7 +1942,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1675,6 +1984,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1682,6 +1997,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1701,8 +2020,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1739,6 +2058,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1746,6 +2069,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1754,7 +2081,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1767,6 +2094,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1789,7 +2122,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1802,6 +2135,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1809,6 +2148,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1816,6 +2159,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1824,7 +2171,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1971,12 +2318,16 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-DiastolicPressure.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-vital-DiastolicPressure.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-vital-HeadCircumference.json b/lib/resources/standard_health_record/StructureDefinition-shr-vital-HeadCircumference.json
old mode 100755
new mode 100644
index c327fec..9845132
--- a/lib/resources/standard_health_record/StructureDefinition-shr-vital-HeadCircumference.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-vital-HeadCircumference.json
@@ -3,7 +3,7 @@
   "id": "shr-vital-HeadCircumference",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR HeadCircumference Profile</b></p>\n  <p>Circumference of the head (typically 0-2 years).</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.vital.HeadCircumference maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  BodySite maps to bodySite\n  BodyPosition maps to http://hl7.org/fhir/StructureDefinition/observation-bodyPosition\n  Device maps to device\n  TBD &quot;Specimen&quot; maps to specimen\n  Interpretation maps to interpretation\n  ReferenceRange maps to referenceRange\n  ChangeFlag maps to http://hl7.org/fhir/StructureDefinition/observation-delta\n  Quantity maps to value[x].Quantity\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR HeadCircumference Profile</b></p>\n  <p>Circumference of the head (typically 0-2 years).</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.vital.HeadCircumference maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  BodySite maps to bodySite\n  BodyPosition maps to http://hl7.org/fhir/StructureDefinition/observation-bodyPosition\n  Device maps to device\n  &lt;TBD &quot;Specimen&quot;&gt; maps to specimen\n  Interpretation maps to interpretation\n  ReferenceRange maps to referenceRange\n  ChangeFlag maps to http://hl7.org/fhir/StructureDefinition/observation-delta\n  TestRequest maps to basedOn\n  Quantity maps to value[x].Quantity\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-vital-HeadCircumference",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.vital.HeadCircumference"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR HeadCircumference Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.534Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.597Z",
   "description": "Circumference of the head (typically 0-2 years).",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR HeadCircumference Profile",
         "definition": "Circumference of the head (typically 0-2 years).",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-vital-HeadCircumference.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "304",
+          "id": "294",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "bodyposition",
         "definition": "The position or physical attitude of the body.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "changeflag",
         "definition": "Indicator of significant change (delta) from the last or previous measurement.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -398,6 +435,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -430,6 +468,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -457,52 +496,23 @@
           }
         ]
       },
-      {
-        "id": "Observation:shr-vital-HeadCircumference.extension:testrequest",
-        "path": "Observation.extension",
-        "sliceName": "testrequest",
-        "definition": "A record of a request (order) for a test to be performed.",
-        "alias": [
-          "extensions",
-          "user content"
-        ],
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "DomainResource.extension",
-          "min": 0,
-          "max": "*"
-        },
-        "type": [
-          {
-            "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest-extension"
-          }
-        ],
-        "mustSupport": false,
-        "isModifier": false,
-        "isSummary": false,
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "N/A"
-          }
-        ]
-      },
       {
         "id": "Observation:shr-vital-HeadCircumference.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "305",
+          "id": "295",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -532,6 +542,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -562,8 +573,8 @@
       {
         "id": "Observation:shr-vital-HeadCircumference.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -572,7 +583,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -587,6 +603,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-vital-HeadCircumference.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-vital-HeadCircumference.status",
         "extension": [
@@ -598,6 +671,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -609,6 +683,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -616,6 +696,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -634,17 +722,20 @@
         "id": "Observation:shr-vital-HeadCircumference.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "302",
+          "id": "292",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 1,
         "max": "*",
         "type": [
@@ -654,8 +745,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -672,9 +769,9 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-HeadCircumference.category:vital-sign",
+        "id": "Observation:shr-vital-HeadCircumference.category:vital-signs",
         "path": "Observation.category",
-        "sliceName": "vital-sign",
+        "sliceName": "vital-signs",
         "min": 1,
         "max": "1",
         "type": [
@@ -687,7 +784,7 @@
           "coding": [
             {
               "system": "http://hl7.org/fhir/observation-category",
-              "code": "vital-sign"
+              "code": "vital-signs"
             }
           ]
         }
@@ -698,6 +795,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -716,6 +816,12 @@
         },
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -723,6 +829,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -731,6 +845,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -742,7 +860,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -766,6 +884,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -781,20 +903,32 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-HeadCircumference.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-vital-HeadCircumference.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -814,8 +948,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -829,6 +966,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -848,7 +989,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -900,6 +1041,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -918,17 +1063,20 @@
         "id": "Observation:shr-vital-HeadCircumference.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "303",
+          "id": "293",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 1,
         "max": "1",
         "type": [
@@ -942,6 +1090,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -949,6 +1105,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -977,7 +1137,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -990,6 +1150,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -997,6 +1163,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -1027,10 +1197,14 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-TestInterpretationVS"
+            "reference": "http://standardhealthrecord.org/shr/lab/vs/TestInterpretationVS"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1038,6 +1212,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1055,6 +1233,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -1070,8 +1252,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1083,10 +1264,14 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -1094,6 +1279,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1102,7 +1291,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1113,6 +1302,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1135,7 +1330,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1145,6 +1340,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1152,6 +1351,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1160,7 +1363,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1174,6 +1377,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1181,6 +1388,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1189,7 +1400,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "1",
@@ -1258,7 +1469,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1287,7 +1498,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1369,30 +1580,82 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-HeadCircumference.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-vital-HeadCircumference.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-vital-HeadCircumference.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1448,8 +1711,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1511,7 +1774,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1540,7 +1803,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1572,7 +1835,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1582,6 +1845,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1632,7 +1901,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1695,7 +1964,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1724,7 +1993,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1766,6 +2035,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1773,6 +2048,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1792,8 +2071,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1830,6 +2109,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1837,6 +2120,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1845,7 +2132,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1858,6 +2145,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1880,7 +2173,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1893,6 +2186,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1900,6 +2199,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1907,6 +2210,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1915,7 +2222,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -2006,44 +2313,67 @@
         "isSummary": false
       },
       {
-        "id": "Observation:shr-vital-HeadCircumference.extension:testrequest",
-        "path": "Observation.extension",
-        "sliceName": "testrequest",
+        "id": "Observation:shr-vital-HeadCircumference.modifierExtension:observationnonoccurrencemodifier",
+        "path": "Observation.modifierExtension",
+        "sliceName": "observationnonoccurrencemodifier",
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest-extension"
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-observation-ObservationNonOccurrenceModifier-extension"
           }
         ],
-        "mustSupport": false,
-        "isModifier": false,
+        "mustSupport": true,
+        "isModifier": true,
         "isSummary": false
       },
       {
-        "id": "Observation:shr-vital-HeadCircumference.modifierExtension:observationnonoccurrencemodifier",
-        "path": "Observation.modifierExtension",
-        "sliceName": "observationnonoccurrencemodifier",
+        "id": "Observation:shr-vital-HeadCircumference.basedOn",
+        "path": "Observation.basedOn",
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-observation-ObservationNonOccurrenceModifier-extension"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
           }
-        ],
-        "mustSupport": true,
-        "isModifier": true,
-        "isSummary": false
+        ]
       },
       {
         "id": "Observation:shr-vital-HeadCircumference.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "302",
+          "id": "292",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -2058,9 +2388,9 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-HeadCircumference.category:vital-sign",
+        "id": "Observation:shr-vital-HeadCircumference.category:vital-signs",
         "path": "Observation.category",
-        "sliceName": "vital-sign",
+        "sliceName": "vital-signs",
         "min": 1,
         "max": "1",
         "type": [
@@ -2073,7 +2403,7 @@
           "coding": [
             {
               "system": "http://hl7.org/fhir/observation-category",
-              "code": "vital-sign"
+              "code": "vital-signs"
             }
           ]
         }
@@ -2121,12 +2451,16 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-HeadCircumference.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-vital-HeadCircumference.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
@@ -2175,9 +2509,12 @@
         "id": "Observation:shr-vital-HeadCircumference.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "303",
+          "id": "293",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -2217,7 +2554,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-TestInterpretationVS"
+            "reference": "http://standardhealthrecord.org/shr/lab/vs/TestInterpretationVS"
           }
         }
       },
@@ -2233,7 +2570,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-vital-HeadTiltAngle-extension.json b/lib/resources/standard_health_record/StructureDefinition-shr-vital-HeadTiltAngle-extension.json
old mode 100755
new mode 100644
index a1ca7d1..fb22cca
--- a/lib/resources/standard_health_record/StructureDefinition-shr-vital-HeadTiltAngle-extension.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-vital-HeadTiltAngle-extension.json
@@ -12,9 +12,11 @@
       "value": "shr.vital.HeadTiltAngle"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR HeadTiltAngle Extension",
   "title": "SHR HeadTiltAngle Extension",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.644Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -26,9 +28,8 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.626Z",
   "description": "The angle at which the head is tilted relative to a level position while physiologic tests are taken.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "kind": "complex-type",
   "abstract": false,
   "contextType": "resource",
@@ -128,7 +129,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-vital-HeartRate.json b/lib/resources/standard_health_record/StructureDefinition-shr-vital-HeartRate.json
old mode 100755
new mode 100644
index cebf40e..ce1bd2d
--- a/lib/resources/standard_health_record/StructureDefinition-shr-vital-HeartRate.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-vital-HeartRate.json
@@ -3,7 +3,7 @@
   "id": "shr-vital-HeartRate",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR HeartRate Profile</b></p>\n  <p>The number of times the heart ventricles contract per unit of time, usually per minute.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.vital.HeartRate maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  BodySite maps to bodySite\n  BodyPosition maps to http://hl7.org/fhir/StructureDefinition/observation-bodyPosition\n  Device maps to device\n  TBD &quot;Specimen&quot; maps to specimen\n  Interpretation maps to interpretation\n  ReferenceRange maps to referenceRange\n  ChangeFlag maps to http://hl7.org/fhir/StructureDefinition/observation-delta\n  Quantity maps to value[x].Quantity\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR HeartRate Profile</b></p>\n  <p>The number of times the heart ventricles contract per unit of time, usually per minute.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.vital.HeartRate maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  BodySite maps to bodySite\n  BodyPosition maps to http://hl7.org/fhir/StructureDefinition/observation-bodyPosition\n  Device maps to device\n  &lt;TBD &quot;Specimen&quot;&gt; maps to specimen\n  Interpretation maps to interpretation\n  ReferenceRange maps to referenceRange\n  ChangeFlag maps to http://hl7.org/fhir/StructureDefinition/observation-delta\n  TestRequest maps to basedOn\n  Quantity maps to value[x].Quantity\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-vital-HeartRate",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.vital.HeartRate"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR HeartRate Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.217Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.545Z",
   "description": "The number of times the heart ventricles contract per unit of time, usually per minute.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR HeartRate Profile",
         "definition": "The number of times the heart ventricles contract per unit of time, usually per minute.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-vital-HeartRate.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "280",
+          "id": "270",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "bodyposition",
         "definition": "The position or physical attitude of the body.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "changeflag",
         "definition": "Indicator of significant change (delta) from the last or previous measurement.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -398,6 +435,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -430,6 +468,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -511,7 +550,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -553,41 +591,9 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-vital-HeartRateQualifierVS"
-          }
-        },
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "N/A"
+            "reference": "http://standardhealthrecord.org/shr/vital/vs/HeartRateQualifierVS"
           }
-        ]
-      },
-      {
-        "id": "Observation:shr-vital-HeartRate.extension:testrequest",
-        "path": "Observation.extension",
-        "sliceName": "testrequest",
-        "definition": "A record of a request (order) for a test to be performed.",
-        "alias": [
-          "extensions",
-          "user content"
-        ],
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "DomainResource.extension",
-          "min": 0,
-          "max": "*"
         },
-        "type": [
-          {
-            "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest-extension"
-          }
-        ],
-        "mustSupport": false,
-        "isModifier": false,
-        "isSummary": false,
         "mapping": [
           {
             "identity": "rim",
@@ -599,16 +605,19 @@
         "id": "Observation:shr-vital-HeartRate.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "281",
+          "id": "271",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -638,6 +647,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -668,8 +678,8 @@
       {
         "id": "Observation:shr-vital-HeartRate.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -678,7 +688,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -693,6 +708,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-vital-HeartRate.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-vital-HeartRate.status",
         "extension": [
@@ -704,6 +776,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -715,6 +788,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -722,6 +801,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -740,17 +827,20 @@
         "id": "Observation:shr-vital-HeartRate.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "278",
+          "id": "268",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 1,
         "max": "*",
         "type": [
@@ -760,8 +850,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -778,9 +874,9 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-HeartRate.category:vital-sign",
+        "id": "Observation:shr-vital-HeartRate.category:vital-signs",
         "path": "Observation.category",
-        "sliceName": "vital-sign",
+        "sliceName": "vital-signs",
         "min": 1,
         "max": "1",
         "type": [
@@ -793,7 +889,7 @@
           "coding": [
             {
               "system": "http://hl7.org/fhir/observation-category",
-              "code": "vital-sign"
+              "code": "vital-signs"
             }
           ]
         }
@@ -804,6 +900,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -822,6 +921,12 @@
         },
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -829,6 +934,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -837,6 +950,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -848,7 +965,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -872,6 +989,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -887,20 +1008,32 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-HeartRate.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-vital-HeartRate.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -920,8 +1053,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -935,6 +1071,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -954,7 +1094,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -1006,6 +1146,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -1024,17 +1168,20 @@
         "id": "Observation:shr-vital-HeartRate.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "279",
+          "id": "269",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 1,
         "max": "1",
         "type": [
@@ -1048,6 +1195,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1055,6 +1210,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1083,7 +1242,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1096,6 +1255,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1103,6 +1268,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -1133,10 +1302,14 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-TestInterpretationVS"
+            "reference": "http://standardhealthrecord.org/shr/lab/vs/TestInterpretationVS"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1144,6 +1317,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1161,6 +1338,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -1176,8 +1357,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1189,10 +1369,14 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -1200,6 +1384,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1208,7 +1396,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1221,7 +1409,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-vital-HeartRateMethodVS"
+            "reference": "http://standardhealthrecord.org/shr/vital/vs/HeartRateMethodVS"
           }
         },
         "mapping": [
@@ -1240,7 +1428,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1250,6 +1438,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1257,6 +1449,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1265,7 +1461,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1279,6 +1475,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1286,6 +1486,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1294,7 +1498,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "1",
@@ -1363,7 +1567,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1392,7 +1596,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1474,30 +1678,82 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-HeartRate.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-vital-HeartRate.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-vital-HeartRate.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1553,8 +1809,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1616,7 +1872,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1645,7 +1901,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1677,7 +1933,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1687,6 +1943,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1737,7 +1999,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1800,7 +2062,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1829,7 +2091,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1871,6 +2133,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1878,6 +2146,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1897,8 +2169,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1935,6 +2207,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1942,6 +2218,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1950,7 +2230,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1963,6 +2243,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1985,7 +2271,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1998,6 +2284,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -2005,6 +2297,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -2012,6 +2308,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -2020,7 +2320,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -2112,49 +2412,72 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-vital-HeartRateQualifierVS"
+            "reference": "http://standardhealthrecord.org/shr/vital/vs/HeartRateQualifierVS"
           }
         }
       },
       {
-        "id": "Observation:shr-vital-HeartRate.extension:testrequest",
-        "path": "Observation.extension",
-        "sliceName": "testrequest",
+        "id": "Observation:shr-vital-HeartRate.modifierExtension:observationnonoccurrencemodifier",
+        "path": "Observation.modifierExtension",
+        "sliceName": "observationnonoccurrencemodifier",
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest-extension"
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-observation-ObservationNonOccurrenceModifier-extension"
           }
         ],
-        "mustSupport": false,
-        "isModifier": false,
+        "mustSupport": true,
+        "isModifier": true,
         "isSummary": false
       },
       {
-        "id": "Observation:shr-vital-HeartRate.modifierExtension:observationnonoccurrencemodifier",
-        "path": "Observation.modifierExtension",
-        "sliceName": "observationnonoccurrencemodifier",
+        "id": "Observation:shr-vital-HeartRate.basedOn",
+        "path": "Observation.basedOn",
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-observation-ObservationNonOccurrenceModifier-extension"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
           }
-        ],
-        "mustSupport": true,
-        "isModifier": true,
-        "isSummary": false
+        ]
       },
       {
         "id": "Observation:shr-vital-HeartRate.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "278",
+          "id": "268",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -2169,9 +2492,9 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-HeartRate.category:vital-sign",
+        "id": "Observation:shr-vital-HeartRate.category:vital-signs",
         "path": "Observation.category",
-        "sliceName": "vital-sign",
+        "sliceName": "vital-signs",
         "min": 1,
         "max": "1",
         "type": [
@@ -2184,7 +2507,7 @@
           "coding": [
             {
               "system": "http://hl7.org/fhir/observation-category",
-              "code": "vital-sign"
+              "code": "vital-signs"
             }
           ]
         }
@@ -2232,12 +2555,16 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-HeartRate.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-vital-HeartRate.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
@@ -2286,9 +2613,12 @@
         "id": "Observation:shr-vital-HeartRate.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "279",
+          "id": "269",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -2328,7 +2658,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-TestInterpretationVS"
+            "reference": "http://standardhealthrecord.org/shr/lab/vs/TestInterpretationVS"
           }
         }
       },
@@ -2344,7 +2674,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
           }
         }
       },
@@ -2360,7 +2690,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-vital-HeartRateMethodVS"
+            "reference": "http://standardhealthrecord.org/shr/vital/vs/HeartRateMethodVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-vital-OxygenSaturation.json b/lib/resources/standard_health_record/StructureDefinition-shr-vital-OxygenSaturation.json
old mode 100755
new mode 100644
index 2bf9b46..dbb2744
--- a/lib/resources/standard_health_record/StructureDefinition-shr-vital-OxygenSaturation.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-vital-OxygenSaturation.json
@@ -3,7 +3,7 @@
   "id": "shr-vital-OxygenSaturation",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR OxygenSaturation Profile</b></p>\n  <p>Oxygen saturation in Arterial blood by Pulse oximetry.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.vital.OxygenSaturation maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  BodySite maps to bodySite\n  BodyPosition maps to http://hl7.org/fhir/StructureDefinition/observation-bodyPosition\n  Device maps to device\n  TBD &quot;Specimen&quot; maps to specimen\n  Interpretation maps to interpretation\n  ReferenceRange maps to referenceRange\n  ChangeFlag maps to http://hl7.org/fhir/StructureDefinition/observation-delta\n  Quantity maps to value[x].Quantity\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR OxygenSaturation Profile</b></p>\n  <p>Oxygen saturation in Arterial blood by Pulse oximetry.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.vital.OxygenSaturation maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  BodySite maps to bodySite\n  BodyPosition maps to http://hl7.org/fhir/StructureDefinition/observation-bodyPosition\n  Device maps to device\n  &lt;TBD &quot;Specimen&quot;&gt; maps to specimen\n  Interpretation maps to interpretation\n  ReferenceRange maps to referenceRange\n  ChangeFlag maps to http://hl7.org/fhir/StructureDefinition/observation-delta\n  TestRequest maps to basedOn\n  Quantity maps to value[x].Quantity\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-vital-OxygenSaturation",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.vital.OxygenSaturation"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR OxygenSaturation Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.264Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.554Z",
   "description": "Oxygen saturation in Arterial blood by Pulse oximetry.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR OxygenSaturation Profile",
         "definition": "Oxygen saturation in Arterial blood by Pulse oximetry.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-vital-OxygenSaturation.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "284",
+          "id": "274",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "bodyposition",
         "definition": "The position or physical attitude of the body.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "changeflag",
         "definition": "Indicator of significant change (delta) from the last or previous measurement.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -398,6 +435,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -430,6 +468,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -457,52 +496,23 @@
           }
         ]
       },
-      {
-        "id": "Observation:shr-vital-OxygenSaturation.extension:testrequest",
-        "path": "Observation.extension",
-        "sliceName": "testrequest",
-        "definition": "A record of a request (order) for a test to be performed.",
-        "alias": [
-          "extensions",
-          "user content"
-        ],
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "DomainResource.extension",
-          "min": 0,
-          "max": "*"
-        },
-        "type": [
-          {
-            "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest-extension"
-          }
-        ],
-        "mustSupport": false,
-        "isModifier": false,
-        "isSummary": false,
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "N/A"
-          }
-        ]
-      },
       {
         "id": "Observation:shr-vital-OxygenSaturation.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "285",
+          "id": "275",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -532,6 +542,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -562,8 +573,8 @@
       {
         "id": "Observation:shr-vital-OxygenSaturation.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -572,7 +583,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -587,6 +603,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-vital-OxygenSaturation.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-vital-OxygenSaturation.status",
         "extension": [
@@ -598,6 +671,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -609,6 +683,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -616,6 +696,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -634,17 +722,20 @@
         "id": "Observation:shr-vital-OxygenSaturation.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "282",
+          "id": "272",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 1,
         "max": "*",
         "type": [
@@ -654,8 +745,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -672,9 +769,9 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-OxygenSaturation.category:vital-sign",
+        "id": "Observation:shr-vital-OxygenSaturation.category:vital-signs",
         "path": "Observation.category",
-        "sliceName": "vital-sign",
+        "sliceName": "vital-signs",
         "min": 1,
         "max": "1",
         "type": [
@@ -687,7 +784,7 @@
           "coding": [
             {
               "system": "http://hl7.org/fhir/observation-category",
-              "code": "vital-sign"
+              "code": "vital-signs"
             }
           ]
         }
@@ -698,6 +795,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -716,6 +816,12 @@
         },
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -723,6 +829,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -731,6 +845,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -742,7 +860,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -766,6 +884,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -781,20 +903,32 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-OxygenSaturation.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-vital-OxygenSaturation.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -814,8 +948,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -829,6 +966,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -848,7 +989,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -900,6 +1041,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -918,17 +1063,20 @@
         "id": "Observation:shr-vital-OxygenSaturation.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "283",
+          "id": "273",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 1,
         "max": "1",
         "type": [
@@ -942,6 +1090,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -949,6 +1105,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -977,7 +1137,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -990,6 +1150,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -997,6 +1163,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -1027,10 +1197,14 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-TestInterpretationVS"
+            "reference": "http://standardhealthrecord.org/shr/lab/vs/TestInterpretationVS"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1038,6 +1212,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1055,6 +1233,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -1070,8 +1252,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1083,10 +1264,14 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-vital-OxygenSaturationBodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/vital/vs/OxygenSaturationBodySiteVS"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -1094,6 +1279,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1102,7 +1291,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1113,6 +1302,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1135,7 +1330,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1145,6 +1340,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1152,6 +1351,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1160,7 +1363,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1174,6 +1377,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1181,6 +1388,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1189,7 +1400,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "1",
@@ -1258,7 +1469,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1287,7 +1498,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1369,30 +1580,82 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-OxygenSaturation.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-vital-OxygenSaturation.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-vital-OxygenSaturation.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1448,8 +1711,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1511,7 +1774,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1540,7 +1803,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1572,7 +1835,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1582,6 +1845,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1632,7 +1901,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1695,7 +1964,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1724,7 +1993,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1766,6 +2035,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1773,6 +2048,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1792,8 +2071,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1830,6 +2109,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1837,6 +2120,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1845,7 +2132,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1858,6 +2145,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1880,7 +2173,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1893,6 +2186,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1900,6 +2199,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1907,6 +2210,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1915,7 +2222,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -2006,44 +2313,67 @@
         "isSummary": false
       },
       {
-        "id": "Observation:shr-vital-OxygenSaturation.extension:testrequest",
-        "path": "Observation.extension",
-        "sliceName": "testrequest",
+        "id": "Observation:shr-vital-OxygenSaturation.modifierExtension:observationnonoccurrencemodifier",
+        "path": "Observation.modifierExtension",
+        "sliceName": "observationnonoccurrencemodifier",
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest-extension"
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-observation-ObservationNonOccurrenceModifier-extension"
           }
         ],
-        "mustSupport": false,
-        "isModifier": false,
+        "mustSupport": true,
+        "isModifier": true,
         "isSummary": false
       },
       {
-        "id": "Observation:shr-vital-OxygenSaturation.modifierExtension:observationnonoccurrencemodifier",
-        "path": "Observation.modifierExtension",
-        "sliceName": "observationnonoccurrencemodifier",
+        "id": "Observation:shr-vital-OxygenSaturation.basedOn",
+        "path": "Observation.basedOn",
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-observation-ObservationNonOccurrenceModifier-extension"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
           }
-        ],
-        "mustSupport": true,
-        "isModifier": true,
-        "isSummary": false
+        ]
       },
       {
         "id": "Observation:shr-vital-OxygenSaturation.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "282",
+          "id": "272",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -2058,9 +2388,9 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-OxygenSaturation.category:vital-sign",
+        "id": "Observation:shr-vital-OxygenSaturation.category:vital-signs",
         "path": "Observation.category",
-        "sliceName": "vital-sign",
+        "sliceName": "vital-signs",
         "min": 1,
         "max": "1",
         "type": [
@@ -2073,7 +2403,7 @@
           "coding": [
             {
               "system": "http://hl7.org/fhir/observation-category",
-              "code": "vital-sign"
+              "code": "vital-signs"
             }
           ]
         }
@@ -2121,12 +2451,16 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-OxygenSaturation.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-vital-OxygenSaturation.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
@@ -2175,9 +2509,12 @@
         "id": "Observation:shr-vital-OxygenSaturation.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "283",
+          "id": "273",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -2217,7 +2554,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-TestInterpretationVS"
+            "reference": "http://standardhealthrecord.org/shr/lab/vs/TestInterpretationVS"
           }
         }
       },
@@ -2233,7 +2570,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-vital-OxygenSaturationBodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/vital/vs/OxygenSaturationBodySiteVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-vital-RespiratoryRate.json b/lib/resources/standard_health_record/StructureDefinition-shr-vital-RespiratoryRate.json
old mode 100755
new mode 100644
index c176168..2ca151b
--- a/lib/resources/standard_health_record/StructureDefinition-shr-vital-RespiratoryRate.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-vital-RespiratoryRate.json
@@ -3,7 +3,7 @@
   "id": "shr-vital-RespiratoryRate",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR RespiratoryRate Profile</b></p>\n  <p>The rate of breathing (inhalation and exhalation) measured within in a unit time, expressed as breaths per minute.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.vital.RespiratoryRate maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  BodySite maps to bodySite\n  BodyPosition maps to http://hl7.org/fhir/StructureDefinition/observation-bodyPosition\n  Device maps to device\n  TBD &quot;Specimen&quot; maps to specimen\n  Interpretation maps to interpretation\n  ReferenceRange maps to referenceRange\n  ChangeFlag maps to http://hl7.org/fhir/StructureDefinition/observation-delta\n  Quantity maps to value[x].Quantity\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR RespiratoryRate Profile</b></p>\n  <p>The rate of breathing (inhalation and exhalation) measured within in a unit time, expressed as breaths per minute.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.vital.RespiratoryRate maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  BodySite maps to bodySite\n  BodyPosition maps to http://hl7.org/fhir/StructureDefinition/observation-bodyPosition\n  Device maps to device\n  &lt;TBD &quot;Specimen&quot;&gt; maps to specimen\n  Interpretation maps to interpretation\n  ReferenceRange maps to referenceRange\n  ChangeFlag maps to http://hl7.org/fhir/StructureDefinition/observation-delta\n  TestRequest maps to basedOn\n  Quantity maps to value[x].Quantity\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-vital-RespiratoryRate",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.vital.RespiratoryRate"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR RespiratoryRate Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.177Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.537Z",
   "description": "The rate of breathing (inhalation and exhalation) measured within in a unit time, expressed as breaths per minute.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR RespiratoryRate Profile",
         "definition": "The rate of breathing (inhalation and exhalation) measured within in a unit time, expressed as breaths per minute.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-vital-RespiratoryRate.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "276",
+          "id": "266",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "bodyposition",
         "definition": "The position or physical attitude of the body.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -366,6 +402,7 @@
         "path": "Observation.extension",
         "sliceName": "changeflag",
         "definition": "Indicator of significant change (delta) from the last or previous measurement.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -398,6 +435,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -430,6 +468,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -511,7 +550,6 @@
         ],
         "short": "identifies the meaning of the extension",
         "definition": "Source of the definition for the extension code - a logical name or a URL.",
-        "comments": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
         "min": 1,
         "max": "1",
         "base": {
@@ -553,41 +591,9 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-vital-RespiratoryRateQualifierVS"
-          }
-        },
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "N/A"
+            "reference": "http://standardhealthrecord.org/shr/vital/vs/RespiratoryRateQualifierVS"
           }
-        ]
-      },
-      {
-        "id": "Observation:shr-vital-RespiratoryRate.extension:testrequest",
-        "path": "Observation.extension",
-        "sliceName": "testrequest",
-        "definition": "A record of a request (order) for a test to be performed.",
-        "alias": [
-          "extensions",
-          "user content"
-        ],
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "DomainResource.extension",
-          "min": 0,
-          "max": "*"
         },
-        "type": [
-          {
-            "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest-extension"
-          }
-        ],
-        "mustSupport": false,
-        "isModifier": false,
-        "isSummary": false,
         "mapping": [
           {
             "identity": "rim",
@@ -599,16 +605,19 @@
         "id": "Observation:shr-vital-RespiratoryRate.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "277",
+          "id": "267",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -638,6 +647,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -668,8 +678,8 @@
       {
         "id": "Observation:shr-vital-RespiratoryRate.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -678,7 +688,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -693,6 +708,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-vital-RespiratoryRate.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-vital-RespiratoryRate.status",
         "extension": [
@@ -704,6 +776,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -715,6 +788,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -722,6 +801,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -740,17 +827,20 @@
         "id": "Observation:shr-vital-RespiratoryRate.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "274",
+          "id": "264",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 1,
         "max": "*",
         "type": [
@@ -760,8 +850,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -778,9 +874,9 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-RespiratoryRate.category:vital-sign",
+        "id": "Observation:shr-vital-RespiratoryRate.category:vital-signs",
         "path": "Observation.category",
-        "sliceName": "vital-sign",
+        "sliceName": "vital-signs",
         "min": 1,
         "max": "1",
         "type": [
@@ -793,7 +889,7 @@
           "coding": [
             {
               "system": "http://hl7.org/fhir/observation-category",
-              "code": "vital-sign"
+              "code": "vital-signs"
             }
           ]
         }
@@ -804,6 +900,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -822,6 +921,12 @@
         },
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -829,6 +934,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -837,6 +950,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -848,7 +965,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -872,6 +989,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -887,20 +1008,32 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-RespiratoryRate.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-vital-RespiratoryRate.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -920,8 +1053,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -935,6 +1071,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -954,7 +1094,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -1006,6 +1146,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -1024,17 +1168,20 @@
         "id": "Observation:shr-vital-RespiratoryRate.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "275",
+          "id": "265",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 1,
         "max": "1",
         "type": [
@@ -1048,6 +1195,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1055,6 +1210,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1083,7 +1242,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1096,6 +1255,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1103,6 +1268,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -1133,10 +1302,14 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-TestInterpretationVS"
+            "reference": "http://standardhealthrecord.org/shr/lab/vs/TestInterpretationVS"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1144,6 +1317,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1161,6 +1338,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -1176,8 +1357,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1189,10 +1369,14 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -1200,6 +1384,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1208,7 +1396,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1221,7 +1409,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-vital-RespiratoryRateMethodVS"
+            "reference": "http://standardhealthrecord.org/shr/vital/vs/RespiratoryRateMethodVS"
           }
         },
         "mapping": [
@@ -1240,7 +1428,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1250,6 +1438,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1257,6 +1449,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1265,7 +1461,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1279,6 +1475,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1286,6 +1486,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1294,7 +1498,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "1",
@@ -1363,7 +1567,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1392,7 +1596,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1474,30 +1678,82 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-RespiratoryRate.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-vital-RespiratoryRate.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-vital-RespiratoryRate.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1553,8 +1809,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1616,7 +1872,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1645,7 +1901,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1677,7 +1933,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1687,6 +1943,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1737,7 +1999,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1800,7 +2062,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1829,7 +2091,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1871,6 +2133,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1878,6 +2146,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1897,8 +2169,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1935,6 +2207,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1942,6 +2218,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1950,7 +2230,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1963,6 +2243,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1985,7 +2271,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1998,6 +2284,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -2005,6 +2297,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -2012,6 +2308,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -2020,7 +2320,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -2112,49 +2412,72 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-vital-RespiratoryRateQualifierVS"
+            "reference": "http://standardhealthrecord.org/shr/vital/vs/RespiratoryRateQualifierVS"
           }
         }
       },
       {
-        "id": "Observation:shr-vital-RespiratoryRate.extension:testrequest",
-        "path": "Observation.extension",
-        "sliceName": "testrequest",
+        "id": "Observation:shr-vital-RespiratoryRate.modifierExtension:observationnonoccurrencemodifier",
+        "path": "Observation.modifierExtension",
+        "sliceName": "observationnonoccurrencemodifier",
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest-extension"
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-observation-ObservationNonOccurrenceModifier-extension"
           }
         ],
-        "mustSupport": false,
-        "isModifier": false,
+        "mustSupport": true,
+        "isModifier": true,
         "isSummary": false
       },
       {
-        "id": "Observation:shr-vital-RespiratoryRate.modifierExtension:observationnonoccurrencemodifier",
-        "path": "Observation.modifierExtension",
-        "sliceName": "observationnonoccurrencemodifier",
+        "id": "Observation:shr-vital-RespiratoryRate.basedOn",
+        "path": "Observation.basedOn",
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-observation-ObservationNonOccurrenceModifier-extension"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
           }
-        ],
-        "mustSupport": true,
-        "isModifier": true,
-        "isSummary": false
+        ]
       },
       {
         "id": "Observation:shr-vital-RespiratoryRate.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "274",
+          "id": "264",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -2169,9 +2492,9 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-RespiratoryRate.category:vital-sign",
+        "id": "Observation:shr-vital-RespiratoryRate.category:vital-signs",
         "path": "Observation.category",
-        "sliceName": "vital-sign",
+        "sliceName": "vital-signs",
         "min": 1,
         "max": "1",
         "type": [
@@ -2184,7 +2507,7 @@
           "coding": [
             {
               "system": "http://hl7.org/fhir/observation-category",
-              "code": "vital-sign"
+              "code": "vital-signs"
             }
           ]
         }
@@ -2232,12 +2555,16 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-RespiratoryRate.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-vital-RespiratoryRate.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
@@ -2286,9 +2613,12 @@
         "id": "Observation:shr-vital-RespiratoryRate.value[x]",
         "path": "Observation.value[x]",
         "slicing": {
-          "id": "275",
+          "id": "265",
           "discriminator": [
-            "@type"
+            {
+              "type": "type",
+              "path": "$this"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -2328,7 +2658,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-TestInterpretationVS"
+            "reference": "http://standardhealthrecord.org/shr/lab/vs/TestInterpretationVS"
           }
         }
       },
@@ -2344,7 +2674,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
           }
         }
       },
@@ -2360,7 +2690,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-vital-RespiratoryRateMethodVS"
+            "reference": "http://standardhealthrecord.org/shr/vital/vs/RespiratoryRateMethodVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-vital-SystolicPressure.json b/lib/resources/standard_health_record/StructureDefinition-shr-vital-SystolicPressure.json
old mode 100755
new mode 100644
index e888d44..0058174
--- a/lib/resources/standard_health_record/StructureDefinition-shr-vital-SystolicPressure.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-vital-SystolicPressure.json
@@ -3,7 +3,7 @@
   "id": "shr-vital-SystolicPressure",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR SystolicPressure Profile</b></p>\n  <p>The blood pressure during the contraction of the left ventricle of the heart, when blood pressure is at its highest.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.vital.SystolicPressure maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR SystolicPressure Profile</b></p>\n  <p>The blood pressure during the contraction of the left ventricle of the heart, when blood pressure is at its highest.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.vital.SystolicPressure maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-vital-SystolicPressure",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.vital.SystolicPressure"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR SystolicPressure Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.665Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,11 +27,20 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.632Z",
   "description": "The blood pressure during the contraction of the left ventricle of the heart, when blood pressure is at its highest.",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -44,6 +55,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -58,7 +74,7 @@
         "path": "Observation",
         "short": "SHR SystolicPressure Profile",
         "definition": "The blood pressure during the contraction of the left ventricle of the heart, when blood pressure is at its highest.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -120,6 +136,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -139,7 +163,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -178,7 +202,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -199,7 +223,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -219,6 +243,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -233,7 +265,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -267,7 +299,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -296,16 +328,19 @@
         "id": "Observation:shr-vital-SystolicPressure.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "318",
+          "id": "308",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -334,6 +369,7 @@
         "path": "Observation.extension",
         "sliceName": "quantity",
         "definition": "A quantity with Units.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -370,6 +406,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -402,6 +439,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -433,16 +471,19 @@
         "id": "Observation:shr-vital-SystolicPressure.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "319",
+          "id": "309",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -472,6 +513,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -502,8 +544,8 @@
       {
         "id": "Observation:shr-vital-SystolicPressure.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -512,7 +554,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -527,6 +574,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-vital-SystolicPressure.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-vital-SystolicPressure.status",
         "extension": [
@@ -538,6 +642,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -549,6 +654,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -556,6 +667,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -575,8 +694,8 @@
         "path": "Observation.category",
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 0,
         "max": "*",
         "type": [
@@ -586,8 +705,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -609,6 +734,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -627,6 +755,12 @@
         },
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -634,6 +768,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -642,6 +784,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -653,7 +799,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -677,6 +823,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -692,20 +842,32 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-SystolicPressure.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-vital-SystolicPressure.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -725,8 +887,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -740,6 +905,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -759,7 +928,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -811,6 +980,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -830,8 +1003,8 @@
         "path": "Observation.value[x]",
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -844,6 +1017,9 @@
           {
             "code": "string"
           },
+          {
+            "code": "boolean"
+          },
           {
             "code": "Range"
           },
@@ -871,6 +1047,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -878,6 +1062,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -886,7 +1074,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -899,6 +1087,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -906,6 +1100,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -933,6 +1131,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -940,6 +1144,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -947,6 +1155,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -964,6 +1176,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -979,8 +1195,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -989,6 +1204,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "BodySite"
+            }
+          ],
           "strength": "example",
           "description": "Codes describing anatomical locations. May include laterality.",
           "valueSetReference": {
@@ -996,6 +1217,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -1003,6 +1228,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1011,7 +1240,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1022,6 +1251,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1044,7 +1279,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1054,6 +1289,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1061,6 +1300,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1069,7 +1312,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1083,6 +1326,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1090,6 +1337,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1098,7 +1349,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1167,7 +1418,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1196,7 +1447,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1278,30 +1529,82 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-SystolicPressure.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-vital-SystolicPressure.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-vital-SystolicPressure.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1357,8 +1660,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1420,7 +1723,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1449,7 +1752,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1481,7 +1784,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1491,6 +1794,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1541,7 +1850,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1604,7 +1913,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1633,7 +1942,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1675,6 +1984,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1682,6 +1997,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1701,8 +2020,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1739,6 +2058,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1746,6 +2069,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1754,7 +2081,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1767,6 +2094,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1789,7 +2122,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1802,6 +2135,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1809,6 +2148,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1816,6 +2159,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1824,7 +2171,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1971,12 +2318,16 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-SystolicPressure.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-vital-SystolicPressure.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
diff --git a/lib/resources/standard_health_record/StructureDefinition-shr-vital-VitalSign.json b/lib/resources/standard_health_record/StructureDefinition-shr-vital-VitalSign.json
old mode 100755
new mode 100644
index 57a13f7..b2274d3
--- a/lib/resources/standard_health_record/StructureDefinition-shr-vital-VitalSign.json
+++ b/lib/resources/standard_health_record/StructureDefinition-shr-vital-VitalSign.json
@@ -3,7 +3,7 @@
   "id": "shr-vital-VitalSign",
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR VitalSign Profile</b></p>\n  <p></p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.vital.VitalSign maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to encounter\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  BodySite maps to bodySite\n  BodyPosition maps to http://hl7.org/fhir/StructureDefinition/observation-bodyPosition\n  Device maps to device\n  TBD &quot;Specimen&quot; maps to specimen\n  Interpretation maps to interpretation\n  ReferenceRange maps to referenceRange\n  ChangeFlag maps to http://hl7.org/fhir/StructureDefinition/observation-delta\n  Quantity maps to value[x].Quantity\n</pre></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR VitalSign Profile</b></p>\n  <p/>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.vital.VitalSign maps to Observation:\n  Entry.FocalSubject maps to subject\n  Entry.AssociatedEncounter maps to context\n  Entry.OriginalCreationDate maps to issued\n  ObservationCode maps to code\n  ObservationCategory maps to category\n  ObservationStatus maps to status\n  ObservationMethod maps to method\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.TimePeriod maps to effective[x].Period\n  ClinicallyRelevantTime.GeneralizedTemporalContext.GeneralizedDateTime.dateTime maps to effective[x].dateTime\n  Participant maps to performer\n  BodySite maps to bodySite\n  BodyPosition maps to http://hl7.org/fhir/StructureDefinition/observation-bodyPosition\n  Device maps to device\n  &lt;TBD &quot;Specimen&quot;&gt; maps to specimen\n  Interpretation maps to interpretation\n  ReferenceRange maps to referenceRange\n  ChangeFlag maps to http://hl7.org/fhir/StructureDefinition/observation-delta\n  TestRequest maps to basedOn\n  Quantity maps to value[x].Quantity\n</pre></p>\n</div>"
   },
   "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-vital-VitalSign",
   "identifier": [
@@ -12,8 +12,10 @@
       "value": "shr.vital.VitalSign"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR VitalSign Profile",
   "status": "draft",
+  "date": "2017-04-18T15:12:23.138Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -25,10 +27,19 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:36.527Z",
   "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
-  "fhirVersion": "1.8.0",
+  "fhirVersion": "3.0.0",
   "mapping": [
+    {
+      "identity": "workflow",
+      "uri": "http://hl7.org/fhir/workflow",
+      "name": "Workflow Mapping"
+    },
+    {
+      "identity": "sct-concept",
+      "uri": "http://snomed.info/conceptdomain",
+      "name": "SNOMED CT Concept Domain Binding"
+    },
     {
       "identity": "v2",
       "uri": "http://hl7.org/v2",
@@ -43,6 +54,11 @@
       "identity": "w5",
       "uri": "http://hl7.org/fhir/w5",
       "name": "W5 Mapping"
+    },
+    {
+      "identity": "sct-attr",
+      "uri": "http://snomed.info/sct",
+      "name": "SNOMED CT Attribute Binding"
     }
   ],
   "kind": "resource",
@@ -57,7 +73,7 @@
         "path": "Observation",
         "short": "SHR VitalSign Profile",
         "definition": "Measurements and simple assertions made about a patient, device or other subject.",
-        "comments": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
+        "comment": "Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as lab reports, etc.",
         "alias": [
           "Vital Signs",
           "Measurement",
@@ -119,6 +135,14 @@
             "identity": "rim",
             "map": "Entity. Role, or Act"
           },
+          {
+            "identity": "workflow",
+            "map": "Event"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity|"
+          },
           {
             "identity": "v2",
             "map": "OBX"
@@ -138,7 +162,7 @@
         "path": "Observation.id",
         "short": "Logical id of this artifact",
         "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
-        "comments": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
+        "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -177,7 +201,7 @@
         "path": "Observation.implicitRules",
         "short": "A set of rules under which this content was created",
         "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
-        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
+        "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
         "min": 0,
         "max": "1",
         "base": {
@@ -198,7 +222,7 @@
         "path": "Observation.language",
         "short": "Language of the resource content",
         "definition": "The base language in which the resource is written.",
-        "comments": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
+        "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
         "min": 0,
         "max": "1",
         "base": {
@@ -218,6 +242,14 @@
               "valueReference": {
                 "reference": "http://hl7.org/fhir/ValueSet/all-languages"
               }
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "Language"
+            },
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
+              "valueBoolean": true
             }
           ],
           "strength": "extensible",
@@ -232,7 +264,7 @@
         "path": "Observation.text",
         "short": "Text summary of the resource, for human interpretation",
         "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
-        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
+        "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
         "alias": [
           "narrative",
           "html",
@@ -266,7 +298,7 @@
         "path": "Observation.contained",
         "short": "Contained, inline Resources",
         "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
-        "comments": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
+        "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
         "alias": [
           "inline resources",
           "anonymous resources",
@@ -295,16 +327,19 @@
         "id": "Observation:shr-vital-VitalSign.extension",
         "path": "Observation.extension",
         "slicing": {
-          "id": "272",
+          "id": "262",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -333,6 +368,7 @@
         "path": "Observation.extension",
         "sliceName": "bodyposition",
         "definition": "The position or physical attitude of the body.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -365,6 +401,7 @@
         "path": "Observation.extension",
         "sliceName": "changeflag",
         "definition": "Indicator of significant change (delta) from the last or previous measurement.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -397,6 +434,7 @@
         "path": "Observation.extension",
         "sliceName": "observationreason",
         "definition": "The reason for making the observation.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -429,6 +467,7 @@
         "path": "Observation.extension",
         "sliceName": "observationqualifier",
         "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -456,52 +495,23 @@
           }
         ]
       },
-      {
-        "id": "Observation:shr-vital-VitalSign.extension:testrequest",
-        "path": "Observation.extension",
-        "sliceName": "testrequest",
-        "definition": "A record of a request (order) for a test to be performed.",
-        "alias": [
-          "extensions",
-          "user content"
-        ],
-        "min": 0,
-        "max": "1",
-        "base": {
-          "path": "DomainResource.extension",
-          "min": 0,
-          "max": "*"
-        },
-        "type": [
-          {
-            "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest-extension"
-          }
-        ],
-        "mustSupport": false,
-        "isModifier": false,
-        "isSummary": false,
-        "mapping": [
-          {
-            "identity": "rim",
-            "map": "N/A"
-          }
-        ]
-      },
       {
         "id": "Observation:shr-vital-VitalSign.modifierExtension",
         "path": "Observation.modifierExtension",
         "slicing": {
-          "id": "273",
+          "id": "263",
           "discriminator": [
-            "url"
+            {
+              "type": "value",
+              "path": "url"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -531,6 +541,7 @@
         "path": "Observation.modifierExtension",
         "sliceName": "observationnonoccurrencemodifier",
         "definition": "True if the observation did not occcur, e.g., if a test was not performed or the assessment was not done, when it might otherwise be expected.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -561,8 +572,8 @@
       {
         "id": "Observation:shr-vital-VitalSign.identifier",
         "path": "Observation.identifier",
-        "short": "Unique Id for this particular observation",
-        "definition": "A unique identifier for the simple observation instance.",
+        "short": "Business Identifier for observation",
+        "definition": "A unique identifier assigned to this observation.",
         "requirements": "Allows observations to be distinguished and referenced.",
         "min": 0,
         "max": "*",
@@ -571,7 +582,12 @@
             "code": "Identifier"
           }
         ],
+        "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.identifier"
+          },
           {
             "identity": "v2",
             "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4."
@@ -586,6 +602,63 @@
           }
         ]
       },
+      {
+        "id": "Observation:shr-vital-VitalSign.basedOn",
+        "path": "Observation.basedOn",
+        "short": "Fulfills plan, proposal or order",
+        "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
+        "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
+        "alias": [
+          "Fulfills"
+        ],
+        "min": 0,
+        "max": "1",
+        "type": [
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
+          }
+        ],
+        "isSummary": true,
+        "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.basedOn"
+          },
+          {
+            "identity": "v2",
+            "map": "ORC"
+          },
+          {
+            "identity": "rim",
+            "map": ".outboundRelationship[typeCode=FLFS].target"
+          }
+        ]
+      },
       {
         "id": "Observation:shr-vital-VitalSign.status",
         "extension": [
@@ -597,6 +670,7 @@
         "path": "Observation.status",
         "short": "registered | preliminary | final | amended +",
         "definition": "The status of the result value.",
+        "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
         "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
         "min": 1,
         "max": "1",
@@ -608,6 +682,12 @@
         "isModifier": true,
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationStatus"
+            }
+          ],
           "strength": "required",
           "description": "Codes providing the status of an observation.",
           "valueSetReference": {
@@ -615,6 +695,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.status"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 445584004 |Report by finality status|"
+          },
           {
             "identity": "v2",
             "map": "OBX-11"
@@ -633,17 +721,20 @@
         "id": "Observation:shr-vital-VitalSign.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "271",
+          "id": "261",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
         },
         "short": "Classification of  type of observation",
         "definition": "A code that classifies the general type of observation being made.",
-        "comments": "There may be multiple axis of categoriization depending on the context or use case for retrieving or displaying the resource.  The level of granularity is defined by the category concepts in the value set.",
-        "requirements": "Used for filtering what observations are retreived and displayed.",
+        "comment": "In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.",
+        "requirements": "Used for filtering what observations are retrieved and displayed.",
         "min": 1,
         "max": "*",
         "type": [
@@ -653,8 +744,14 @@
           }
         ],
         "binding": {
-          "strength": "example",
-          "description": "Codes for high level observation categories .",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCategory"
+            }
+          ],
+          "strength": "preferred",
+          "description": "Codes for high level observation categories.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/observation-category"
           }
@@ -671,9 +768,9 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-VitalSign.category:vital-sign",
+        "id": "Observation:shr-vital-VitalSign.category:vital-signs",
         "path": "Observation.category",
-        "sliceName": "vital-sign",
+        "sliceName": "vital-signs",
         "min": 1,
         "max": "1",
         "type": [
@@ -686,7 +783,7 @@
           "coding": [
             {
               "system": "http://hl7.org/fhir/observation-category",
-              "code": "vital-sign"
+              "code": "vital-signs"
             }
           ]
         }
@@ -697,6 +794,9 @@
         "short": "Type of observation (code / type)",
         "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
         "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
+        "alias": [
+          "Name"
+        ],
         "min": 1,
         "max": "1",
         "type": [
@@ -707,6 +807,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -714,6 +820,14 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.code"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -722,6 +836,10 @@
             "identity": "rim",
             "map": "code"
           },
+          {
+            "identity": "sct-attr",
+            "map": "116680003 |Is a|"
+          },
           {
             "identity": "w5",
             "map": "what"
@@ -733,7 +851,7 @@
         "path": "Observation.subject",
         "short": "Who and/or what this is about",
         "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
-        "comments": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
+        "comment": "One would expect this element to be a cardinality  of 1..1.  The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.\r\rIf the target of the observation is different than the subject, the general extension [observation-focal-subject](extension-observation-focal-subject.html).  may be used.  However, the distinction between the patient's own value for an observation versus that of the fetus, or the donor or blood product unit, etc., are often specified in the observation code.",
         "requirements": "Observations have no value if you don't know who or what they're about.",
         "min": 1,
         "max": "1",
@@ -757,6 +875,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.subject"
+          },
           {
             "identity": "v2",
             "map": "PID-3"
@@ -772,20 +894,32 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-VitalSign.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-vital-VitalSign.context",
+        "path": "Observation.context",
         "short": "Healthcare event during which this observation is made",
         "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
+        "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).",
         "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
+        "alias": [
+          "Encounter"
+        ],
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.context"
+          },
           {
             "identity": "v2",
             "map": "PV1"
@@ -805,8 +939,11 @@
         "path": "Observation.effective[x]",
         "short": "Clinically relevant time/time-period for observation",
         "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
-        "comments": "At least a date should be present unless this observation is a historical report.",
+        "comment": "At least a date should be present unless this observation is a historical report.",
         "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
+        "alias": [
+          "Occurrence"
+        ],
         "min": 0,
         "max": "1",
         "type": [
@@ -820,6 +957,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.occurrence[x]"
+          },
           {
             "identity": "v2",
             "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)"
@@ -839,7 +980,7 @@
         "path": "Observation.issued",
         "short": "Date/Time this was made available",
         "definition": "The date and time this observation was made available to providers, typically after the results have been reviewed and verified.",
-        "comments": "Updated when the result is updated.",
+        "comment": "Updated when the result is updated.",
         "min": 1,
         "max": "1",
         "type": [
@@ -891,6 +1032,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.performer"
+          },
           {
             "identity": "v2",
             "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'"
@@ -910,8 +1055,8 @@
         "path": "Observation.value[x]",
         "short": "Actual result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.  For boolean values use valueCodeableConcept and select codes from [HL7 Version 2 Table 0136](v2/0136/index.html). These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed.   For further discussion and examples see the  [notes section](observation.html#4.20.4) below.",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. This element has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueRange, valueRatio, valueSampledData, valueAttachment, valueTime, valueDateTime, or valuePeriod. (The name format is \"'value' + the type name\" with a capital on the first letter of the type).\r\r\rIf the data element is usually coded or if the type associated with the Observation.value defines a coded value, use CodeableConcept instead of string datatype even if the value is uncoded text.  A value set is bound to the ValueCodeableConcept element.    For further discussion and examples see the  [notes section](observation.html#notes) below.",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -925,6 +1070,14 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
+          {
+            "identity": "sct-concept",
+            "map": "< 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -932,6 +1085,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -940,7 +1097,7 @@
         "path": "Observation.dataAbsentReason",
         "short": "Why the result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -953,6 +1110,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -960,6 +1123,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.notDone, Event.notDoneReason  (maps to valeu[x] or dataAbsentReason)"
+          },
           {
             "identity": "v2",
             "map": "N/A"
@@ -990,10 +1157,14 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-TestInterpretationVS"
+            "reference": "http://standardhealthrecord.org/shr/lab/vs/TestInterpretationVS"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1001,6 +1172,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1018,6 +1193,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "workflow",
+            "map": "Event.note"
+          },
           {
             "identity": "v2",
             "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)"
@@ -1033,8 +1212,7 @@
         "path": "Observation.bodySite",
         "short": "Observed body part",
         "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
-        "comments": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use The standard extension[ body-site-instance](extension-body-site-instance.html).",
-        "requirements": "Knowing where the observation is made is important for tracking if multiple sites are possible.",
+        "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-site-instance](extension-body-site-instance.html).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1046,10 +1224,14 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123037004 |Body structure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-20"
@@ -1057,6 +1239,10 @@
           {
             "identity": "rim",
             "map": "targetSiteCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "718497002 |Inherent location|"
           }
         ]
       },
@@ -1065,7 +1251,7 @@
         "path": "Observation.method",
         "short": "How it was done",
         "definition": "Indicates the mechanism used to perform the observation.",
-        "comments": "Only used if not implicit in code for Observation.code.",
+        "comment": "Only used if not implicit in code for Observation.code.",
         "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
         "min": 0,
         "max": "1",
@@ -1076,6 +1262,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationMethod"
+            }
+          ],
           "strength": "example",
           "description": "Methods for simple observations.",
           "valueSetReference": {
@@ -1098,7 +1290,7 @@
         "path": "Observation.specimen",
         "short": "Specimen used for this observation",
         "definition": "The specimen that was used when this observation was made.",
-        "comments": "Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
+        "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
         "min": 0,
         "max": "1",
         "type": [
@@ -1108,6 +1300,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 123038009 |Specimen|"
+          },
           {
             "identity": "v2",
             "map": "SPM segment"
@@ -1115,6 +1311,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=SPC].specimen"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "704319004 |Inherent in|"
           }
         ]
       },
@@ -1123,7 +1323,7 @@
         "path": "Observation.device",
         "short": "(Measurement) Device",
         "definition": "The device used to generate the observation data.",
-        "comments": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element.",
+        "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using either an extension or through the Observation.related element.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1137,6 +1337,10 @@
           }
         ],
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 49062001 |Device|"
+          },
           {
             "identity": "v2",
             "map": "OBX-17 / PRT -10"
@@ -1144,6 +1348,10 @@
           {
             "identity": "rim",
             "map": "participation[typeCode=DEV]"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "424226004 |Using device|"
           }
         ]
       },
@@ -1152,7 +1360,7 @@
         "path": "Observation.referenceRange",
         "short": "Provides guide for interpretation",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "1",
@@ -1221,7 +1429,7 @@
         "path": "Observation.referenceRange.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1250,7 +1458,7 @@
         "path": "Observation.referenceRange.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1332,30 +1540,82 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-VitalSign.referenceRange.meaning",
-        "path": "Observation.referenceRange.meaning",
+        "id": "Observation:shr-vital-VitalSign.referenceRange.type",
+        "path": "Observation.referenceRange.type",
         "short": "Reference range qualifier",
-        "definition": "Codes to indicate the the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex, race, therapeutic status, or endocrine or reproductive status.",
-        "comments": "This SHOULD be populated if there is more than one range.  If this element is not present then the norma population is assumed.",
-        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc  - for proper interpretation.",
+        "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
+        "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc,  - for proper interpretation.",
         "min": 0,
-        "max": "*",
+        "max": "1",
         "type": [
           {
             "code": "CodeableConcept"
           }
         ],
         "binding": {
-          "strength": "example",
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeMeaning"
+            }
+          ],
+          "strength": "extensible",
           "description": "Code for the meaning of a reference range.",
           "valueSetReference": {
             "reference": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
+          {
+            "identity": "v2",
+            "map": "OBX-10"
+          },
+          {
+            "identity": "rim",
+            "map": "interpretationCode"
+          }
+        ]
+      },
+      {
+        "id": "Observation:shr-vital-VitalSign.referenceRange.appliesTo",
+        "path": "Observation.referenceRange.appliesTo",
+        "short": "Reference range population",
+        "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
+        "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
+        "requirements": "Need to be able to identify the target population for proper interpretation.",
+        "min": 0,
+        "max": "*",
+        "type": [
+          {
+            "code": "CodeableConcept"
+          }
+        ],
+        "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRangeType"
+            }
+          ],
+          "strength": "example",
+          "description": "Codes identifying the population the reference range applies to.",
+          "valueSetReference": {
+            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
+          }
+        },
+        "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|"
+          },
           {
             "identity": "v2",
-            "map": "OBX-10?"
+            "map": "OBX-10"
           },
           {
             "identity": "rim",
@@ -1411,8 +1671,8 @@
         "path": "Observation.related",
         "short": "Resource related to this observation",
         "definition": "A  reference to another resource (usually another Observation) whose relationship is defined by the relationship type code.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
-        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes QuestionnaireResponse  from which the measure is derived.",
+        "comment": "For a discussion on the ways Observations can assembled in groups together see [Notes below](observation.html#4.20.4).",
+        "requirements": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and a set of related observations or sometimes a QuestionnaireResponse from which the measure is derived.",
         "min": 0,
         "max": "*",
         "type": [
@@ -1474,7 +1734,7 @@
         "path": "Observation.related.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1503,7 +1763,7 @@
         "path": "Observation.related.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1535,7 +1795,7 @@
         "path": "Observation.related.type",
         "short": "has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by",
         "definition": "A code specifying the kind of relationship that exists with the target resource.",
-        "comments": "\"derived-from\" is only logical choice when referencing QuestionnaireAnswer resource.",
+        "comment": "The \"derived-from\" type is the only logical choice when referencing the QuestionnaireAnswer resource.",
         "requirements": "A relationship type SHOULD be provided.",
         "min": 0,
         "max": "1",
@@ -1545,6 +1805,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationRelationshipType"
+            }
+          ],
           "strength": "required",
           "description": "Codes specifying how two observations are related.",
           "valueSetReference": {
@@ -1595,7 +1861,7 @@
         "path": "Observation.component",
         "short": "Component results",
         "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
-        "comments": "For a discussion on the ways Observations can assembled in groups together see [Notes](observation.html#notes) below.",
+        "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
         "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
         "min": 0,
         "max": "*",
@@ -1658,7 +1924,7 @@
         "path": "Observation.component.extension",
         "short": "Additional Content defined by implementations",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content"
@@ -1687,7 +1953,7 @@
         "path": "Observation.component.modifierExtension",
         "short": "Extensions that cannot be ignored",
         "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
-        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
+        "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
         "alias": [
           "extensions",
           "user content",
@@ -1729,6 +1995,12 @@
         ],
         "isSummary": true,
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationCode"
+            }
+          ],
           "strength": "example",
           "description": "Codes identifying names of simple observations.",
           "valueSetReference": {
@@ -1736,6 +2008,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|"
+          },
           {
             "identity": "v2",
             "map": "OBX-3"
@@ -1755,8 +2031,8 @@
         "path": "Observation.component.value[x]",
         "short": "Actual component result",
         "definition": "The information determined as a result of making the observation, if the information has a simple value.",
-        "comments": "Normally, an observation will have either a value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (These \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is \"'value' + the type name\" with a capital on the first letter of the type).",
-        "requirements": "An observation exists to have a value, though it may not if it is in error, or it represents a group of observations.",
+        "comment": "Normally, an observation will have either a single value or a set of related observations. A few observations (e.g. Apgar score) may have both a value and related observations (for an Apgar score, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.   For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/ValueSet/v2-0136> (these \"yes/no\" concepts can be mapped to the display name \"true/false\" or other mutually exclusive terms that may be needed\").  The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (the name format is \"'value' + the type name\" with a capital on the first letter of the type).",
+        "requirements": "An observation exists to have a value, though it may not if it is in error, or if it represents a group of observations.",
         "min": 0,
         "max": "1",
         "type": [
@@ -1793,6 +2069,10 @@
         ],
         "isSummary": true,
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "363714003 |Interprets| < 441742003 |Evaluation finding|"
+          },
           {
             "identity": "v2",
             "map": "OBX.2, OBX.5, OBX.6"
@@ -1800,6 +2080,10 @@
           {
             "identity": "rim",
             "map": "value"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363714003 |Interprets|"
           }
         ]
       },
@@ -1808,7 +2092,7 @@
         "path": "Observation.component.dataAbsentReason",
         "short": "Why the component result is missing",
         "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
-        "comments": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
+        "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\".   The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
         "requirements": "For many results it is necessary to handle exceptional values in measurements.",
         "min": 0,
         "max": "1",
@@ -1821,6 +2105,12 @@
           "obs-6"
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationValueAbsentReason"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes specifying why the result (Observation.value[x]) is missing.",
           "valueSetReference": {
@@ -1843,7 +2133,7 @@
         "path": "Observation.component.interpretation",
         "short": "High, low, normal, etc.",
         "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
-        "comments": "The component interpretation is applies only to the indivual component value.  For an overall interpretation all components together use Observation.interpretation element.",
+        "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use thes Observation.interpretation element.",
         "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
         "alias": [
           "Abnormal Flag"
@@ -1856,6 +2146,12 @@
           }
         ],
         "binding": {
+          "extension": [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "ObservationInterpretation"
+            }
+          ],
           "strength": "extensible",
           "description": "Codes identifying interpretations of observations.",
           "valueSetReference": {
@@ -1863,6 +2159,10 @@
           }
         },
         "mapping": [
+          {
+            "identity": "sct-concept",
+            "map": "< 260245000 |Findings values|"
+          },
           {
             "identity": "v2",
             "map": "OBX-8"
@@ -1870,6 +2170,10 @@
           {
             "identity": "rim",
             "map": "interpretationCode"
+          },
+          {
+            "identity": "sct-attr",
+            "map": "363713009 |Has interpretation|"
           }
         ]
       },
@@ -1878,7 +2182,7 @@
         "path": "Observation.component.referenceRange",
         "short": "Provides guide for interpretation of component result",
         "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
-        "comments": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
+        "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
         "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
         "min": 0,
         "max": "*",
@@ -1969,44 +2273,67 @@
         "isSummary": false
       },
       {
-        "id": "Observation:shr-vital-VitalSign.extension:testrequest",
-        "path": "Observation.extension",
-        "sliceName": "testrequest",
+        "id": "Observation:shr-vital-VitalSign.modifierExtension:observationnonoccurrencemodifier",
+        "path": "Observation.modifierExtension",
+        "sliceName": "observationnonoccurrencemodifier",
         "min": 0,
         "max": "1",
         "type": [
           {
             "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest-extension"
+            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-observation-ObservationNonOccurrenceModifier-extension"
           }
         ],
-        "mustSupport": false,
-        "isModifier": false,
+        "mustSupport": true,
+        "isModifier": true,
         "isSummary": false
       },
       {
-        "id": "Observation:shr-vital-VitalSign.modifierExtension:observationnonoccurrencemodifier",
-        "path": "Observation.modifierExtension",
-        "sliceName": "observationnonoccurrencemodifier",
+        "id": "Observation:shr-vital-VitalSign.basedOn",
+        "path": "Observation.basedOn",
         "min": 0,
         "max": "1",
         "type": [
           {
-            "code": "Extension",
-            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-observation-ObservationNonOccurrenceModifier-extension"
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/CarePlan"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/DeviceRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/ReferralRequest"
           }
-        ],
-        "mustSupport": true,
-        "isModifier": true,
-        "isSummary": false
+        ]
       },
       {
         "id": "Observation:shr-vital-VitalSign.category",
         "path": "Observation.category",
         "slicing": {
-          "id": "271",
+          "id": "261",
           "discriminator": [
-            "coding"
+            {
+              "type": "value",
+              "path": "coding"
+            }
           ],
           "ordered": false,
           "rules": "open"
@@ -2021,9 +2348,9 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-VitalSign.category:vital-sign",
+        "id": "Observation:shr-vital-VitalSign.category:vital-signs",
         "path": "Observation.category",
-        "sliceName": "vital-sign",
+        "sliceName": "vital-signs",
         "min": 1,
         "max": "1",
         "type": [
@@ -2036,7 +2363,7 @@
           "coding": [
             {
               "system": "http://hl7.org/fhir/observation-category",
-              "code": "vital-sign"
+              "code": "vital-signs"
             }
           ]
         }
@@ -2076,12 +2403,16 @@
         ]
       },
       {
-        "id": "Observation:shr-vital-VitalSign.encounter",
-        "path": "Observation.encounter",
+        "id": "Observation:shr-vital-VitalSign.context",
+        "path": "Observation.context",
         "type": [
           {
             "code": "Reference",
             "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-Encounter"
+          },
+          {
+            "code": "Reference",
+            "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
           }
         ]
       },
@@ -2148,7 +2479,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-TestInterpretationVS"
+            "reference": "http://standardhealthrecord.org/shr/lab/vs/TestInterpretationVS"
           }
         }
       },
@@ -2164,7 +2495,7 @@
         "binding": {
           "strength": "required",
           "valueSetReference": {
-            "reference": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS"
+            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
           }
         }
       },
diff --git a/lib/resources/standard_health_record/ValueSet-shr-actor-AgeGroupVS.json b/lib/resources/standard_health_record/ValueSet-shr-actor-AgeGroupVS.json
old mode 100755
new mode 100644
index 7432987..64318e6
--- a/lib/resources/standard_health_record/ValueSet-shr-actor-AgeGroupVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-actor-AgeGroupVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR AgeGroupVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR AgeGroupVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-actor-AgeGroupVS",
+  "url": "http://standardhealthrecord.org/shr/actor/vs/AgeGroupVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.actor.AgeGroupVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR AgeGroupVS ValueSet",
   "title": "SHR AgeGroupVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.486Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,7 +33,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.810Z",
   "compose": {
     "include": [
       {
diff --git a/lib/resources/standard_health_record/ValueSet-shr-actor-HealthcareRoleVS.json b/lib/resources/standard_health_record/ValueSet-shr-actor-HealthcareRoleVS.json
old mode 100755
new mode 100644
index 6a7b5c3..9c07db0
--- a/lib/resources/standard_health_record/ValueSet-shr-actor-HealthcareRoleVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-actor-HealthcareRoleVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR HealthcareRoleVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR HealthcareRoleVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-actor-HealthcareRoleVS",
+  "url": "http://standardhealthrecord.org/shr/actor/vs/HealthcareRoleVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.actor.HealthcareRoleVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR HealthcareRoleVS ValueSet",
   "title": "SHR HealthcareRoleVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.485Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,7 +33,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.809Z",
   "compose": {
     "include": [
       {
diff --git a/lib/resources/standard_health_record/ValueSet-shr-actor-LanguageQualifierVS.json b/lib/resources/standard_health_record/ValueSet-shr-actor-LanguageQualifierVS.json
old mode 100755
new mode 100644
index 9744135..be4af10
--- a/lib/resources/standard_health_record/ValueSet-shr-actor-LanguageQualifierVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-actor-LanguageQualifierVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR LanguageQualifierVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR LanguageQualifierVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-actor-LanguageQualifierVS",
+  "url": "http://standardhealthrecord.org/shr/actor/vs/LanguageQualifierVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.actor.LanguageQualifierVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR LanguageQualifierVS ValueSet",
   "title": "SHR LanguageQualifierVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.486Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.810Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-actor-LanguageQualifierVS",
+        "system": "http://standardhealthrecord.org/shr/actor/cs/LanguageQualifierCS",
         "concept": [
           {
             "code": "preferred_spoken",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-adverse-MedDRAVS.json b/lib/resources/standard_health_record/ValueSet-shr-adverse-MedDRAVS.json
new file mode 100644
index 0000000..01fd054
--- /dev/null
+++ b/lib/resources/standard_health_record/ValueSet-shr-adverse-MedDRAVS.json
@@ -0,0 +1,43 @@
+{
+  "resourceType": "ValueSet",
+  "id": "shr-adverse-MedDRAVS",
+  "meta": {
+    "profile": [
+      "http://hl7.org/fhir/StructureDefinition/valueset-shareable-definition"
+    ]
+  },
+  "text": {
+    "status": "generated",
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR MedDRAVS ValueSet</b></p>\n<p/>\n</div>"
+  },
+  "url": "http://standardhealthrecord.org/shr/adverse/vs/MedDRAVS",
+  "identifier": [
+    {
+      "system": "http://standardhealthrecord.org",
+      "value": "shr.adverse.MedDRAVS"
+    }
+  ],
+  "version": "0.0.1",
+  "name": "SHR MedDRAVS ValueSet",
+  "title": "SHR MedDRAVS ValueSet",
+  "status": "draft",
+  "date": "2017-04-18T15:12:20.486Z",
+  "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
+  "contact": [
+    {
+      "telecom": [
+        {
+          "system": "url",
+          "value": "http://www.standardhealthrecord.org"
+        }
+      ]
+    }
+  ],
+  "compose": {
+    "include": [
+      {
+        "system": "http://www.meddra.org"
+      }
+    ]
+  }
+}
\ No newline at end of file
diff --git a/lib/resources/standard_health_record/ValueSet-shr-allergy-AllergenIrritantVS.json b/lib/resources/standard_health_record/ValueSet-shr-allergy-AllergenIrritantVS.json
old mode 100755
new mode 100644
index 054aecf..f426f8c
--- a/lib/resources/standard_health_record/ValueSet-shr-allergy-AllergenIrritantVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-allergy-AllergenIrritantVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR AllergenIrritantVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR AllergenIrritantVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-allergy-AllergenIrritantVS",
+  "url": "http://standardhealthrecord.org/shr/allergy/vs/AllergenIrritantVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.allergy.AllergenIrritantVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR AllergenIrritantVS ValueSet",
   "title": "SHR AllergenIrritantVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.486Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,7 +33,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.810Z",
   "compose": {
     "include": [
       {
diff --git a/lib/resources/standard_health_record/ValueSet-shr-allergy-AllergyVerificationStatusVS.json b/lib/resources/standard_health_record/ValueSet-shr-allergy-AllergyVerificationStatusVS.json
old mode 100755
new mode 100644
index 42521c1..93078ba
--- a/lib/resources/standard_health_record/ValueSet-shr-allergy-AllergyVerificationStatusVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-allergy-AllergyVerificationStatusVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR AllergyVerificationStatusVS ValueSet</b></p>\n<p>Whether the allergy has been verified or not. Intentionally a subset of the codes in FHIR, since refuted would be reflected by correcting the &#039;elevated risk&#039; element, and records entered in error are not included in SHR.</p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR AllergyVerificationStatusVS ValueSet</b></p>\n<p>Whether the allergy has been verified or not. Intentionally a subset of the codes in FHIR, since refuted would be reflected by correcting the 'elevated risk' element, and records entered in error are not included in SHR.</p>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-allergy-AllergyVerificationStatusVS",
+  "url": "http://standardhealthrecord.org/shr/allergy/vs/AllergyVerificationStatusVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.allergy.AllergyVerificationStatusVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR AllergyVerificationStatusVS ValueSet",
   "title": "SHR AllergyVerificationStatusVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.487Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,7 +33,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.810Z",
   "description": "Whether the allergy has been verified or not. Intentionally a subset of the codes in FHIR, since refuted would be reflected by correcting the 'elevated risk' element, and records entered in error are not included in SHR.",
   "compose": {
     "include": [
diff --git a/lib/resources/standard_health_record/ValueSet-shr-allergy-DrugIngredientVS.json b/lib/resources/standard_health_record/ValueSet-shr-allergy-DrugIngredientVS.json
old mode 100755
new mode 100644
index f1df590..5732f4d
--- a/lib/resources/standard_health_record/ValueSet-shr-allergy-DrugIngredientVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-allergy-DrugIngredientVS.json
@@ -10,16 +10,18 @@
     "status": "generated",
     "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR DrugIngredientVS ValueSet</b></p>\n<p>Drug allergies involve ingredients or mixtures, not specific dose forms. The value set focuses on drug ingredients.</p>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-allergy-DrugIngredientVS",
+  "url": "http://standardhealthrecord.org/shr/allergy/vs/DrugIngredientVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.allergy.DrugIngredientVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR DrugIngredientVS ValueSet",
   "title": "SHR DrugIngredientVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.486Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,6 +33,5 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.810Z",
   "description": "Drug allergies involve ingredients or mixtures, not specific dose forms. The value set focuses on drug ingredients."
 }
\ No newline at end of file
diff --git a/lib/resources/standard_health_record/ValueSet-shr-allergy-FoodSubstanceVS.json b/lib/resources/standard_health_record/ValueSet-shr-allergy-FoodSubstanceVS.json
old mode 100755
new mode 100644
index 42c3a60..4760523
--- a/lib/resources/standard_health_record/ValueSet-shr-allergy-FoodSubstanceVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-allergy-FoodSubstanceVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR FoodSubstanceVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR FoodSubstanceVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-allergy-FoodSubstanceVS",
+  "url": "http://standardhealthrecord.org/shr/allergy/vs/FoodSubstanceVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.allergy.FoodSubstanceVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR FoodSubstanceVS ValueSet",
   "title": "SHR FoodSubstanceVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.486Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -30,6 +32,5 @@
         }
       ]
     }
-  ],
-  "date": "2017-03-21T00:21:35.810Z"
+  ]
 }
\ No newline at end of file
diff --git a/lib/resources/standard_health_record/ValueSet-shr-base-GenericAnswersVS.json b/lib/resources/standard_health_record/ValueSet-shr-base-GenericAnswersVS.json
old mode 100755
new mode 100644
index da4514a..cad1c1c
--- a/lib/resources/standard_health_record/ValueSet-shr-base-GenericAnswersVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-base-GenericAnswersVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR GenericAnswersVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR GenericAnswersVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-base-GenericAnswersVS",
+  "url": "http://standardhealthrecord.org/shr/base/vs/GenericAnswersVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.base.GenericAnswersVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR GenericAnswersVS ValueSet",
   "title": "SHR GenericAnswersVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.487Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.810Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-base-GenericAnswersVS",
+        "system": "http://standardhealthrecord.org/shr/base/cs/GenericAnswersCS",
         "concept": [
           {
             "code": "dont_know_answer",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-base-MissingValueReasonVS.json b/lib/resources/standard_health_record/ValueSet-shr-base-MissingValueReasonVS.json
old mode 100755
new mode 100644
index 4f549fb..387049d
--- a/lib/resources/standard_health_record/ValueSet-shr-base-MissingValueReasonVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-base-MissingValueReasonVS.json
@@ -10,16 +10,18 @@
     "status": "generated",
     "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR MissingValueReasonVS ValueSet</b></p>\n<p>Reasons that a value associated with a test or other observation is missing.</p>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-base-MissingValueReasonVS",
+  "url": "http://standardhealthrecord.org/shr/base/vs/MissingValueReasonVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.base.MissingValueReasonVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR MissingValueReasonVS ValueSet",
   "title": "SHR MissingValueReasonVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.487Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,12 +33,11 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.810Z",
   "description": "Reasons that a value associated with a test or other observation is missing.",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-base-MissingValueReasonVS",
+        "system": "http://standardhealthrecord.org/shr/base/cs/MissingValueReasonCS",
         "concept": [
           {
             "code": "missing_unanswered",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-behavior-AlcoholUseScreeningToolVS.json b/lib/resources/standard_health_record/ValueSet-shr-behavior-AlcoholUseScreeningToolVS.json
old mode 100755
new mode 100644
index bf175ce..fabe8ec
--- a/lib/resources/standard_health_record/ValueSet-shr-behavior-AlcoholUseScreeningToolVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-behavior-AlcoholUseScreeningToolVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR AlcoholUseScreeningToolVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR AlcoholUseScreeningToolVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-behavior-AlcoholUseScreeningToolVS",
+  "url": "http://standardhealthrecord.org/shr/behavior/vs/AlcoholUseScreeningToolVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.behavior.AlcoholUseScreeningToolVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR AlcoholUseScreeningToolVS ValueSet",
   "title": "SHR AlcoholUseScreeningToolVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.487Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.810Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-behavior-AlcoholUseScreeningToolVS",
+        "system": "http://standardhealthrecord.org/shr/behavior/cs/AlcoholUseScreeningToolCS",
         "concept": [
           {
             "code": "audit",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-behavior-DietNutritionConcernVS.json b/lib/resources/standard_health_record/ValueSet-shr-behavior-DietNutritionConcernVS.json
old mode 100755
new mode 100644
index faa8539..c52b5f4
--- a/lib/resources/standard_health_record/ValueSet-shr-behavior-DietNutritionConcernVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-behavior-DietNutritionConcernVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR DietNutritionConcernVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR DietNutritionConcernVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-behavior-DietNutritionConcernVS",
+  "url": "http://standardhealthrecord.org/shr/behavior/vs/DietNutritionConcernVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.behavior.DietNutritionConcernVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR DietNutritionConcernVS ValueSet",
   "title": "SHR DietNutritionConcernVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.487Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.811Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-behavior-DietNutritionConcernVS",
+        "system": "http://standardhealthrecord.org/shr/behavior/cs/DietNutritionConcernCS",
         "concept": [
           {
             "code": "sugar",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-behavior-PhysicalActivityLimitationVS.json b/lib/resources/standard_health_record/ValueSet-shr-behavior-PhysicalActivityLimitationVS.json
old mode 100755
new mode 100644
index 54453bc..caafa21
--- a/lib/resources/standard_health_record/ValueSet-shr-behavior-PhysicalActivityLimitationVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-behavior-PhysicalActivityLimitationVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR PhysicalActivityLimitationVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR PhysicalActivityLimitationVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-behavior-PhysicalActivityLimitationVS",
+  "url": "http://standardhealthrecord.org/shr/behavior/vs/PhysicalActivityLimitationVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.behavior.PhysicalActivityLimitationVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR PhysicalActivityLimitationVS ValueSet",
   "title": "SHR PhysicalActivityLimitationVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.487Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.811Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-behavior-PhysicalActivityLimitationVS",
+        "system": "http://standardhealthrecord.org/shr/behavior/cs/PhysicalActivityLimitationCS",
         "concept": [
           {
             "code": "conditions",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-behavior-ReligiousPracticeStatusVS.json b/lib/resources/standard_health_record/ValueSet-shr-behavior-ReligiousPracticeStatusVS.json
old mode 100755
new mode 100644
index 5448c75..211781a
--- a/lib/resources/standard_health_record/ValueSet-shr-behavior-ReligiousPracticeStatusVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-behavior-ReligiousPracticeStatusVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ReligiousPracticeStatusVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ReligiousPracticeStatusVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-behavior-ReligiousPracticeStatusVS",
+  "url": "http://standardhealthrecord.org/shr/behavior/vs/ReligiousPracticeStatusVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.behavior.ReligiousPracticeStatusVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ReligiousPracticeStatusVS ValueSet",
   "title": "SHR ReligiousPracticeStatusVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.487Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.810Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-behavior-ReligiousPracticeStatusVS",
+        "system": "http://standardhealthrecord.org/shr/behavior/cs/ReligiousPracticeStatusCS",
         "concept": [
           {
             "code": "practicing",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-behavior-ReligiousRestrictionVS.json b/lib/resources/standard_health_record/ValueSet-shr-behavior-ReligiousRestrictionVS.json
old mode 100755
new mode 100644
index b4e3336..06d8406
--- a/lib/resources/standard_health_record/ValueSet-shr-behavior-ReligiousRestrictionVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-behavior-ReligiousRestrictionVS.json
@@ -10,16 +10,18 @@
     "status": "generated",
     "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ReligiousRestrictionVS ValueSet</b></p>\n<p>Includes religious restrictions that could impact care, other than dietary restrictions (handled elsewhere).</p>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-behavior-ReligiousRestrictionVS",
+  "url": "http://standardhealthrecord.org/shr/behavior/vs/ReligiousRestrictionVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.behavior.ReligiousRestrictionVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ReligiousRestrictionVS ValueSet",
   "title": "SHR ReligiousRestrictionVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.487Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,12 +33,11 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.810Z",
   "description": "Includes religious restrictions that could impact care, other than dietary restrictions (handled elsewhere).",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-behavior-ReligiousRestrictionVS",
+        "system": "http://standardhealthrecord.org/shr/behavior/cs/ReligiousRestrictionCS",
         "concept": [
           {
             "code": "same_sex",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-behavior-SleepQualityReasonVS.json b/lib/resources/standard_health_record/ValueSet-shr-behavior-SleepQualityReasonVS.json
old mode 100755
new mode 100644
index 8113dc2..d35936c
--- a/lib/resources/standard_health_record/ValueSet-shr-behavior-SleepQualityReasonVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-behavior-SleepQualityReasonVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR SleepQualityReasonVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR SleepQualityReasonVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-behavior-SleepQualityReasonVS",
+  "url": "http://standardhealthrecord.org/shr/behavior/vs/SleepQualityReasonVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.behavior.SleepQualityReasonVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR SleepQualityReasonVS ValueSet",
   "title": "SHR SleepQualityReasonVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.487Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.811Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-behavior-SleepQualityReasonVS",
+        "system": "http://standardhealthrecord.org/shr/behavior/cs/SleepQualityReasonCS",
         "concept": [
           {
             "code": "sleep_location",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-behavior-SpecialDietFollowedVS.json b/lib/resources/standard_health_record/ValueSet-shr-behavior-SpecialDietFollowedVS.json
old mode 100755
new mode 100644
index 6662b2b..f6a0e64
--- a/lib/resources/standard_health_record/ValueSet-shr-behavior-SpecialDietFollowedVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-behavior-SpecialDietFollowedVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR SpecialDietFollowedVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR SpecialDietFollowedVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-behavior-SpecialDietFollowedVS",
+  "url": "http://standardhealthrecord.org/shr/behavior/vs/SpecialDietFollowedVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.behavior.SpecialDietFollowedVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR SpecialDietFollowedVS ValueSet",
   "title": "SHR SpecialDietFollowedVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.487Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.811Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-behavior-SpecialDietFollowedVS",
+        "system": "http://standardhealthrecord.org/shr/behavior/cs/SpecialDietFollowedCS",
         "concept": [
           {
             "code": "vegetarian",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-behavior-SubstanceAbuseTreatmentTypeVS.json b/lib/resources/standard_health_record/ValueSet-shr-behavior-SubstanceAbuseTreatmentTypeVS.json
old mode 100755
new mode 100644
index 64d0c6c..014b464
--- a/lib/resources/standard_health_record/ValueSet-shr-behavior-SubstanceAbuseTreatmentTypeVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-behavior-SubstanceAbuseTreatmentTypeVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR SubstanceAbuseTreatmentTypeVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR SubstanceAbuseTreatmentTypeVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-behavior-SubstanceAbuseTreatmentTypeVS",
+  "url": "http://standardhealthrecord.org/shr/behavior/vs/SubstanceAbuseTreatmentTypeVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.behavior.SubstanceAbuseTreatmentTypeVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR SubstanceAbuseTreatmentTypeVS ValueSet",
   "title": "SHR SubstanceAbuseTreatmentTypeVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.487Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.810Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-behavior-SubstanceAbuseTreatmentTypeVS",
+        "system": "http://standardhealthrecord.org/shr/behavior/cs/SubstanceAbuseTreatmentTypeCS",
         "concept": [
           {
             "code": "day_treatment",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-behavior-SubstanceOfAbuseVS.json b/lib/resources/standard_health_record/ValueSet-shr-behavior-SubstanceOfAbuseVS.json
old mode 100755
new mode 100644
index 92d29b0..c9a9e70
--- a/lib/resources/standard_health_record/ValueSet-shr-behavior-SubstanceOfAbuseVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-behavior-SubstanceOfAbuseVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR SubstanceOfAbuseVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR SubstanceOfAbuseVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-behavior-SubstanceOfAbuseVS",
+  "url": "http://standardhealthrecord.org/shr/behavior/vs/SubstanceOfAbuseVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.behavior.SubstanceOfAbuseVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR SubstanceOfAbuseVS ValueSet",
   "title": "SHR SubstanceOfAbuseVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.487Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,7 +33,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.810Z",
   "compose": {
     "include": [
       {
diff --git a/lib/resources/standard_health_record/ValueSet-shr-core-BodyPositionVS.json b/lib/resources/standard_health_record/ValueSet-shr-core-BodyPositionVS.json
old mode 100755
new mode 100644
index c071dae..6ef4b8f
--- a/lib/resources/standard_health_record/ValueSet-shr-core-BodyPositionVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-core-BodyPositionVS.json
@@ -10,16 +10,18 @@
     "status": "generated",
     "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR BodyPositionVS ValueSet</b></p>\n<p>The body position with respect to gravity.</p>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodyPositionVS",
+  "url": "http://standardhealthrecord.org/shr/core/vs/BodyPositionVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.core.BodyPositionVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR BodyPositionVS ValueSet",
   "title": "SHR BodyPositionVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.489Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,7 +33,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.813Z",
   "description": "The body position with respect to gravity.",
   "compose": {
     "include": [
diff --git a/lib/resources/standard_health_record/ValueSet-shr-core-BodySiteVS.json b/lib/resources/standard_health_record/ValueSet-shr-core-BodySiteVS.json
old mode 100755
new mode 100644
index add45b6..4d01f54
--- a/lib/resources/standard_health_record/ValueSet-shr-core-BodySiteVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-core-BodySiteVS.json
@@ -10,16 +10,18 @@
     "status": "generated",
     "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR BodySiteVS ValueSet</b></p>\n<p>Location on or in the body.</p>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS",
+  "url": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.core.BodySiteVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR BodySiteVS ValueSet",
   "title": "SHR BodySiteVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.489Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,7 +33,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.813Z",
   "description": "Location on or in the body.",
   "compose": {
     "include": [
diff --git a/lib/resources/standard_health_record/ValueSet-shr-core-ClinicalFindingAbsentVS.json b/lib/resources/standard_health_record/ValueSet-shr-core-ClinicalFindingAbsentVS.json
old mode 100755
new mode 100644
index 726101e..cd52d1f
--- a/lib/resources/standard_health_record/ValueSet-shr-core-ClinicalFindingAbsentVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-core-ClinicalFindingAbsentVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ClinicalFindingAbsentVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ClinicalFindingAbsentVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-ClinicalFindingAbsentVS",
+  "url": "http://standardhealthrecord.org/shr/core/vs/ClinicalFindingAbsentVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.core.ClinicalFindingAbsentVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ClinicalFindingAbsentVS ValueSet",
   "title": "SHR ClinicalFindingAbsentVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.489Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,7 +33,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.813Z",
   "compose": {
     "include": [
       {
diff --git a/lib/resources/standard_health_record/ValueSet-shr-core-ClockDirectionVS.json b/lib/resources/standard_health_record/ValueSet-shr-core-ClockDirectionVS.json
old mode 100755
new mode 100644
index cca60af..a45ea85
--- a/lib/resources/standard_health_record/ValueSet-shr-core-ClockDirectionVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-core-ClockDirectionVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ClockDirectionVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ClockDirectionVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-ClockDirectionVS",
+  "url": "http://standardhealthrecord.org/shr/core/vs/ClockDirectionVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.core.ClockDirectionVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ClockDirectionVS ValueSet",
   "title": "SHR ClockDirectionVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.487Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,7 +33,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.811Z",
   "compose": {
     "include": [
       {
diff --git a/lib/resources/standard_health_record/ValueSet-shr-core-CodingQualifierVS.json b/lib/resources/standard_health_record/ValueSet-shr-core-CodingQualifierVS.json
old mode 100755
new mode 100644
index 271f02c..9545c42
--- a/lib/resources/standard_health_record/ValueSet-shr-core-CodingQualifierVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-core-CodingQualifierVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR CodingQualifierVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR CodingQualifierVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-CodingQualifierVS",
+  "url": "http://standardhealthrecord.org/shr/core/vs/CodingQualifierVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.core.CodingQualifierVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR CodingQualifierVS ValueSet",
   "title": "SHR CodingQualifierVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.487Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.811Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-core-CodingQualifierVS",
+        "system": "http://standardhealthrecord.org/shr/core/cs/CodingQualifierCS",
         "concept": [
           {
             "code": "preferred_code",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-core-DirectionalityVS.json b/lib/resources/standard_health_record/ValueSet-shr-core-DirectionalityVS.json
old mode 100755
new mode 100644
index e9e15a1..d22cc3f
--- a/lib/resources/standard_health_record/ValueSet-shr-core-DirectionalityVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-core-DirectionalityVS.json
@@ -10,16 +10,18 @@
     "status": "generated",
     "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR DirectionalityVS ValueSet</b></p>\n<p>Anatomical location or specimen further detailing directionality.</p>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-DirectionalityVS",
+  "url": "http://standardhealthrecord.org/shr/core/vs/DirectionalityVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.core.DirectionalityVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR DirectionalityVS ValueSet",
   "title": "SHR DirectionalityVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.489Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,7 +33,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.813Z",
   "description": "Anatomical location or specimen further detailing directionality.",
   "compose": {
     "include": [
diff --git a/lib/resources/standard_health_record/ValueSet-shr-core-DiseaseFindingVS.json b/lib/resources/standard_health_record/ValueSet-shr-core-DiseaseFindingVS.json
old mode 100755
new mode 100644
index ecc1442..02e8f2b
--- a/lib/resources/standard_health_record/ValueSet-shr-core-DiseaseFindingVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-core-DiseaseFindingVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR DiseaseFindingVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR DiseaseFindingVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-DiseaseFindingVS",
+  "url": "http://standardhealthrecord.org/shr/core/vs/DiseaseFindingVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.core.DiseaseFindingVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR DiseaseFindingVS ValueSet",
   "title": "SHR DiseaseFindingVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.489Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,7 +33,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.813Z",
   "compose": {
     "include": [
       {
diff --git a/lib/resources/standard_health_record/ValueSet-shr-core-LateralityVS.json b/lib/resources/standard_health_record/ValueSet-shr-core-LateralityVS.json
old mode 100755
new mode 100644
index 16d12c3..1044dd5
--- a/lib/resources/standard_health_record/ValueSet-shr-core-LateralityVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-core-LateralityVS.json
@@ -10,16 +10,18 @@
     "status": "generated",
     "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR LateralityVS ValueSet</b></p>\n<p>Anatomical location or specimen further detailing the side(s) of interest.</p>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-LateralityVS",
+  "url": "http://standardhealthrecord.org/shr/core/vs/LateralityVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.core.LateralityVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR LateralityVS ValueSet",
   "title": "SHR LateralityVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.489Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,7 +33,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.813Z",
   "description": "Anatomical location or specimen further detailing the side(s) of interest.",
   "compose": {
     "include": [
diff --git a/lib/resources/standard_health_record/ValueSet-shr-core-LowerBoundTypeVS.json b/lib/resources/standard_health_record/ValueSet-shr-core-LowerBoundTypeVS.json
old mode 100755
new mode 100644
index ea3921a..9bc315c
--- a/lib/resources/standard_health_record/ValueSet-shr-core-LowerBoundTypeVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-core-LowerBoundTypeVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR LowerBoundTypeVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR LowerBoundTypeVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-LowerBoundTypeVS",
+  "url": "http://standardhealthrecord.org/shr/core/vs/LowerBoundTypeVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.core.LowerBoundTypeVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR LowerBoundTypeVS ValueSet",
   "title": "SHR LowerBoundTypeVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.488Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.812Z",
   "compose": {
     "include": [
       {
-        "system": "http://hl7.org/fhir/ValueSet/quantity-comparator",
+        "system": "http://hl7.org/fhir/quantity-comparator",
         "concept": [
           {
             "code": ">",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-core-ManifestationVS.json b/lib/resources/standard_health_record/ValueSet-shr-core-ManifestationVS.json
old mode 100755
new mode 100644
index efa26c7..4fd1606
--- a/lib/resources/standard_health_record/ValueSet-shr-core-ManifestationVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-core-ManifestationVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ManifestationVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ManifestationVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-ManifestationVS",
+  "url": "http://standardhealthrecord.org/shr/core/vs/ManifestationVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.core.ManifestationVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ManifestationVS ValueSet",
   "title": "SHR ManifestationVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.489Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,7 +33,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.813Z",
   "compose": {
     "include": [
       {
diff --git a/lib/resources/standard_health_record/ValueSet-shr-core-PerformanceGradingScaleVS.json b/lib/resources/standard_health_record/ValueSet-shr-core-PerformanceGradingScaleVS.json
old mode 100755
new mode 100644
index 885488f..7e2e1e8
--- a/lib/resources/standard_health_record/ValueSet-shr-core-PerformanceGradingScaleVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-core-PerformanceGradingScaleVS.json
@@ -10,16 +10,18 @@
     "status": "generated",
     "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR PerformanceGradingScaleVS ValueSet</b></p>\n<p>A simple performance grading scale. Also useful for grading quality.</p>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-PerformanceGradingScaleVS",
+  "url": "http://standardhealthrecord.org/shr/core/vs/PerformanceGradingScaleVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.core.PerformanceGradingScaleVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR PerformanceGradingScaleVS ValueSet",
   "title": "SHR PerformanceGradingScaleVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.489Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,12 +33,11 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.813Z",
   "description": "A simple performance grading scale. Also useful for grading quality.",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-core-PerformanceGradingScaleVS",
+        "system": "http://standardhealthrecord.org/shr/core/cs/PerformanceGradingScaleCS",
         "concept": [
           {
             "code": "excellent",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-core-PortionTotalityVS.json b/lib/resources/standard_health_record/ValueSet-shr-core-PortionTotalityVS.json
old mode 100755
new mode 100644
index f6e213e..3bbda76
--- a/lib/resources/standard_health_record/ValueSet-shr-core-PortionTotalityVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-core-PortionTotalityVS.json
@@ -10,16 +10,18 @@
     "status": "generated",
     "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR PortionTotalityVS ValueSet</b></p>\n<p>ObservationQualifier for anatomical location or specimen further detailing the portion or totality, which means arrangement of, or apportioning of an entity.</p>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-PortionTotalityVS",
+  "url": "http://standardhealthrecord.org/shr/core/vs/PortionTotalityVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.core.PortionTotalityVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR PortionTotalityVS ValueSet",
   "title": "SHR PortionTotalityVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.489Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,7 +33,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.813Z",
   "description": "ObservationQualifier for anatomical location or specimen further detailing the portion or totality, which means arrangement of, or apportioning of an entity.",
   "compose": {
     "include": [
diff --git a/lib/resources/standard_health_record/ValueSet-shr-core-QualitativeDateTimeVS.json b/lib/resources/standard_health_record/ValueSet-shr-core-QualitativeDateTimeVS.json
old mode 100755
new mode 100644
index ec19745..ef8419a
--- a/lib/resources/standard_health_record/ValueSet-shr-core-QualitativeDateTimeVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-core-QualitativeDateTimeVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR QualitativeDateTimeVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR QualitativeDateTimeVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeDateTimeVS",
+  "url": "http://standardhealthrecord.org/shr/core/vs/QualitativeDateTimeVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.core.QualitativeDateTimeVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR QualitativeDateTimeVS ValueSet",
   "title": "SHR QualitativeDateTimeVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.488Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.812Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-core-QualitativeDateTimeVS",
+        "system": "http://standardhealthrecord.org/shr/core/cs/QualitativeDateTimeCS",
         "concept": [
           {
             "code": "past",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-core-QualitativeFrequencyVS.json b/lib/resources/standard_health_record/ValueSet-shr-core-QualitativeFrequencyVS.json
old mode 100755
new mode 100644
index 842e80c..a25ab8a
--- a/lib/resources/standard_health_record/ValueSet-shr-core-QualitativeFrequencyVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-core-QualitativeFrequencyVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR QualitativeFrequencyVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR QualitativeFrequencyVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeFrequencyVS",
+  "url": "http://standardhealthrecord.org/shr/core/vs/QualitativeFrequencyVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.core.QualitativeFrequencyVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR QualitativeFrequencyVS ValueSet",
   "title": "SHR QualitativeFrequencyVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.489Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.812Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-core-QualitativeFrequencyVS",
+        "system": "http://standardhealthrecord.org/shr/core/cs/QualitativeFrequencyCS",
         "concept": [
           {
             "code": "always",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-core-QualitativeLikelihoodVS.json b/lib/resources/standard_health_record/ValueSet-shr-core-QualitativeLikelihoodVS.json
old mode 100755
new mode 100644
index 04626ee..0e1bd02
--- a/lib/resources/standard_health_record/ValueSet-shr-core-QualitativeLikelihoodVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-core-QualitativeLikelihoodVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR QualitativeLikelihoodVS ValueSet</b></p>\n<p>The likelihood of an event or state, expressed qualitatively. Qualitative likelihoods are associated with judgments and assessments. Values are based on US Intelligence Community&#039;s standard language used to describe judgements of likelihood.</p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR QualitativeLikelihoodVS ValueSet</b></p>\n<p>The likelihood of an event or state, expressed qualitatively. Qualitative likelihoods are associated with judgments and assessments. Values are based on US Intelligence Community's standard language used to describe judgements of likelihood.</p>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeLikelihoodVS",
+  "url": "http://standardhealthrecord.org/shr/core/vs/QualitativeLikelihoodVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.core.QualitativeLikelihoodVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR QualitativeLikelihoodVS ValueSet",
   "title": "SHR QualitativeLikelihoodVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.489Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,12 +33,11 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.812Z",
   "description": "The likelihood of an event or state, expressed qualitatively. Qualitative likelihoods are associated with judgments and assessments. Values are based on US Intelligence Community's standard language used to describe judgements of likelihood.",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-core-QualitativeLikelihoodVS",
+        "system": "http://standardhealthrecord.org/shr/core/cs/QualitativeLikelihoodCS",
         "concept": [
           {
             "code": "definitely",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-core-QualitativeValueScaleVS.json b/lib/resources/standard_health_record/ValueSet-shr-core-QualitativeValueScaleVS.json
old mode 100755
new mode 100644
index 23808ea..1f05f1c
--- a/lib/resources/standard_health_record/ValueSet-shr-core-QualitativeValueScaleVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-core-QualitativeValueScaleVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR QualitativeValueScaleVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR QualitativeValueScaleVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeValueScaleVS",
+  "url": "http://standardhealthrecord.org/shr/core/vs/QualitativeValueScaleVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.core.QualitativeValueScaleVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR QualitativeValueScaleVS ValueSet",
   "title": "SHR QualitativeValueScaleVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.489Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.812Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-core-QualitativeValueScaleVS",
+        "system": "http://standardhealthrecord.org/shr/core/cs/QualitativeValueScaleCS",
         "concept": [
           {
             "code": "very_high",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-core-SemiquantitativeDurationVS.json b/lib/resources/standard_health_record/ValueSet-shr-core-SemiquantitativeDurationVS.json
old mode 100755
new mode 100644
index 2fa62a6..ca0a6d2
--- a/lib/resources/standard_health_record/ValueSet-shr-core-SemiquantitativeDurationVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-core-SemiquantitativeDurationVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR SemiquantitativeDurationVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR SemiquantitativeDurationVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-SemiquantitativeDurationVS",
+  "url": "http://standardhealthrecord.org/shr/core/vs/SemiquantitativeDurationVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.core.SemiquantitativeDurationVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR SemiquantitativeDurationVS ValueSet",
   "title": "SHR SemiquantitativeDurationVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.489Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.812Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-core-SemiquantitativeDurationVS",
+        "system": "http://standardhealthrecord.org/shr/core/cs/SemiquantitativeDurationCS",
         "concept": [
           {
             "code": "many_years",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-core-SemiquantitativeFrequencyVS.json b/lib/resources/standard_health_record/ValueSet-shr-core-SemiquantitativeFrequencyVS.json
old mode 100755
new mode 100644
index 4e98221..36c0763
--- a/lib/resources/standard_health_record/ValueSet-shr-core-SemiquantitativeFrequencyVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-core-SemiquantitativeFrequencyVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR SemiquantitativeFrequencyVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR SemiquantitativeFrequencyVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-SemiquantitativeFrequencyVS",
+  "url": "http://standardhealthrecord.org/shr/core/vs/SemiquantitativeFrequencyVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.core.SemiquantitativeFrequencyVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR SemiquantitativeFrequencyVS ValueSet",
   "title": "SHR SemiquantitativeFrequencyVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.489Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.812Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-core-SemiquantitativeFrequencyVS",
+        "system": "http://standardhealthrecord.org/shr/core/cs/SemiquantitativeFrequencyCS",
         "concept": [
           {
             "code": "never",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-core-SettingVS.json b/lib/resources/standard_health_record/ValueSet-shr-core-SettingVS.json
old mode 100755
new mode 100644
index 6f2fb40..9a00208
--- a/lib/resources/standard_health_record/ValueSet-shr-core-SettingVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-core-SettingVS.json
@@ -10,16 +10,18 @@
     "status": "generated",
     "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR SettingVS ValueSet</b></p>\n<p>What type of place is found at a given location. More than one descriptor may be applicable.</p>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-SettingVS",
+  "url": "http://standardhealthrecord.org/shr/core/vs/SettingVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.core.SettingVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR SettingVS ValueSet",
   "title": "SHR SettingVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.489Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,12 +33,11 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.812Z",
   "description": "What type of place is found at a given location. More than one descriptor may be applicable.",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-core-SettingVS",
+        "system": "http://standardhealthrecord.org/shr/core/cs/SettingCS",
         "concept": [
           {
             "code": "work",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-core-StatisticTypeVS.json b/lib/resources/standard_health_record/ValueSet-shr-core-StatisticTypeVS.json
old mode 100755
new mode 100644
index e1aeda0..ab00438
--- a/lib/resources/standard_health_record/ValueSet-shr-core-StatisticTypeVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-core-StatisticTypeVS.json
@@ -10,16 +10,18 @@
     "status": "generated",
     "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR StatisticTypeVS ValueSet</b></p>\n<p>How to interpret a reported quantity, i.e, whether the quantity is an maximum, minimum, mean, median, etc.</p>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-StatisticTypeVS",
+  "url": "http://standardhealthrecord.org/shr/core/vs/StatisticTypeVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.core.StatisticTypeVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR StatisticTypeVS ValueSet",
   "title": "SHR StatisticTypeVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.488Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,7 +33,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.812Z",
   "description": "How to interpret a reported quantity, i.e, whether the quantity is an maximum, minimum, mean, median, etc.",
   "compose": {
     "include": [
diff --git a/lib/resources/standard_health_record/ValueSet-shr-core-ThreePriorityVS.json b/lib/resources/standard_health_record/ValueSet-shr-core-ThreePriorityVS.json
old mode 100755
new mode 100644
index 2c7aa57..e49d7b6
--- a/lib/resources/standard_health_record/ValueSet-shr-core-ThreePriorityVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-core-ThreePriorityVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ThreePriorityVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ThreePriorityVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-ThreePriorityVS",
+  "url": "http://standardhealthrecord.org/shr/core/vs/ThreePriorityVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.core.ThreePriorityVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ThreePriorityVS ValueSet",
   "title": "SHR ThreePriorityVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.489Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.812Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-core-ThreePriorityVS",
+        "system": "http://standardhealthrecord.org/shr/core/cs/ThreePriorityCS",
         "concept": [
           {
             "code": "primary",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-core-ThreeValueLogicVS.json b/lib/resources/standard_health_record/ValueSet-shr-core-ThreeValueLogicVS.json
old mode 100755
new mode 100644
index fc0c044..1edc598
--- a/lib/resources/standard_health_record/ValueSet-shr-core-ThreeValueLogicVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-core-ThreeValueLogicVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ThreeValueLogicVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ThreeValueLogicVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-ThreeValueLogicVS",
+  "url": "http://standardhealthrecord.org/shr/core/vs/ThreeValueLogicVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.core.ThreeValueLogicVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ThreeValueLogicVS ValueSet",
   "title": "SHR ThreeValueLogicVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.489Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.812Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-core-ThreeValueLogicVS",
+        "system": "http://standardhealthrecord.org/shr/core/cs/ThreeValueLogicCS",
         "concept": [
           {
             "code": "true",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-core-TimeUnitOfMeasureVS.json b/lib/resources/standard_health_record/ValueSet-shr-core-TimeUnitOfMeasureVS.json
old mode 100755
new mode 100644
index a1d21de..d18291c
--- a/lib/resources/standard_health_record/ValueSet-shr-core-TimeUnitOfMeasureVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-core-TimeUnitOfMeasureVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR TimeUnitOfMeasureVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR TimeUnitOfMeasureVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-TimeUnitOfMeasureVS",
+  "url": "http://standardhealthrecord.org/shr/core/vs/TimeUnitOfMeasureVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.core.TimeUnitOfMeasureVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR TimeUnitOfMeasureVS ValueSet",
   "title": "SHR TimeUnitOfMeasureVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.488Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,7 +33,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.812Z",
   "compose": {
     "include": [
       {
diff --git a/lib/resources/standard_health_record/ValueSet-shr-core-UpperBoundTypeVS.json b/lib/resources/standard_health_record/ValueSet-shr-core-UpperBoundTypeVS.json
old mode 100755
new mode 100644
index 01e57ee..9462c96
--- a/lib/resources/standard_health_record/ValueSet-shr-core-UpperBoundTypeVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-core-UpperBoundTypeVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR UpperBoundTypeVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR UpperBoundTypeVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-core-UpperBoundTypeVS",
+  "url": "http://standardhealthrecord.org/shr/core/vs/UpperBoundTypeVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.core.UpperBoundTypeVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR UpperBoundTypeVS ValueSet",
   "title": "SHR UpperBoundTypeVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.488Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.811Z",
   "compose": {
     "include": [
       {
-        "system": "http://hl7.org/fhir/ValueSet/quantity-comparator",
+        "system": "http://hl7.org/fhir/quantity-comparator",
         "concept": [
           {
             "code": "<",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-demographics-AddressUseVS.json b/lib/resources/standard_health_record/ValueSet-shr-demographics-AddressUseVS.json
old mode 100755
new mode 100644
index 7c7fe70..9a35536
--- a/lib/resources/standard_health_record/ValueSet-shr-demographics-AddressUseVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-demographics-AddressUseVS.json
@@ -10,16 +10,18 @@
     "status": "generated",
     "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR AddressUseVS ValueSet</b></p>\n<p>How an address is used by the subject, for example, as a dwelling or as a mailing address.</p>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-demographics-AddressUseVS",
+  "url": "http://standardhealthrecord.org/shr/demographics/vs/AddressUseVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.demographics.AddressUseVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR AddressUseVS ValueSet",
   "title": "SHR AddressUseVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.489Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,12 +33,11 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.813Z",
   "description": "How an address is used by the subject, for example, as a dwelling or as a mailing address.",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-demographics-AddressUseVS",
+        "system": "http://standardhealthrecord.org/shr/demographics/cs/AddressUseCS",
         "concept": [
           {
             "code": "primary_residence",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-demographics-InsuranceProviderTypeVS.json b/lib/resources/standard_health_record/ValueSet-shr-demographics-InsuranceProviderTypeVS.json
old mode 100755
new mode 100644
index 0414ef0..c42558b
--- a/lib/resources/standard_health_record/ValueSet-shr-demographics-InsuranceProviderTypeVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-demographics-InsuranceProviderTypeVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR InsuranceProviderTypeVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR InsuranceProviderTypeVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-demographics-InsuranceProviderTypeVS",
+  "url": "http://standardhealthrecord.org/shr/demographics/vs/InsuranceProviderTypeVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.demographics.InsuranceProviderTypeVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR InsuranceProviderTypeVS ValueSet",
   "title": "SHR InsuranceProviderTypeVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.490Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.813Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-demographics-InsuranceProviderTypeVS",
+        "system": "http://standardhealthrecord.org/shr/demographics/cs/InsuranceProviderTypeCS",
         "concept": [
           {
             "code": "chip",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-demographics-TelecomQualifierVS.json b/lib/resources/standard_health_record/ValueSet-shr-demographics-TelecomQualifierVS.json
old mode 100755
new mode 100644
index 9a64e68..083d7f7
--- a/lib/resources/standard_health_record/ValueSet-shr-demographics-TelecomQualifierVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-demographics-TelecomQualifierVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR TelecomQualifierVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR TelecomQualifierVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-demographics-TelecomQualifierVS",
+  "url": "http://standardhealthrecord.org/shr/demographics/vs/TelecomQualifierVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.demographics.TelecomQualifierVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR TelecomQualifierVS ValueSet",
   "title": "SHR TelecomQualifierVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.490Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.813Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-demographics-TelecomQualifierVS",
+        "system": "http://standardhealthrecord.org/shr/demographics/cs/TelecomQualifierCS",
         "concept": [
           {
             "code": "primary",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-demographics-TelephoneTypeVS.json b/lib/resources/standard_health_record/ValueSet-shr-demographics-TelephoneTypeVS.json
old mode 100755
new mode 100644
index 2c3aa42..f6deca0
--- a/lib/resources/standard_health_record/ValueSet-shr-demographics-TelephoneTypeVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-demographics-TelephoneTypeVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR TelephoneTypeVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR TelephoneTypeVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-demographics-TelephoneTypeVS",
+  "url": "http://standardhealthrecord.org/shr/demographics/vs/TelephoneTypeVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.demographics.TelephoneTypeVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR TelephoneTypeVS ValueSet",
   "title": "SHR TelephoneTypeVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.489Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.813Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-demographics-TelephoneTypeVS",
+        "system": "http://standardhealthrecord.org/shr/demographics/cs/TelephoneTypeCS",
         "concept": [
           {
             "code": "mobile",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-device-RespiratoryAssistDeviceVS.json b/lib/resources/standard_health_record/ValueSet-shr-device-RespiratoryAssistDeviceVS.json
old mode 100755
new mode 100644
index 72ae0f3..cdbfd65
--- a/lib/resources/standard_health_record/ValueSet-shr-device-RespiratoryAssistDeviceVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-device-RespiratoryAssistDeviceVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR RespiratoryAssistDeviceVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR RespiratoryAssistDeviceVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-device-RespiratoryAssistDeviceVS",
+  "url": "http://standardhealthrecord.org/shr/device/vs/RespiratoryAssistDeviceVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.device.RespiratoryAssistDeviceVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR RespiratoryAssistDeviceVS ValueSet",
   "title": "SHR RespiratoryAssistDeviceVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.490Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.813Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-device-RespiratoryAssistDeviceVS",
+        "system": "http://standardhealthrecord.org/shr/device/cs/RespiratoryAssistDeviceCS",
         "concept": [
           {
             "code": "apnea",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-device-RespiratoryRateSettingVS.json b/lib/resources/standard_health_record/ValueSet-shr-device-RespiratoryRateSettingVS.json
old mode 100755
new mode 100644
index 0a39a43..e3cb332
--- a/lib/resources/standard_health_record/ValueSet-shr-device-RespiratoryRateSettingVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-device-RespiratoryRateSettingVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR RespiratoryRateSettingVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR RespiratoryRateSettingVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-device-RespiratoryRateSettingVS",
+  "url": "http://standardhealthrecord.org/shr/device/vs/RespiratoryRateSettingVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.device.RespiratoryRateSettingVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR RespiratoryRateSettingVS ValueSet",
   "title": "SHR RespiratoryRateSettingVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.490Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.813Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-device-RespiratoryRateSettingVS",
+        "system": "http://standardhealthrecord.org/shr/device/cs/RespiratoryRateSettingCS",
         "concept": [
           {
             "code": "set_min_alarm",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-encounter-EncounterTypeVS.json b/lib/resources/standard_health_record/ValueSet-shr-encounter-EncounterTypeVS.json
old mode 100755
new mode 100644
index 0c5a272..d8b4a9c
--- a/lib/resources/standard_health_record/ValueSet-shr-encounter-EncounterTypeVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-encounter-EncounterTypeVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR EncounterTypeVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR EncounterTypeVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-encounter-EncounterTypeVS",
+  "url": "http://standardhealthrecord.org/shr/encounter/vs/EncounterTypeVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.encounter.EncounterTypeVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR EncounterTypeVS ValueSet",
   "title": "SHR EncounterTypeVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.490Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.813Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-encounter-EncounterTypeVS",
+        "system": "http://standardhealthrecord.org/shr/encounter/cs/EncounterTypeCS",
         "concept": [
           {
             "code": "inpatient",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-encounter-EncounterUrgencyVS.json b/lib/resources/standard_health_record/ValueSet-shr-encounter-EncounterUrgencyVS.json
old mode 100755
new mode 100644
index 79ddea1..bb0f58d
--- a/lib/resources/standard_health_record/ValueSet-shr-encounter-EncounterUrgencyVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-encounter-EncounterUrgencyVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR EncounterUrgencyVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR EncounterUrgencyVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-encounter-EncounterUrgencyVS",
+  "url": "http://standardhealthrecord.org/shr/encounter/vs/EncounterUrgencyVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.encounter.EncounterUrgencyVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR EncounterUrgencyVS ValueSet",
   "title": "SHR EncounterUrgencyVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.490Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,7 +33,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.813Z",
   "compose": {
     "include": [
       {
diff --git a/lib/resources/standard_health_record/ValueSet-shr-encounter-EpisodeOfCareCompletionVS.json b/lib/resources/standard_health_record/ValueSet-shr-encounter-EpisodeOfCareCompletionVS.json
old mode 100755
new mode 100644
index 4e6e32c..d1b6f20
--- a/lib/resources/standard_health_record/ValueSet-shr-encounter-EpisodeOfCareCompletionVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-encounter-EpisodeOfCareCompletionVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR EpisodeOfCareCompletionVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR EpisodeOfCareCompletionVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-encounter-EpisodeOfCareCompletionVS",
+  "url": "http://standardhealthrecord.org/shr/encounter/vs/EpisodeOfCareCompletionVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.encounter.EpisodeOfCareCompletionVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR EpisodeOfCareCompletionVS ValueSet",
   "title": "SHR EpisodeOfCareCompletionVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.490Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.813Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-encounter-EpisodeOfCareCompletionVS",
+        "system": "http://standardhealthrecord.org/shr/encounter/cs/EpisodeOfCareCompletionCS",
         "concept": [
           {
             "code": "completed",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-encounter-ReasonEncounterDidNotHappenVS.json b/lib/resources/standard_health_record/ValueSet-shr-encounter-ReasonEncounterDidNotHappenVS.json
old mode 100755
new mode 100644
index e38a375..cba2bcc
--- a/lib/resources/standard_health_record/ValueSet-shr-encounter-ReasonEncounterDidNotHappenVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-encounter-ReasonEncounterDidNotHappenVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ReasonEncounterDidNotHappenVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ReasonEncounterDidNotHappenVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-encounter-ReasonEncounterDidNotHappenVS",
+  "url": "http://standardhealthrecord.org/shr/encounter/vs/ReasonEncounterDidNotHappenVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.encounter.ReasonEncounterDidNotHappenVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ReasonEncounterDidNotHappenVS ValueSet",
   "title": "SHR ReasonEncounterDidNotHappenVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.490Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.813Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-encounter-ReasonEncounterDidNotHappenVS",
+        "system": "http://standardhealthrecord.org/shr/encounter/cs/ReasonEncounterDidNotHappenCS",
         "concept": [
           {
             "code": "cancelled",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-encounter-ReferralSourceTypeVS.json b/lib/resources/standard_health_record/ValueSet-shr-encounter-ReferralSourceTypeVS.json
old mode 100755
new mode 100644
index 14a3ad0..605a5e7
--- a/lib/resources/standard_health_record/ValueSet-shr-encounter-ReferralSourceTypeVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-encounter-ReferralSourceTypeVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ReferralSourceTypeVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ReferralSourceTypeVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-encounter-ReferralSourceTypeVS",
+  "url": "http://standardhealthrecord.org/shr/encounter/vs/ReferralSourceTypeVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.encounter.ReferralSourceTypeVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ReferralSourceTypeVS ValueSet",
   "title": "SHR ReferralSourceTypeVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.490Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.813Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-encounter-ReferralSourceTypeVS",
+        "system": "http://standardhealthrecord.org/shr/encounter/cs/ReferralSourceTypeCS",
         "concept": [
           {
             "code": "self",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-encounter-TreatmentCooperationVS.json b/lib/resources/standard_health_record/ValueSet-shr-encounter-TreatmentCooperationVS.json
old mode 100755
new mode 100644
index aeba5e4..a30e134
--- a/lib/resources/standard_health_record/ValueSet-shr-encounter-TreatmentCooperationVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-encounter-TreatmentCooperationVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR TreatmentCooperationVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR TreatmentCooperationVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-encounter-TreatmentCooperationVS",
+  "url": "http://standardhealthrecord.org/shr/encounter/vs/TreatmentCooperationVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.encounter.TreatmentCooperationVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR TreatmentCooperationVS ValueSet",
   "title": "SHR TreatmentCooperationVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.490Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.813Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-encounter-TreatmentCooperationVS",
+        "system": "http://standardhealthrecord.org/shr/encounter/cs/TreatmentCooperationCS",
         "concept": [
           {
             "code": "voluntary",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-environment-AnimalExposureVS.json b/lib/resources/standard_health_record/ValueSet-shr-environment-AnimalExposureVS.json
old mode 100755
new mode 100644
index e10de27..d3512a1
--- a/lib/resources/standard_health_record/ValueSet-shr-environment-AnimalExposureVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-environment-AnimalExposureVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR AnimalExposureVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR AnimalExposureVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-environment-AnimalExposureVS",
+  "url": "http://standardhealthrecord.org/shr/environment/vs/AnimalExposureVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.environment.AnimalExposureVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR AnimalExposureVS ValueSet",
   "title": "SHR AnimalExposureVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.491Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.813Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-environment-AnimalExposureVS",
+        "system": "http://standardhealthrecord.org/shr/environment/cs/AnimalExposureCS",
         "concept": [
           {
             "code": "dog",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-environment-CoinhabitantVS.json b/lib/resources/standard_health_record/ValueSet-shr-environment-CoinhabitantVS.json
old mode 100755
new mode 100644
index 6651216..c987a3b
--- a/lib/resources/standard_health_record/ValueSet-shr-environment-CoinhabitantVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-environment-CoinhabitantVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR CoinhabitantVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR CoinhabitantVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-environment-CoinhabitantVS",
+  "url": "http://standardhealthrecord.org/shr/environment/vs/CoinhabitantVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.environment.CoinhabitantVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR CoinhabitantVS ValueSet",
   "title": "SHR CoinhabitantVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.491Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.814Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-environment-CoinhabitantVS",
+        "system": "http://standardhealthrecord.org/shr/environment/cs/CoinhabitantCS",
         "concept": [
           {
             "code": "partner",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-environment-HomeEnvironmentRiskVS.json b/lib/resources/standard_health_record/ValueSet-shr-environment-HomeEnvironmentRiskVS.json
old mode 100755
new mode 100644
index 229b118..942d1fb
--- a/lib/resources/standard_health_record/ValueSet-shr-environment-HomeEnvironmentRiskVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-environment-HomeEnvironmentRiskVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR HomeEnvironmentRiskVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR HomeEnvironmentRiskVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-environment-HomeEnvironmentRiskVS",
+  "url": "http://standardhealthrecord.org/shr/environment/vs/HomeEnvironmentRiskVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.environment.HomeEnvironmentRiskVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR HomeEnvironmentRiskVS ValueSet",
   "title": "SHR HomeEnvironmentRiskVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.491Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.814Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-environment-HomeEnvironmentRiskVS",
+        "system": "http://standardhealthrecord.org/shr/environment/cs/HomeEnvironmentRiskCS",
         "concept": [
           {
             "code": "guns",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-environment-IncomeSourceVS.json b/lib/resources/standard_health_record/ValueSet-shr-environment-IncomeSourceVS.json
old mode 100755
new mode 100644
index 1525183..7ac2d17
--- a/lib/resources/standard_health_record/ValueSet-shr-environment-IncomeSourceVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-environment-IncomeSourceVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR IncomeSourceVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR IncomeSourceVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-environment-IncomeSourceVS",
+  "url": "http://standardhealthrecord.org/shr/environment/vs/IncomeSourceVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.environment.IncomeSourceVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR IncomeSourceVS ValueSet",
   "title": "SHR IncomeSourceVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.491Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.813Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-environment-IncomeSourceVS",
+        "system": "http://standardhealthrecord.org/shr/environment/cs/IncomeSourceCS",
         "concept": [
           {
             "code": "earned",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-environment-NonCashBenefitVS.json b/lib/resources/standard_health_record/ValueSet-shr-environment-NonCashBenefitVS.json
old mode 100755
new mode 100644
index 978cc12..87214d2
--- a/lib/resources/standard_health_record/ValueSet-shr-environment-NonCashBenefitVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-environment-NonCashBenefitVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR NonCashBenefitVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR NonCashBenefitVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-environment-NonCashBenefitVS",
+  "url": "http://standardhealthrecord.org/shr/environment/vs/NonCashBenefitVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.environment.NonCashBenefitVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR NonCashBenefitVS ValueSet",
   "title": "SHR NonCashBenefitVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.491Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.813Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-environment-NonCashBenefitVS",
+        "system": "http://standardhealthrecord.org/shr/environment/cs/NonCashBenefitCS",
         "concept": [
           {
             "code": "snap",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-environment-ResourceStabilityVS.json b/lib/resources/standard_health_record/ValueSet-shr-environment-ResourceStabilityVS.json
old mode 100755
new mode 100644
index 716dc4d..fd84811
--- a/lib/resources/standard_health_record/ValueSet-shr-environment-ResourceStabilityVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-environment-ResourceStabilityVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ResourceStabilityVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ResourceStabilityVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-environment-ResourceStabilityVS",
+  "url": "http://standardhealthrecord.org/shr/environment/vs/ResourceStabilityVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.environment.ResourceStabilityVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ResourceStabilityVS ValueSet",
   "title": "SHR ResourceStabilityVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.490Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.813Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-environment-ResourceStabilityVS",
+        "system": "http://standardhealthrecord.org/shr/environment/cs/ResourceStabilityCS",
         "concept": [
           {
             "code": "stable",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-immunization-ImmunizationNotGivenReasonVS.json b/lib/resources/standard_health_record/ValueSet-shr-immunization-ImmunizationNotGivenReasonVS.json
old mode 100755
new mode 100644
index 825294d..640f69e
--- a/lib/resources/standard_health_record/ValueSet-shr-immunization-ImmunizationNotGivenReasonVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-immunization-ImmunizationNotGivenReasonVS.json
@@ -10,16 +10,18 @@
     "status": "generated",
     "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ImmunizationNotGivenReasonVS ValueSet</b></p>\n<p>Reasons for an immunization not given or not recommended. SHR does not use http://hl7.org/fhir/ValueSet/no-immunization-reason because it includes SNOMED precoordinated codes,such as SCT#171266004 No consent - diphtheria immunization.</p>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-immunization-ImmunizationNotGivenReasonVS",
+  "url": "http://standardhealthrecord.org/shr/immunization/vs/ImmunizationNotGivenReasonVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.immunization.ImmunizationNotGivenReasonVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ImmunizationNotGivenReasonVS ValueSet",
   "title": "SHR ImmunizationNotGivenReasonVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.491Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,7 +33,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.814Z",
   "description": "Reasons for an immunization not given or not recommended. SHR does not use http://hl7.org/fhir/ValueSet/no-immunization-reason because it includes SNOMED precoordinated codes,such as SCT#171266004 No consent - diphtheria immunization.",
   "compose": {
     "include": [
diff --git a/lib/resources/standard_health_record/ValueSet-shr-lab-ChangeFlagVS.json b/lib/resources/standard_health_record/ValueSet-shr-lab-ChangeFlagVS.json
old mode 100755
new mode 100644
index 42f17f0..f5b84dd
--- a/lib/resources/standard_health_record/ValueSet-shr-lab-ChangeFlagVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-lab-ChangeFlagVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ChangeFlagVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ChangeFlagVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-ChangeFlagVS",
+  "url": "http://standardhealthrecord.org/shr/lab/vs/ChangeFlagVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.lab.ChangeFlagVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ChangeFlagVS ValueSet",
   "title": "SHR ChangeFlagVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.491Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,7 +33,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.814Z",
   "compose": {
     "include": [
       {
diff --git a/lib/resources/standard_health_record/ValueSet-shr-lab-HIVScreeningTestCodeVS.json b/lib/resources/standard_health_record/ValueSet-shr-lab-HIVScreeningTestCodeVS.json
old mode 100755
new mode 100644
index 29644d9..ae6c43e
--- a/lib/resources/standard_health_record/ValueSet-shr-lab-HIVScreeningTestCodeVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-lab-HIVScreeningTestCodeVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR HIVScreeningTestCodeVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR HIVScreeningTestCodeVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-HIVScreeningTestCodeVS",
+  "url": "http://standardhealthrecord.org/shr/lab/vs/HIVScreeningTestCodeVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.lab.HIVScreeningTestCodeVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR HIVScreeningTestCodeVS ValueSet",
   "title": "SHR HIVScreeningTestCodeVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.491Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -30,6 +32,5 @@
         }
       ]
     }
-  ],
-  "date": "2017-03-21T00:21:35.814Z"
+  ]
 }
\ No newline at end of file
diff --git a/lib/resources/standard_health_record/ValueSet-shr-lab-HIVScreeningTestResultVS.json b/lib/resources/standard_health_record/ValueSet-shr-lab-HIVScreeningTestResultVS.json
old mode 100755
new mode 100644
index 0ca7d51..42201b5
--- a/lib/resources/standard_health_record/ValueSet-shr-lab-HIVScreeningTestResultVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-lab-HIVScreeningTestResultVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR HIVScreeningTestResultVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR HIVScreeningTestResultVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-HIVScreeningTestResultVS",
+  "url": "http://standardhealthrecord.org/shr/lab/vs/HIVScreeningTestResultVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.lab.HIVScreeningTestResultVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR HIVScreeningTestResultVS ValueSet",
   "title": "SHR HIVScreeningTestResultVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.491Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,7 +33,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.814Z",
   "compose": {
     "include": [
       {
diff --git a/lib/resources/standard_health_record/ValueSet-shr-lab-HIVSupplementalTestCodeVS.json b/lib/resources/standard_health_record/ValueSet-shr-lab-HIVSupplementalTestCodeVS.json
old mode 100755
new mode 100644
index 5c6dfd4..56500b2
--- a/lib/resources/standard_health_record/ValueSet-shr-lab-HIVSupplementalTestCodeVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-lab-HIVSupplementalTestCodeVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR HIVSupplementalTestCodeVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR HIVSupplementalTestCodeVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-HIVSupplementalTestCodeVS",
+  "url": "http://standardhealthrecord.org/shr/lab/vs/HIVSupplementalTestCodeVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.lab.HIVSupplementalTestCodeVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR HIVSupplementalTestCodeVS ValueSet",
   "title": "SHR HIVSupplementalTestCodeVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.491Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -30,6 +32,5 @@
         }
       ]
     }
-  ],
-  "date": "2017-03-21T00:21:35.814Z"
+  ]
 }
\ No newline at end of file
diff --git a/lib/resources/standard_health_record/ValueSet-shr-lab-HIVSupplementalTestResultVS.json b/lib/resources/standard_health_record/ValueSet-shr-lab-HIVSupplementalTestResultVS.json
old mode 100755
new mode 100644
index 9a08d5a..23a79db
--- a/lib/resources/standard_health_record/ValueSet-shr-lab-HIVSupplementalTestResultVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-lab-HIVSupplementalTestResultVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR HIVSupplementalTestResultVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR HIVSupplementalTestResultVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-HIVSupplementalTestResultVS",
+  "url": "http://standardhealthrecord.org/shr/lab/vs/HIVSupplementalTestResultVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.lab.HIVSupplementalTestResultVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR HIVSupplementalTestResultVS ValueSet",
   "title": "SHR HIVSupplementalTestResultVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.492Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,7 +33,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.814Z",
   "compose": {
     "include": [
       {
diff --git a/lib/resources/standard_health_record/ValueSet-shr-lab-RequestStatusVS.json b/lib/resources/standard_health_record/ValueSet-shr-lab-RequestStatusVS.json
old mode 100755
new mode 100644
index 56dbac2..e1bf058
--- a/lib/resources/standard_health_record/ValueSet-shr-lab-RequestStatusVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-lab-RequestStatusVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR RequestStatusVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR RequestStatusVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-RequestStatusVS",
+  "url": "http://standardhealthrecord.org/shr/lab/vs/RequestStatusVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.lab.RequestStatusVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR RequestStatusVS ValueSet",
   "title": "SHR RequestStatusVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.491Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.814Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-lab-RequestStatusVS",
+        "system": "http://standardhealthrecord.org/shr/lab/cs/RequestStatusCS",
         "concept": [
           {
             "code": "active",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-lab-TestInterpretationVS.json b/lib/resources/standard_health_record/ValueSet-shr-lab-TestInterpretationVS.json
old mode 100755
new mode 100644
index c6c83e0..85dd1e9
--- a/lib/resources/standard_health_record/ValueSet-shr-lab-TestInterpretationVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-lab-TestInterpretationVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR TestInterpretationVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR TestInterpretationVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-TestInterpretationVS",
+  "url": "http://standardhealthrecord.org/shr/lab/vs/TestInterpretationVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.lab.TestInterpretationVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR TestInterpretationVS ValueSet",
   "title": "SHR TestInterpretationVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.491Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,7 +33,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.814Z",
   "compose": {
     "include": [
       {
diff --git a/lib/resources/standard_health_record/ValueSet-shr-lifehistory-CongenitalAbnormalitiesVS.json b/lib/resources/standard_health_record/ValueSet-shr-lifehistory-CongenitalAbnormalitiesVS.json
old mode 100755
new mode 100644
index 3b2a727..592a567
--- a/lib/resources/standard_health_record/ValueSet-shr-lifehistory-CongenitalAbnormalitiesVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-lifehistory-CongenitalAbnormalitiesVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR CongenitalAbnormalitiesVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR CongenitalAbnormalitiesVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-lifehistory-CongenitalAbnormalitiesVS",
+  "url": "http://standardhealthrecord.org/shr/lifehistory/vs/CongenitalAbnormalitiesVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.lifehistory.CongenitalAbnormalitiesVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR CongenitalAbnormalitiesVS ValueSet",
   "title": "SHR CongenitalAbnormalitiesVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.492Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,7 +33,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.814Z",
   "compose": {
     "include": [
       {
diff --git a/lib/resources/standard_health_record/ValueSet-shr-lifehistory-EducationalAttainmentVS.json b/lib/resources/standard_health_record/ValueSet-shr-lifehistory-EducationalAttainmentVS.json
old mode 100755
new mode 100644
index 92af67c..67efe42
--- a/lib/resources/standard_health_record/ValueSet-shr-lifehistory-EducationalAttainmentVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-lifehistory-EducationalAttainmentVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR EducationalAttainmentVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR EducationalAttainmentVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-lifehistory-EducationalAttainmentVS",
+  "url": "http://standardhealthrecord.org/shr/lifehistory/vs/EducationalAttainmentVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.lifehistory.EducationalAttainmentVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR EducationalAttainmentVS ValueSet",
   "title": "SHR EducationalAttainmentVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.492Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.814Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-lifehistory-EducationalAttainmentVS",
+        "system": "http://standardhealthrecord.org/shr/lifehistory/cs/EducationalAttainmentCS",
         "concept": [
           {
             "code": "no_formal",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-lifehistory-EmploymentStatusVS.json b/lib/resources/standard_health_record/ValueSet-shr-lifehistory-EmploymentStatusVS.json
old mode 100755
new mode 100644
index 64b70e2..396730e
--- a/lib/resources/standard_health_record/ValueSet-shr-lifehistory-EmploymentStatusVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-lifehistory-EmploymentStatusVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR EmploymentStatusVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR EmploymentStatusVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-lifehistory-EmploymentStatusVS",
+  "url": "http://standardhealthrecord.org/shr/lifehistory/vs/EmploymentStatusVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.lifehistory.EmploymentStatusVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR EmploymentStatusVS ValueSet",
   "title": "SHR EmploymentStatusVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.492Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.814Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-lifehistory-EmploymentStatusVS",
+        "system": "http://standardhealthrecord.org/shr/lifehistory/cs/EmploymentStatusCS",
         "concept": [
           {
             "code": "self_employed",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-lifehistory-MilitaryServiceDischargeStatusVS.json b/lib/resources/standard_health_record/ValueSet-shr-lifehistory-MilitaryServiceDischargeStatusVS.json
old mode 100755
new mode 100644
index b73a6b7..b85995f
--- a/lib/resources/standard_health_record/ValueSet-shr-lifehistory-MilitaryServiceDischargeStatusVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-lifehistory-MilitaryServiceDischargeStatusVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR MilitaryServiceDischargeStatusVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR MilitaryServiceDischargeStatusVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-lifehistory-MilitaryServiceDischargeStatusVS",
+  "url": "http://standardhealthrecord.org/shr/lifehistory/vs/MilitaryServiceDischargeStatusVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.lifehistory.MilitaryServiceDischargeStatusVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR MilitaryServiceDischargeStatusVS ValueSet",
   "title": "SHR MilitaryServiceDischargeStatusVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.492Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.814Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-lifehistory-MilitaryServiceDischargeStatusVS",
+        "system": "http://standardhealthrecord.org/shr/lifehistory/cs/MilitaryServiceDischargeStatusCS",
         "concept": [
           {
             "code": "bad",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-lifehistory-MilitaryServiceEraVS.json b/lib/resources/standard_health_record/ValueSet-shr-lifehistory-MilitaryServiceEraVS.json
old mode 100755
new mode 100644
index 59c2a09..c513df7
--- a/lib/resources/standard_health_record/ValueSet-shr-lifehistory-MilitaryServiceEraVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-lifehistory-MilitaryServiceEraVS.json
@@ -10,16 +10,18 @@
     "status": "generated",
     "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR MilitaryServiceEraVS ValueSet</b></p>\n<p>Values were taken from Final HMIS Data Standards March 2010 (Homeless Management Information System), field 4.15E Veteran’s Information. See: https://www.onecpd.info/resources/documents/FinalHMISDataStandards_March2010.pdf.</p>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-lifehistory-MilitaryServiceEraVS",
+  "url": "http://standardhealthrecord.org/shr/lifehistory/vs/MilitaryServiceEraVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.lifehistory.MilitaryServiceEraVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR MilitaryServiceEraVS ValueSet",
   "title": "SHR MilitaryServiceEraVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.492Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,12 +33,11 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.814Z",
   "description": "Values were taken from Final HMIS Data Standards March 2010 (Homeless Management Information System), field 4.15E Veteran’s Information. See: https://www.onecpd.info/resources/documents/FinalHMISDataStandards_March2010.pdf.",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-lifehistory-MilitaryServiceEraVS",
+        "system": "http://standardhealthrecord.org/shr/lifehistory/cs/MilitaryServiceEraCS",
         "concept": [
           {
             "code": "post_9_11_era",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-lifehistory-MilitaryStatusVS.json b/lib/resources/standard_health_record/ValueSet-shr-lifehistory-MilitaryStatusVS.json
old mode 100755
new mode 100644
index 61145d2..fed4ef3
--- a/lib/resources/standard_health_record/ValueSet-shr-lifehistory-MilitaryStatusVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-lifehistory-MilitaryStatusVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR MilitaryStatusVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR MilitaryStatusVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-lifehistory-MilitaryStatusVS",
+  "url": "http://standardhealthrecord.org/shr/lifehistory/vs/MilitaryStatusVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.lifehistory.MilitaryStatusVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR MilitaryStatusVS ValueSet",
   "title": "SHR MilitaryStatusVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.492Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.814Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-lifehistory-MilitaryStatusVS",
+        "system": "http://standardhealthrecord.org/shr/lifehistory/cs/MilitaryStatusCS",
         "concept": [
           {
             "code": "active",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-lifehistory-TeratogenVS.json b/lib/resources/standard_health_record/ValueSet-shr-lifehistory-TeratogenVS.json
old mode 100755
new mode 100644
index dda9c86..89918a1
--- a/lib/resources/standard_health_record/ValueSet-shr-lifehistory-TeratogenVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-lifehistory-TeratogenVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR TeratogenVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR TeratogenVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-lifehistory-TeratogenVS",
+  "url": "http://standardhealthrecord.org/shr/lifehistory/vs/TeratogenVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.lifehistory.TeratogenVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR TeratogenVS ValueSet",
   "title": "SHR TeratogenVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.492Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.814Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-lifehistory-TeratogenVS",
+        "system": "http://standardhealthrecord.org/shr/lifehistory/cs/TeratogenCS",
         "concept": [
           {
             "code": "chlamydia",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-lifehistory-USMilitaryBranchVS.json b/lib/resources/standard_health_record/ValueSet-shr-lifehistory-USMilitaryBranchVS.json
old mode 100755
new mode 100644
index 54dc819..266d6ab
--- a/lib/resources/standard_health_record/ValueSet-shr-lifehistory-USMilitaryBranchVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-lifehistory-USMilitaryBranchVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR USMilitaryBranchVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR USMilitaryBranchVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-lifehistory-USMilitaryBranchVS",
+  "url": "http://standardhealthrecord.org/shr/lifehistory/vs/USMilitaryBranchVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.lifehistory.USMilitaryBranchVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR USMilitaryBranchVS ValueSet",
   "title": "SHR USMilitaryBranchVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.492Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.814Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-lifehistory-USMilitaryBranchVS",
+        "system": "http://standardhealthrecord.org/shr/lifehistory/cs/USMilitaryBranchCS",
         "concept": [
           {
             "code": "usa",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-medication-MedicationChangeReasonVS.json b/lib/resources/standard_health_record/ValueSet-shr-medication-MedicationChangeReasonVS.json
old mode 100755
new mode 100644
index c445160..558c561
--- a/lib/resources/standard_health_record/ValueSet-shr-medication-MedicationChangeReasonVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-medication-MedicationChangeReasonVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR MedicationChangeReasonVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR MedicationChangeReasonVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-medication-MedicationChangeReasonVS",
+  "url": "http://standardhealthrecord.org/shr/medication/vs/MedicationChangeReasonVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.medication.MedicationChangeReasonVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR MedicationChangeReasonVS ValueSet",
   "title": "SHR MedicationChangeReasonVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.492Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.815Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-medication-MedicationChangeReasonVS",
+        "system": "http://standardhealthrecord.org/shr/medication/cs/MedicationChangeReasonCS",
         "concept": [
           {
             "code": "not_needed",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-medication-MedicationChangeTypeVS.json b/lib/resources/standard_health_record/ValueSet-shr-medication-MedicationChangeTypeVS.json
old mode 100755
new mode 100644
index ec0333c..f4b1367
--- a/lib/resources/standard_health_record/ValueSet-shr-medication-MedicationChangeTypeVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-medication-MedicationChangeTypeVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR MedicationChangeTypeVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR MedicationChangeTypeVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-medication-MedicationChangeTypeVS",
+  "url": "http://standardhealthrecord.org/shr/medication/vs/MedicationChangeTypeVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.medication.MedicationChangeTypeVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR MedicationChangeTypeVS ValueSet",
   "title": "SHR MedicationChangeTypeVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.492Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.815Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-medication-MedicationChangeTypeVS",
+        "system": "http://standardhealthrecord.org/shr/medication/cs/MedicationChangeTypeCS",
         "concept": [
           {
             "code": "reduced",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-medication-MedicationNonAdherenceReasonVS.json b/lib/resources/standard_health_record/ValueSet-shr-medication-MedicationNonAdherenceReasonVS.json
old mode 100755
new mode 100644
index 6b8f77d..b0f889b
--- a/lib/resources/standard_health_record/ValueSet-shr-medication-MedicationNonAdherenceReasonVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-medication-MedicationNonAdherenceReasonVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR MedicationNonAdherenceReasonVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR MedicationNonAdherenceReasonVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-medication-MedicationNonAdherenceReasonVS",
+  "url": "http://standardhealthrecord.org/shr/medication/vs/MedicationNonAdherenceReasonVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.medication.MedicationNonAdherenceReasonVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR MedicationNonAdherenceReasonVS ValueSet",
   "title": "SHR MedicationNonAdherenceReasonVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.492Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,7 +33,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.815Z",
   "compose": {
     "include": [
       {
diff --git a/lib/resources/standard_health_record/ValueSet-shr-medication-MedicationVS.json b/lib/resources/standard_health_record/ValueSet-shr-medication-MedicationVS.json
new file mode 100644
index 0000000..7f3477c
--- /dev/null
+++ b/lib/resources/standard_health_record/ValueSet-shr-medication-MedicationVS.json
@@ -0,0 +1,43 @@
+{
+  "resourceType": "ValueSet",
+  "id": "shr-medication-MedicationVS",
+  "meta": {
+    "profile": [
+      "http://hl7.org/fhir/StructureDefinition/valueset-shareable-definition"
+    ]
+  },
+  "text": {
+    "status": "generated",
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR MedicationVS ValueSet</b></p>\n<p/>\n</div>"
+  },
+  "url": "http://standardhealthrecord.org/shr/medication/vs/MedicationVS",
+  "identifier": [
+    {
+      "system": "http://standardhealthrecord.org",
+      "value": "shr.medication.MedicationVS"
+    }
+  ],
+  "version": "0.0.1",
+  "name": "SHR MedicationVS ValueSet",
+  "title": "SHR MedicationVS ValueSet",
+  "status": "draft",
+  "date": "2017-04-18T15:12:20.492Z",
+  "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
+  "contact": [
+    {
+      "telecom": [
+        {
+          "system": "url",
+          "value": "http://www.standardhealthrecord.org"
+        }
+      ]
+    }
+  ],
+  "compose": {
+    "include": [
+      {
+        "system": "http://www.nlm.nih.gov/research/umls/rxnorm"
+      }
+    ]
+  }
+}
\ No newline at end of file
diff --git a/lib/resources/standard_health_record/ValueSet-shr-medication-ReasonMedicationNotUsedVS.json b/lib/resources/standard_health_record/ValueSet-shr-medication-ReasonMedicationNotUsedVS.json
old mode 100755
new mode 100644
index dd9fbb3..ab475b7
--- a/lib/resources/standard_health_record/ValueSet-shr-medication-ReasonMedicationNotUsedVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-medication-ReasonMedicationNotUsedVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ReasonMedicationNotUsedVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ReasonMedicationNotUsedVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-medication-ReasonMedicationNotUsedVS",
+  "url": "http://standardhealthrecord.org/shr/medication/vs/ReasonMedicationNotUsedVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.medication.ReasonMedicationNotUsedVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ReasonMedicationNotUsedVS ValueSet",
   "title": "SHR ReasonMedicationNotUsedVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.492Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.814Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-medication-ReasonMedicationNotUsedVS",
+        "system": "http://standardhealthrecord.org/shr/medication/cs/ReasonMedicationNotUsedCS",
         "concept": [
           {
             "code": "not_indicated",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-observation-ExposureReasonVS.json b/lib/resources/standard_health_record/ValueSet-shr-observation-ExposureReasonVS.json
old mode 100755
new mode 100644
index 7a785f8..f5e59e8
--- a/lib/resources/standard_health_record/ValueSet-shr-observation-ExposureReasonVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-observation-ExposureReasonVS.json
@@ -10,16 +10,18 @@
     "status": "generated",
     "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ExposureReasonVS ValueSet</b></p>\n<p>The reason that an exposure occurred.</p>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-observation-ExposureReasonVS",
+  "url": "http://standardhealthrecord.org/shr/observation/vs/ExposureReasonVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.observation.ExposureReasonVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ExposureReasonVS ValueSet",
   "title": "SHR ExposureReasonVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.492Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,12 +33,11 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.815Z",
   "description": "The reason that an exposure occurred.",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-observation-ExposureReasonVS",
+        "system": "http://standardhealthrecord.org/shr/observation/cs/ExposureReasonCS",
         "concept": [
           {
             "code": "voluntary",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-observation-NonLabObservationStatusVS.json b/lib/resources/standard_health_record/ValueSet-shr-observation-NonLabObservationStatusVS.json
old mode 100755
new mode 100644
index 209500c..6ef2d73
--- a/lib/resources/standard_health_record/ValueSet-shr-observation-NonLabObservationStatusVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-observation-NonLabObservationStatusVS.json
@@ -10,16 +10,18 @@
     "status": "generated",
     "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR NonLabObservationStatusVS ValueSet</b></p>\n<p>Whether the observation is complete and definite. The set of values is a subset of status values associated with lab tests.</p>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-observation-NonLabObservationStatusVS",
+  "url": "http://standardhealthrecord.org/shr/observation/vs/NonLabObservationStatusVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.observation.NonLabObservationStatusVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR NonLabObservationStatusVS ValueSet",
   "title": "SHR NonLabObservationStatusVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.492Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,7 +33,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.815Z",
   "description": "Whether the observation is complete and definite. The set of values is a subset of status values associated with lab tests.",
   "compose": {
     "include": [
diff --git a/lib/resources/standard_health_record/ValueSet-shr-observation-ObservationNotMadeReasonVS.json b/lib/resources/standard_health_record/ValueSet-shr-observation-ObservationNotMadeReasonVS.json
old mode 100755
new mode 100644
index 6748c91..94941e0
--- a/lib/resources/standard_health_record/ValueSet-shr-observation-ObservationNotMadeReasonVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-observation-ObservationNotMadeReasonVS.json
@@ -10,16 +10,18 @@
     "status": "generated",
     "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ObservationNotMadeReasonVS ValueSet</b></p>\n<p>An explanation of why the observation was not made (or ordered), i.e., why test was not ordered, or why a question was not asked. Since an observation is really a type of procedure, reasons that an observation was not carried out are similar to reasons any procedure might not be carried out.</p>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-observation-ObservationNotMadeReasonVS",
+  "url": "http://standardhealthrecord.org/shr/observation/vs/ObservationNotMadeReasonVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.observation.ObservationNotMadeReasonVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ObservationNotMadeReasonVS ValueSet",
   "title": "SHR ObservationNotMadeReasonVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.492Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,12 +33,11 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.815Z",
   "description": "An explanation of why the observation was not made (or ordered), i.e., why test was not ordered, or why a question was not asked. Since an observation is really a type of procedure, reasons that an observation was not carried out are similar to reasons any procedure might not be carried out.",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-observation-ObservationNotMadeReasonVS",
+        "system": "http://standardhealthrecord.org/shr/observation/cs/ObservationNotMadeReasonCS",
         "concept": [
           {
             "code": "not_applicable",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-problem-DSMVS.json b/lib/resources/standard_health_record/ValueSet-shr-problem-DSMVS.json
new file mode 100644
index 0000000..69764ed
--- /dev/null
+++ b/lib/resources/standard_health_record/ValueSet-shr-problem-DSMVS.json
@@ -0,0 +1,43 @@
+{
+  "resourceType": "ValueSet",
+  "id": "shr-problem-DSMVS",
+  "meta": {
+    "profile": [
+      "http://hl7.org/fhir/StructureDefinition/valueset-shareable-definition"
+    ]
+  },
+  "text": {
+    "status": "generated",
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR DSMVS ValueSet</b></p>\n<p/>\n</div>"
+  },
+  "url": "http://standardhealthrecord.org/shr/problem/vs/DSMVS",
+  "identifier": [
+    {
+      "system": "http://standardhealthrecord.org",
+      "value": "shr.problem.DSMVS"
+    }
+  ],
+  "version": "0.0.1",
+  "name": "SHR DSMVS ValueSet",
+  "title": "SHR DSMVS ValueSet",
+  "status": "draft",
+  "date": "2017-04-18T15:12:20.492Z",
+  "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
+  "contact": [
+    {
+      "telecom": [
+        {
+          "system": "url",
+          "value": "http://www.standardhealthrecord.org"
+        }
+      ]
+    }
+  ],
+  "compose": {
+    "include": [
+      {
+        "system": "http://www.dsm5.org/"
+      }
+    ]
+  }
+}
\ No newline at end of file
diff --git a/lib/resources/standard_health_record/ValueSet-shr-problem-EvidenceQualityVS.json b/lib/resources/standard_health_record/ValueSet-shr-problem-EvidenceQualityVS.json
old mode 100755
new mode 100644
index 72305b0..e94b375
--- a/lib/resources/standard_health_record/ValueSet-shr-problem-EvidenceQualityVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-problem-EvidenceQualityVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR EvidenceQualityVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR EvidenceQualityVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-problem-EvidenceQualityVS",
+  "url": "http://standardhealthrecord.org/shr/problem/vs/EvidenceQualityVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.problem.EvidenceQualityVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR EvidenceQualityVS ValueSet",
   "title": "SHR EvidenceQualityVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.492Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.815Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-problem-EvidenceQualityVS",
+        "system": "http://standardhealthrecord.org/shr/problem/cs/EvidenceQualityCS",
         "concept": [
           {
             "code": "compelling_evidence",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-problem-GradeOrStageVS.json b/lib/resources/standard_health_record/ValueSet-shr-problem-GradeOrStageVS.json
old mode 100755
new mode 100644
index 479a906..6472418
--- a/lib/resources/standard_health_record/ValueSet-shr-problem-GradeOrStageVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-problem-GradeOrStageVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR GradeOrStageVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR GradeOrStageVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-problem-GradeOrStageVS",
+  "url": "http://standardhealthrecord.org/shr/problem/vs/GradeOrStageVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.problem.GradeOrStageVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR GradeOrStageVS ValueSet",
   "title": "SHR GradeOrStageVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.492Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.815Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-problem-GradeOrStageVS",
+        "system": "http://standardhealthrecord.org/shr/problem/cs/GradeOrStageCS",
         "concept": [
           {
             "code": "grade_1",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-problem-ProblemCategoryVS.json b/lib/resources/standard_health_record/ValueSet-shr-problem-ProblemCategoryVS.json
old mode 100755
new mode 100644
index 772cb16..48193e4
--- a/lib/resources/standard_health_record/ValueSet-shr-problem-ProblemCategoryVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-problem-ProblemCategoryVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ProblemCategoryVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ProblemCategoryVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-problem-ProblemCategoryVS",
+  "url": "http://standardhealthrecord.org/shr/problem/vs/ProblemCategoryVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.problem.ProblemCategoryVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ProblemCategoryVS ValueSet",
   "title": "SHR ProblemCategoryVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.492Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.815Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-problem-ProblemCategoryVS",
+        "system": "http://standardhealthrecord.org/shr/problem/cs/ProblemCategoryCS",
         "concept": [
           {
             "code": "disease",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-sex-CommonPregnancyComplicationVS.json b/lib/resources/standard_health_record/ValueSet-shr-sex-CommonPregnancyComplicationVS.json
old mode 100755
new mode 100644
index ae0d252..2e161e4
--- a/lib/resources/standard_health_record/ValueSet-shr-sex-CommonPregnancyComplicationVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-sex-CommonPregnancyComplicationVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR CommonPregnancyComplicationVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR CommonPregnancyComplicationVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-sex-CommonPregnancyComplicationVS",
+  "url": "http://standardhealthrecord.org/shr/sex/vs/CommonPregnancyComplicationVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.sex.CommonPregnancyComplicationVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR CommonPregnancyComplicationVS ValueSet",
   "title": "SHR CommonPregnancyComplicationVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.492Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,7 +33,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.815Z",
   "compose": {
     "include": [
       {
diff --git a/lib/resources/standard_health_record/ValueSet-shr-sex-ContraceptiveMethodReasonVS.json b/lib/resources/standard_health_record/ValueSet-shr-sex-ContraceptiveMethodReasonVS.json
old mode 100755
new mode 100644
index 7aa86df..a49bfc4
--- a/lib/resources/standard_health_record/ValueSet-shr-sex-ContraceptiveMethodReasonVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-sex-ContraceptiveMethodReasonVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ContraceptiveMethodReasonVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ContraceptiveMethodReasonVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-sex-ContraceptiveMethodReasonVS",
+  "url": "http://standardhealthrecord.org/shr/sex/vs/ContraceptiveMethodReasonVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.sex.ContraceptiveMethodReasonVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ContraceptiveMethodReasonVS ValueSet",
   "title": "SHR ContraceptiveMethodReasonVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.492Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.815Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-sex-ContraceptiveMethodReasonVS",
+        "system": "http://standardhealthrecord.org/shr/sex/cs/ContraceptiveMethodReasonCS",
         "concept": [
           {
             "code": "control",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-sex-ContraceptiveMethodVS.json b/lib/resources/standard_health_record/ValueSet-shr-sex-ContraceptiveMethodVS.json
old mode 100755
new mode 100644
index 3330515..d983383
--- a/lib/resources/standard_health_record/ValueSet-shr-sex-ContraceptiveMethodVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-sex-ContraceptiveMethodVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ContraceptiveMethodVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ContraceptiveMethodVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-sex-ContraceptiveMethodVS",
+  "url": "http://standardhealthrecord.org/shr/sex/vs/ContraceptiveMethodVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.sex.ContraceptiveMethodVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ContraceptiveMethodVS ValueSet",
   "title": "SHR ContraceptiveMethodVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.492Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.815Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-sex-ContraceptiveMethodVS",
+        "system": "http://standardhealthrecord.org/shr/sex/cs/ContraceptiveMethodCS",
         "concept": [
           {
             "code": "no_contraceptive",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-sex-ContraceptiveNotUsedReasonVS.json b/lib/resources/standard_health_record/ValueSet-shr-sex-ContraceptiveNotUsedReasonVS.json
old mode 100755
new mode 100644
index f59169b..f671e5e
--- a/lib/resources/standard_health_record/ValueSet-shr-sex-ContraceptiveNotUsedReasonVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-sex-ContraceptiveNotUsedReasonVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ContraceptiveNotUsedReasonVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR ContraceptiveNotUsedReasonVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-sex-ContraceptiveNotUsedReasonVS",
+  "url": "http://standardhealthrecord.org/shr/sex/vs/ContraceptiveNotUsedReasonVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.sex.ContraceptiveNotUsedReasonVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR ContraceptiveNotUsedReasonVS ValueSet",
   "title": "SHR ContraceptiveNotUsedReasonVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.492Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.815Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-sex-ContraceptiveNotUsedReasonVS",
+        "system": "http://standardhealthrecord.org/shr/sex/cs/ContraceptiveNotUsedReasonCS",
         "concept": [
           {
             "code": "abstinent",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-sex-DifficultyWithIntercourseVS.json b/lib/resources/standard_health_record/ValueSet-shr-sex-DifficultyWithIntercourseVS.json
old mode 100755
new mode 100644
index 724668d..5ba91dc
--- a/lib/resources/standard_health_record/ValueSet-shr-sex-DifficultyWithIntercourseVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-sex-DifficultyWithIntercourseVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR DifficultyWithIntercourseVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR DifficultyWithIntercourseVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-sex-DifficultyWithIntercourseVS",
+  "url": "http://standardhealthrecord.org/shr/sex/vs/DifficultyWithIntercourseVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.sex.DifficultyWithIntercourseVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR DifficultyWithIntercourseVS ValueSet",
   "title": "SHR DifficultyWithIntercourseVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.493Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,7 +33,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.815Z",
   "compose": {
     "include": [
       {
diff --git a/lib/resources/standard_health_record/ValueSet-shr-sex-GenderIdentityVS.json b/lib/resources/standard_health_record/ValueSet-shr-sex-GenderIdentityVS.json
old mode 100755
new mode 100644
index 7b5cfa2..a17bda8
--- a/lib/resources/standard_health_record/ValueSet-shr-sex-GenderIdentityVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-sex-GenderIdentityVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR GenderIdentityVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR GenderIdentityVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-sex-GenderIdentityVS",
+  "url": "http://standardhealthrecord.org/shr/sex/vs/GenderIdentityVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.sex.GenderIdentityVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR GenderIdentityVS ValueSet",
   "title": "SHR GenderIdentityVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.492Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.815Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-sex-GenderIdentityVS",
+        "system": "http://standardhealthrecord.org/shr/sex/cs/GenderIdentityCS",
         "concept": [
           {
             "code": "male_gender",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-sex-SexualActivityVS.json b/lib/resources/standard_health_record/ValueSet-shr-sex-SexualActivityVS.json
old mode 100755
new mode 100644
index 604fa31..efd31df
--- a/lib/resources/standard_health_record/ValueSet-shr-sex-SexualActivityVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-sex-SexualActivityVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR SexualActivityVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR SexualActivityVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-sex-SexualActivityVS",
+  "url": "http://standardhealthrecord.org/shr/sex/vs/SexualActivityVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.sex.SexualActivityVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR SexualActivityVS ValueSet",
   "title": "SHR SexualActivityVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.493Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,7 +33,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.815Z",
   "compose": {
     "include": [
       {
diff --git a/lib/resources/standard_health_record/ValueSet-shr-sex-SexualOrientationVS.json b/lib/resources/standard_health_record/ValueSet-shr-sex-SexualOrientationVS.json
old mode 100755
new mode 100644
index 69e7091..15258ec
--- a/lib/resources/standard_health_record/ValueSet-shr-sex-SexualOrientationVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-sex-SexualOrientationVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR SexualOrientationVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR SexualOrientationVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-sex-SexualOrientationVS",
+  "url": "http://standardhealthrecord.org/shr/sex/vs/SexualOrientationVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.sex.SexualOrientationVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR SexualOrientationVS ValueSet",
   "title": "SHR SexualOrientationVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.492Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,7 +33,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.815Z",
   "compose": {
     "include": [
       {
diff --git a/lib/resources/standard_health_record/ValueSet-shr-skin-PressureUlcerAssociationVS.json b/lib/resources/standard_health_record/ValueSet-shr-skin-PressureUlcerAssociationVS.json
old mode 100755
new mode 100644
index 3be494e..1cddec5
--- a/lib/resources/standard_health_record/ValueSet-shr-skin-PressureUlcerAssociationVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-skin-PressureUlcerAssociationVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR PressureUlcerAssociationVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR PressureUlcerAssociationVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-skin-PressureUlcerAssociationVS",
+  "url": "http://standardhealthrecord.org/shr/skin/vs/PressureUlcerAssociationVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.skin.PressureUlcerAssociationVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR PressureUlcerAssociationVS ValueSet",
   "title": "SHR PressureUlcerAssociationVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.493Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.815Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-skin-PressureUlcerAssociationVS",
+        "system": "http://standardhealthrecord.org/shr/skin/cs/PressureUlcerAssociationCS",
         "concept": [
           {
             "code": "device",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-skin-PressureUlcerBodySiteVS.json b/lib/resources/standard_health_record/ValueSet-shr-skin-PressureUlcerBodySiteVS.json
old mode 100755
new mode 100644
index 23691ef..ec55bf8
--- a/lib/resources/standard_health_record/ValueSet-shr-skin-PressureUlcerBodySiteVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-skin-PressureUlcerBodySiteVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR PressureUlcerBodySiteVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR PressureUlcerBodySiteVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-skin-PressureUlcerBodySiteVS",
+  "url": "http://standardhealthrecord.org/shr/skin/vs/PressureUlcerBodySiteVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.skin.PressureUlcerBodySiteVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR PressureUlcerBodySiteVS ValueSet",
   "title": "SHR PressureUlcerBodySiteVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.493Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,7 +33,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.815Z",
   "compose": {
     "include": [
       {
diff --git a/lib/resources/standard_health_record/ValueSet-shr-skin-SupportSurfaceBodyPositionVS.json b/lib/resources/standard_health_record/ValueSet-shr-skin-SupportSurfaceBodyPositionVS.json
old mode 100755
new mode 100644
index b677653..e11dcaa
--- a/lib/resources/standard_health_record/ValueSet-shr-skin-SupportSurfaceBodyPositionVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-skin-SupportSurfaceBodyPositionVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR SupportSurfaceBodyPositionVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR SupportSurfaceBodyPositionVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-skin-SupportSurfaceBodyPositionVS",
+  "url": "http://standardhealthrecord.org/shr/skin/vs/SupportSurfaceBodyPositionVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.skin.SupportSurfaceBodyPositionVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR SupportSurfaceBodyPositionVS ValueSet",
   "title": "SHR SupportSurfaceBodyPositionVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.493Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.815Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-skin-SupportSurfaceBodyPositionVS",
+        "system": "http://standardhealthrecord.org/shr/skin/cs/SupportSurfaceBodyPositionCS",
         "concept": [
           {
             "code": "sitting",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-skin-SupportSurfaceCategoryVS.json b/lib/resources/standard_health_record/ValueSet-shr-skin-SupportSurfaceCategoryVS.json
old mode 100755
new mode 100644
index f8d03b2..c1ded5e
--- a/lib/resources/standard_health_record/ValueSet-shr-skin-SupportSurfaceCategoryVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-skin-SupportSurfaceCategoryVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR SupportSurfaceCategoryVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR SupportSurfaceCategoryVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-skin-SupportSurfaceCategoryVS",
+  "url": "http://standardhealthrecord.org/shr/skin/vs/SupportSurfaceCategoryVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.skin.SupportSurfaceCategoryVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR SupportSurfaceCategoryVS ValueSet",
   "title": "SHR SupportSurfaceCategoryVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.493Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.815Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-skin-SupportSurfaceCategoryVS",
+        "system": "http://standardhealthrecord.org/shr/skin/cs/SupportSurfaceCategoryCS",
         "concept": [
           {
             "code": "active_support",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-skin-SupportSurfaceComponentVS.json b/lib/resources/standard_health_record/ValueSet-shr-skin-SupportSurfaceComponentVS.json
old mode 100755
new mode 100644
index 9c0c1d0..40a442c
--- a/lib/resources/standard_health_record/ValueSet-shr-skin-SupportSurfaceComponentVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-skin-SupportSurfaceComponentVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR SupportSurfaceComponentVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR SupportSurfaceComponentVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-skin-SupportSurfaceComponentVS",
+  "url": "http://standardhealthrecord.org/shr/skin/vs/SupportSurfaceComponentVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.skin.SupportSurfaceComponentVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR SupportSurfaceComponentVS ValueSet",
   "title": "SHR SupportSurfaceComponentVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.493Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.815Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-skin-SupportSurfaceComponentVS",
+        "system": "http://standardhealthrecord.org/shr/skin/cs/SupportSurfaceComponentCS",
         "concept": [
           {
             "code": "air",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-skin-SupportSurfaceFeatureVS.json b/lib/resources/standard_health_record/ValueSet-shr-skin-SupportSurfaceFeatureVS.json
old mode 100755
new mode 100644
index 461f1c3..209d3b1
--- a/lib/resources/standard_health_record/ValueSet-shr-skin-SupportSurfaceFeatureVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-skin-SupportSurfaceFeatureVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR SupportSurfaceFeatureVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR SupportSurfaceFeatureVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-skin-SupportSurfaceFeatureVS",
+  "url": "http://standardhealthrecord.org/shr/skin/vs/SupportSurfaceFeatureVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.skin.SupportSurfaceFeatureVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR SupportSurfaceFeatureVS ValueSet",
   "title": "SHR SupportSurfaceFeatureVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.493Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.815Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-skin-SupportSurfaceFeatureVS",
+        "system": "http://standardhealthrecord.org/shr/skin/cs/SupportSurfaceFeatureCS",
         "concept": [
           {
             "code": "fluidized",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-skin-SupportSurfaceVS.json b/lib/resources/standard_health_record/ValueSet-shr-skin-SupportSurfaceVS.json
old mode 100755
new mode 100644
index 09e9244..56a5635
--- a/lib/resources/standard_health_record/ValueSet-shr-skin-SupportSurfaceVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-skin-SupportSurfaceVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR SupportSurfaceVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR SupportSurfaceVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-skin-SupportSurfaceVS",
+  "url": "http://standardhealthrecord.org/shr/skin/vs/SupportSurfaceVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.skin.SupportSurfaceVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR SupportSurfaceVS ValueSet",
   "title": "SHR SupportSurfaceVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.493Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,7 +33,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.815Z",
   "compose": {
     "include": [
       {
diff --git a/lib/resources/standard_health_record/ValueSet-shr-skin-VisibleInternalStructureVS.json b/lib/resources/standard_health_record/ValueSet-shr-skin-VisibleInternalStructureVS.json
old mode 100755
new mode 100644
index 0ed85ab..b36e6a8
--- a/lib/resources/standard_health_record/ValueSet-shr-skin-VisibleInternalStructureVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-skin-VisibleInternalStructureVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR VisibleInternalStructureVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR VisibleInternalStructureVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-skin-VisibleInternalStructureVS",
+  "url": "http://standardhealthrecord.org/shr/skin/vs/VisibleInternalStructureVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.skin.VisibleInternalStructureVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR VisibleInternalStructureVS ValueSet",
   "title": "SHR VisibleInternalStructureVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.493Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,7 +33,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.815Z",
   "compose": {
     "include": [
       {
diff --git a/lib/resources/standard_health_record/ValueSet-shr-skin-WoundEdgeAppearanceVS.json b/lib/resources/standard_health_record/ValueSet-shr-skin-WoundEdgeAppearanceVS.json
old mode 100755
new mode 100644
index b2920d5..10a1a83
--- a/lib/resources/standard_health_record/ValueSet-shr-skin-WoundEdgeAppearanceVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-skin-WoundEdgeAppearanceVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR WoundEdgeAppearanceVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR WoundEdgeAppearanceVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-skin-WoundEdgeAppearanceVS",
+  "url": "http://standardhealthrecord.org/shr/skin/vs/WoundEdgeAppearanceVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.skin.WoundEdgeAppearanceVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR WoundEdgeAppearanceVS ValueSet",
   "title": "SHR WoundEdgeAppearanceVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.493Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,7 +33,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.815Z",
   "compose": {
     "include": [
       {
diff --git a/lib/resources/standard_health_record/ValueSet-shr-vital-BloodPressureBodySiteVS.json b/lib/resources/standard_health_record/ValueSet-shr-vital-BloodPressureBodySiteVS.json
old mode 100755
new mode 100644
index 4e3251f..48215c5
--- a/lib/resources/standard_health_record/ValueSet-shr-vital-BloodPressureBodySiteVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-vital-BloodPressureBodySiteVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR BloodPressureBodySiteVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR BloodPressureBodySiteVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-vital-BloodPressureBodySiteVS",
+  "url": "http://standardhealthrecord.org/shr/vital/vs/BloodPressureBodySiteVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.vital.BloodPressureBodySiteVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR BloodPressureBodySiteVS ValueSet",
   "title": "SHR BloodPressureBodySiteVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.493Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,7 +33,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.816Z",
   "compose": {
     "include": [
       {
diff --git a/lib/resources/standard_health_record/ValueSet-shr-vital-BloodPressureMethodVS.json b/lib/resources/standard_health_record/ValueSet-shr-vital-BloodPressureMethodVS.json
old mode 100755
new mode 100644
index cc54d5e..9f94ad6
--- a/lib/resources/standard_health_record/ValueSet-shr-vital-BloodPressureMethodVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-vital-BloodPressureMethodVS.json
@@ -10,16 +10,18 @@
     "status": "generated",
     "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR BloodPressureMethodVS ValueSet</b></p>\n<p>The method used to measure blood pressure.</p>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-vital-BloodPressureMethodVS",
+  "url": "http://standardhealthrecord.org/shr/vital/vs/BloodPressureMethodVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.vital.BloodPressureMethodVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR BloodPressureMethodVS ValueSet",
   "title": "SHR BloodPressureMethodVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.493Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,12 +33,11 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.816Z",
   "description": "The method used to measure blood pressure.",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-vital-BloodPressureMethodVS",
+        "system": "http://standardhealthrecord.org/shr/vital/cs/BloodPressureMethodCS",
         "concept": [
           {
             "code": "cuff_manual",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-vital-BloodPressureQualifierVS.json b/lib/resources/standard_health_record/ValueSet-shr-vital-BloodPressureQualifierVS.json
old mode 100755
new mode 100644
index f3ef14c..478881f
--- a/lib/resources/standard_health_record/ValueSet-shr-vital-BloodPressureQualifierVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-vital-BloodPressureQualifierVS.json
@@ -10,16 +10,18 @@
     "status": "generated",
     "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR BloodPressureQualifierVS ValueSet</b></p>\n<p>Code further describing the blood pressure measurement.</p>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-vital-BloodPressureQualifierVS",
+  "url": "http://standardhealthrecord.org/shr/vital/vs/BloodPressureQualifierVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.vital.BloodPressureQualifierVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR BloodPressureQualifierVS ValueSet",
   "title": "SHR BloodPressureQualifierVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.493Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,12 +33,11 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.816Z",
   "description": "Code further describing the blood pressure measurement.",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-vital-BloodPressureQualifierVS",
+        "system": "http://standardhealthrecord.org/shr/vital/cs/BloodPressureQualifierCS",
         "concept": [
           {
             "code": "pre_transfusion",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-vital-BodyHeightQualifierVS.json b/lib/resources/standard_health_record/ValueSet-shr-vital-BodyHeightQualifierVS.json
old mode 100755
new mode 100644
index 3c4c020..3da888f
--- a/lib/resources/standard_health_record/ValueSet-shr-vital-BodyHeightQualifierVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-vital-BodyHeightQualifierVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR BodyHeightQualifierVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR BodyHeightQualifierVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-vital-BodyHeightQualifierVS",
+  "url": "http://standardhealthrecord.org/shr/vital/vs/BodyHeightQualifierVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.vital.BodyHeightQualifierVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR BodyHeightQualifierVS ValueSet",
   "title": "SHR BodyHeightQualifierVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.493Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,7 +33,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.816Z",
   "compose": {
     "include": [
       {
@@ -64,7 +65,7 @@
         ]
       },
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-vital-BodyHeightQualifierVS",
+        "system": "http://standardhealthrecord.org/shr/vital/cs/BodyHeightQualifierCS",
         "concept": [
           {
             "code": "shoes_on",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-vital-BodyTemperatureBodySiteVS.json b/lib/resources/standard_health_record/ValueSet-shr-vital-BodyTemperatureBodySiteVS.json
old mode 100755
new mode 100644
index 3dddaae..923dd22
--- a/lib/resources/standard_health_record/ValueSet-shr-vital-BodyTemperatureBodySiteVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-vital-BodyTemperatureBodySiteVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR BodyTemperatureBodySiteVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR BodyTemperatureBodySiteVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-vital-BodyTemperatureBodySiteVS",
+  "url": "http://standardhealthrecord.org/shr/vital/vs/BodyTemperatureBodySiteVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.vital.BodyTemperatureBodySiteVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR BodyTemperatureBodySiteVS ValueSet",
   "title": "SHR BodyTemperatureBodySiteVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.493Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,7 +33,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.816Z",
   "compose": {
     "include": [
       {
diff --git a/lib/resources/standard_health_record/ValueSet-shr-vital-BodyTemperatureQualifierVS.json b/lib/resources/standard_health_record/ValueSet-shr-vital-BodyTemperatureQualifierVS.json
old mode 100755
new mode 100644
index ece94b5..79decc2
--- a/lib/resources/standard_health_record/ValueSet-shr-vital-BodyTemperatureQualifierVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-vital-BodyTemperatureQualifierVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR BodyTemperatureQualifierVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR BodyTemperatureQualifierVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-vital-BodyTemperatureQualifierVS",
+  "url": "http://standardhealthrecord.org/shr/vital/vs/BodyTemperatureQualifierVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.vital.BodyTemperatureQualifierVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR BodyTemperatureQualifierVS ValueSet",
   "title": "SHR BodyTemperatureQualifierVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.493Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.816Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-vital-BodyTemperatureQualifierVS",
+        "system": "http://standardhealthrecord.org/shr/vital/cs/BodyTemperatureQualifierCS",
         "concept": [
           {
             "code": "max_illness",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-vital-BodyWeightQualifierVS.json b/lib/resources/standard_health_record/ValueSet-shr-vital-BodyWeightQualifierVS.json
old mode 100755
new mode 100644
index 41a505e..b898cbd
--- a/lib/resources/standard_health_record/ValueSet-shr-vital-BodyWeightQualifierVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-vital-BodyWeightQualifierVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR BodyWeightQualifierVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR BodyWeightQualifierVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-vital-BodyWeightQualifierVS",
+  "url": "http://standardhealthrecord.org/shr/vital/vs/BodyWeightQualifierVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.vital.BodyWeightQualifierVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR BodyWeightQualifierVS ValueSet",
   "title": "SHR BodyWeightQualifierVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.493Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,11 +33,10 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.816Z",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-vital-BodyWeightQualifierVS",
+        "system": "http://standardhealthrecord.org/shr/vital/cs/BodyWeightQualifierCS",
         "concept": [
           {
             "code": "meas",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-vital-HeartRateMethodVS.json b/lib/resources/standard_health_record/ValueSet-shr-vital-HeartRateMethodVS.json
old mode 100755
new mode 100644
index 2622d21..49e829a
--- a/lib/resources/standard_health_record/ValueSet-shr-vital-HeartRateMethodVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-vital-HeartRateMethodVS.json
@@ -10,16 +10,18 @@
     "status": "generated",
     "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR HeartRateMethodVS ValueSet</b></p>\n<p>Method of measuring heart rate.</p>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-vital-HeartRateMethodVS",
+  "url": "http://standardhealthrecord.org/shr/vital/vs/HeartRateMethodVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.vital.HeartRateMethodVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR HeartRateMethodVS ValueSet",
   "title": "SHR HeartRateMethodVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.493Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,12 +33,11 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.816Z",
   "description": "Method of measuring heart rate.",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-vital-HeartRateMethodVS",
+        "system": "http://standardhealthrecord.org/shr/vital/cs/HeartRateMethodCS",
         "concept": [
           {
             "code": "pulseox",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-vital-HeartRateQualifierVS.json b/lib/resources/standard_health_record/ValueSet-shr-vital-HeartRateQualifierVS.json
old mode 100755
new mode 100644
index dba542f..d2c94e3
--- a/lib/resources/standard_health_record/ValueSet-shr-vital-HeartRateQualifierVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-vital-HeartRateQualifierVS.json
@@ -10,16 +10,18 @@
     "status": "generated",
     "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR HeartRateQualifierVS ValueSet</b></p>\n<p>Details of a heart rate measurement.</p>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-vital-HeartRateQualifierVS",
+  "url": "http://standardhealthrecord.org/shr/vital/vs/HeartRateQualifierVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.vital.HeartRateQualifierVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR HeartRateQualifierVS ValueSet",
   "title": "SHR HeartRateQualifierVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.493Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,12 +33,11 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.815Z",
   "description": "Details of a heart rate measurement.",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-vital-HeartRateQualifierVS",
+        "system": "http://standardhealthrecord.org/shr/vital/cs/HeartRateQualifierCS",
         "concept": [
           {
             "code": "rest",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-vital-OxygenSaturationBodySiteVS.json b/lib/resources/standard_health_record/ValueSet-shr-vital-OxygenSaturationBodySiteVS.json
old mode 100755
new mode 100644
index c81e3cc..e11d543
--- a/lib/resources/standard_health_record/ValueSet-shr-vital-OxygenSaturationBodySiteVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-vital-OxygenSaturationBodySiteVS.json
@@ -8,18 +8,20 @@
   },
   "text": {
     "status": "generated",
-    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR OxygenSaturationBodySiteVS ValueSet</b></p>\n<p></p>\n</div>"
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR OxygenSaturationBodySiteVS ValueSet</b></p>\n<p/>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-vital-OxygenSaturationBodySiteVS",
+  "url": "http://standardhealthrecord.org/shr/vital/vs/OxygenSaturationBodySiteVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.vital.OxygenSaturationBodySiteVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR OxygenSaturationBodySiteVS ValueSet",
   "title": "SHR OxygenSaturationBodySiteVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.493Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,7 +33,6 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.816Z",
   "compose": {
     "include": [
       {
diff --git a/lib/resources/standard_health_record/ValueSet-shr-vital-RespiratoryRateMethodVS.json b/lib/resources/standard_health_record/ValueSet-shr-vital-RespiratoryRateMethodVS.json
old mode 100755
new mode 100644
index c2265d7..df99984
--- a/lib/resources/standard_health_record/ValueSet-shr-vital-RespiratoryRateMethodVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-vital-RespiratoryRateMethodVS.json
@@ -10,16 +10,18 @@
     "status": "generated",
     "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR RespiratoryRateMethodVS ValueSet</b></p>\n<p>Methods of measuring respiratory rate.</p>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-vital-RespiratoryRateMethodVS",
+  "url": "http://standardhealthrecord.org/shr/vital/vs/RespiratoryRateMethodVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.vital.RespiratoryRateMethodVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR RespiratoryRateMethodVS ValueSet",
   "title": "SHR RespiratoryRateMethodVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.493Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,12 +33,11 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.815Z",
   "description": "Methods of measuring respiratory rate.",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-vital-RespiratoryRateMethodVS",
+        "system": "http://standardhealthrecord.org/shr/vital/cs/RespiratoryRateMethodCS",
         "concept": [
           {
             "code": "acoustic",
diff --git a/lib/resources/standard_health_record/ValueSet-shr-vital-RespiratoryRateQualifierVS.json b/lib/resources/standard_health_record/ValueSet-shr-vital-RespiratoryRateQualifierVS.json
old mode 100755
new mode 100644
index 87b4bed..e741e7a
--- a/lib/resources/standard_health_record/ValueSet-shr-vital-RespiratoryRateQualifierVS.json
+++ b/lib/resources/standard_health_record/ValueSet-shr-vital-RespiratoryRateQualifierVS.json
@@ -10,16 +10,18 @@
     "status": "generated",
     "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p><b>SHR RespiratoryRateQualifierVS ValueSet</b></p>\n<p>Details of a respiratory rate measurement.</p>\n</div>"
   },
-  "url": "http://standardhealthrecord.org/fhir/ValueSet/shr-vital-RespiratoryRateQualifierVS",
+  "url": "http://standardhealthrecord.org/shr/vital/vs/RespiratoryRateQualifierVS",
   "identifier": [
     {
       "system": "http://standardhealthrecord.org",
       "value": "shr.vital.RespiratoryRateQualifierVS"
     }
   ],
+  "version": "0.0.1",
   "name": "SHR RespiratoryRateQualifierVS ValueSet",
   "title": "SHR RespiratoryRateQualifierVS ValueSet",
   "status": "draft",
+  "date": "2017-04-18T15:12:20.493Z",
   "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
   "contact": [
     {
@@ -31,12 +33,11 @@
       ]
     }
   ],
-  "date": "2017-03-21T00:21:35.815Z",
   "description": "Details of a respiratory rate measurement.",
   "compose": {
     "include": [
       {
-        "system": "http://standardhealthrecord.org/fhir/CodeSystem/shr-vital-RespiratoryRateQualifierVS",
+        "system": "http://standardhealthrecord.org/shr/vital/cs/RespiratoryRateQualifierCS",
         "concept": [
           {
             "code": "rest",
diff --git a/lib/resources/standard_health_record/spec.internals b/lib/resources/standard_health_record/spec.internals
old mode 100755
new mode 100644
index 36e16a9..719c145
--- a/lib/resources/standard_health_record/spec.internals
+++ b/lib/resources/standard_health_record/spec.internals
@@ -1,8 +1,8 @@
 {
-  "version": "1.8.0",
-  "build": "10514",
+  "version": "3.0.0",
+  "build": "11681",
   "webUrl": "http://standardhealthrecord.org/fhir",
-  "date": "2017-03-20",
+  "date": "2017-04-18",
   "paths": {
     "http://standardhealthrecord.org/fhir/ImplementationGuide/1": "ImplementationGuide-1.html",
     "http://standardhealthrecord.org/fhir/StructureDefinition/shr-actor-EmergencyContact": "StructureDefinition-shr-actor-EmergencyContact.html",
@@ -108,6 +108,7 @@
     "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lifehistory-Occupation": "StructureDefinition-shr-lifehistory-Occupation.html",
     "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lifehistory-PrenatalExposure": "StructureDefinition-shr-lifehistory-PrenatalExposure.html",
     "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lifehistory-Travel": "StructureDefinition-shr-lifehistory-Travel.html",
+    "http://standardhealthrecord.org/fhir/StructureDefinition/shr-medication-MaximumDosePerTimePeriod": "StructureDefinition-shr-medication-MaximumDosePerTimePeriod.html",
     "http://standardhealthrecord.org/fhir/StructureDefinition/shr-medication-Medication": "StructureDefinition-shr-medication-Medication.html",
     "http://standardhealthrecord.org/fhir/StructureDefinition/shr-medication-MedicationChange": "StructureDefinition-shr-medication-MedicationChange.html",
     "http://standardhealthrecord.org/fhir/StructureDefinition/shr-medication-MedicationNotAdministered": "StructureDefinition-shr-medication-MedicationNotAdministered.html",
@@ -152,6 +153,7 @@
     "http://standardhealthrecord.org/fhir/StructureDefinition/shr-vital-RespiratoryRate": "StructureDefinition-shr-vital-RespiratoryRate.html",
     "http://standardhealthrecord.org/fhir/StructureDefinition/shr-vital-SystolicPressure": "StructureDefinition-shr-vital-SystolicPressure.html",
     "http://standardhealthrecord.org/fhir/StructureDefinition/shr-vital-VitalSign": "StructureDefinition-shr-vital-VitalSign.html",
+    "http://standardhealthrecord.org/fhir/StructureDefinition/shr-actor-Affiliation-extension": "StructureDefinition-shr-actor-Affiliation-extension.html",
     "http://standardhealthrecord.org/fhir/StructureDefinition/shr-actor-AgeAtDeath-extension": "StructureDefinition-shr-actor-AgeAtDeath-extension.html",
     "http://standardhealthrecord.org/fhir/StructureDefinition/shr-actor-Anonymized-extension": "StructureDefinition-shr-actor-Anonymized-extension.html",
     "http://standardhealthrecord.org/fhir/StructureDefinition/shr-actor-DateOfDeath-extension": "StructureDefinition-shr-actor-DateOfDeath-extension.html",
@@ -159,6 +161,7 @@
     "http://standardhealthrecord.org/fhir/StructureDefinition/shr-actor-FictionalPerson-extension": "StructureDefinition-shr-actor-FictionalPerson-extension.html",
     "http://standardhealthrecord.org/fhir/StructureDefinition/shr-actor-LanguageQualifier-extension": "StructureDefinition-shr-actor-LanguageQualifier-extension.html",
     "http://standardhealthrecord.org/fhir/StructureDefinition/shr-actor-LanguageUsed-extension": "StructureDefinition-shr-actor-LanguageUsed-extension.html",
+    "http://standardhealthrecord.org/fhir/StructureDefinition/shr-actor-MedicalSpecialty-extension": "StructureDefinition-shr-actor-MedicalSpecialty-extension.html",
     "http://standardhealthrecord.org/fhir/StructureDefinition/shr-actor-Participant-extension": "StructureDefinition-shr-actor-Participant-extension.html",
     "http://standardhealthrecord.org/fhir/StructureDefinition/shr-actor-ParticipationType-extension": "StructureDefinition-shr-actor-ParticipationType-extension.html",
     "http://standardhealthrecord.org/fhir/StructureDefinition/shr-actor-Practitioner-extension": "StructureDefinition-shr-actor-Practitioner-extension.html",
@@ -179,8 +182,6 @@
     "http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-OriginalCreationDate-extension": "StructureDefinition-shr-base-OriginalCreationDate-extension.html",
     "http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-PatientInstructions-extension": "StructureDefinition-shr-base-PatientInstructions-extension.html",
     "http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-PerformerInstructions-extension": "StructureDefinition-shr-base-PerformerInstructions-extension.html",
-    "http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-PriorityOfRequest-extension": "StructureDefinition-shr-base-PriorityOfRequest-extension.html",
-    "http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-RequestNotToPerformActionModifier-extension": "StructureDefinition-shr-base-RequestNotToPerformActionModifier-extension.html",
     "http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-ShrId-extension": "StructureDefinition-shr-base-ShrId-extension.html",
     "http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-SubjectIsThirdPartyModifier-extension": "StructureDefinition-shr-base-SubjectIsThirdPartyModifier-extension.html",
     "http://standardhealthrecord.org/fhir/StructureDefinition/shr-behavior-AlcoholBingeFrequency-extension": "StructureDefinition-shr-behavior-AlcoholBingeFrequency-extension.html",
@@ -289,7 +290,6 @@
     "http://standardhealthrecord.org/fhir/StructureDefinition/shr-environment-TransportationAvailability-extension": "StructureDefinition-shr-environment-TransportationAvailability-extension.html",
     "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-ChangeFlag-extension": "StructureDefinition-shr-lab-ChangeFlag-extension.html",
     "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-Test-extension": "StructureDefinition-shr-lab-Test-extension.html",
-    "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lab-TestRequest-extension": "StructureDefinition-shr-lab-TestRequest-extension.html",
     "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lifehistory-Employer-extension": "StructureDefinition-shr-lifehistory-Employer-extension.html",
     "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lifehistory-EmploymentStatus-extension": "StructureDefinition-shr-lifehistory-EmploymentStatus-extension.html",
     "http://standardhealthrecord.org/fhir/StructureDefinition/shr-lifehistory-MilitaryBranch-extension": "StructureDefinition-shr-lifehistory-MilitaryBranch-extension.html",
@@ -303,7 +303,6 @@
     "http://standardhealthrecord.org/fhir/StructureDefinition/shr-medication-MedicationBeforeChange-extension": "StructureDefinition-shr-medication-MedicationBeforeChange-extension.html",
     "http://standardhealthrecord.org/fhir/StructureDefinition/shr-medication-MedicationNotPrescribedModifier-extension": "StructureDefinition-shr-medication-MedicationNotPrescribedModifier-extension.html",
     "http://standardhealthrecord.org/fhir/StructureDefinition/shr-medication-NonAdherenceReason-extension": "StructureDefinition-shr-medication-NonAdherenceReason-extension.html",
-    "http://standardhealthrecord.org/fhir/StructureDefinition/shr-medication-OverTheCounter-extension": "StructureDefinition-shr-medication-OverTheCounter-extension.html",
     "http://standardhealthrecord.org/fhir/StructureDefinition/shr-medication-RouteIntoBody-extension": "StructureDefinition-shr-medication-RouteIntoBody-extension.html",
     "http://standardhealthrecord.org/fhir/StructureDefinition/shr-medication-TypeOfChange-extension": "StructureDefinition-shr-medication-TypeOfChange-extension.html",
     "http://standardhealthrecord.org/fhir/StructureDefinition/shr-observation-ObservationCode-extension": "StructureDefinition-shr-observation-ObservationCode-extension.html",
@@ -358,489 +357,683 @@
     "http://standardhealthrecord.org/fhir/StructureDefinition/shr-skin-WoundTunnelling-extension": "StructureDefinition-shr-skin-WoundTunnelling-extension.html",
     "http://standardhealthrecord.org/fhir/StructureDefinition/shr-skin-WoundUndermining-extension": "StructureDefinition-shr-skin-WoundUndermining-extension.html",
     "http://standardhealthrecord.org/fhir/StructureDefinition/shr-vital-HeadTiltAngle-extension": "StructureDefinition-shr-vital-HeadTiltAngle-extension.html",
+    "http://standardhealthrecord.org/shr/actor/vs/AgeGroupVS": "ValueSet-shr-actor-AgeGroupVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-actor-AgeGroupVS": "ValueSet-shr-actor-AgeGroupVS.html",
+    "http://standardhealthrecord.org/shr/actor/vs/HealthcareRoleVS": "ValueSet-shr-actor-HealthcareRoleVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-actor-HealthcareRoleVS": "ValueSet-shr-actor-HealthcareRoleVS.html",
+    "http://standardhealthrecord.org/shr/actor/vs/LanguageQualifierVS": "ValueSet-shr-actor-LanguageQualifierVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-actor-LanguageQualifierVS": "ValueSet-shr-actor-LanguageQualifierVS.html",
+    "http://standardhealthrecord.org/shr/adverse/vs/MedDRAVS": "ValueSet-shr-adverse-MedDRAVS.html",
+    "http://standardhealthrecord.org/fhir/ValueSet/shr-adverse-MedDRAVS": "ValueSet-shr-adverse-MedDRAVS.html",
+    "http://standardhealthrecord.org/shr/allergy/vs/AllergenIrritantVS": "ValueSet-shr-allergy-AllergenIrritantVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-allergy-AllergenIrritantVS": "ValueSet-shr-allergy-AllergenIrritantVS.html",
+    "http://standardhealthrecord.org/shr/allergy/vs/AllergyVerificationStatusVS": "ValueSet-shr-allergy-AllergyVerificationStatusVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-allergy-AllergyVerificationStatusVS": "ValueSet-shr-allergy-AllergyVerificationStatusVS.html",
+    "http://standardhealthrecord.org/shr/allergy/vs/DrugIngredientVS": "ValueSet-shr-allergy-DrugIngredientVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-allergy-DrugIngredientVS": "ValueSet-shr-allergy-DrugIngredientVS.html",
+    "http://standardhealthrecord.org/shr/allergy/vs/FoodSubstanceVS": "ValueSet-shr-allergy-FoodSubstanceVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-allergy-FoodSubstanceVS": "ValueSet-shr-allergy-FoodSubstanceVS.html",
+    "http://standardhealthrecord.org/shr/base/vs/GenericAnswersVS": "ValueSet-shr-base-GenericAnswersVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-base-GenericAnswersVS": "ValueSet-shr-base-GenericAnswersVS.html",
+    "http://standardhealthrecord.org/shr/base/vs/MissingValueReasonVS": "ValueSet-shr-base-MissingValueReasonVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-base-MissingValueReasonVS": "ValueSet-shr-base-MissingValueReasonVS.html",
+    "http://standardhealthrecord.org/shr/behavior/vs/AlcoholUseScreeningToolVS": "ValueSet-shr-behavior-AlcoholUseScreeningToolVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-behavior-AlcoholUseScreeningToolVS": "ValueSet-shr-behavior-AlcoholUseScreeningToolVS.html",
+    "http://standardhealthrecord.org/shr/behavior/vs/DietNutritionConcernVS": "ValueSet-shr-behavior-DietNutritionConcernVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-behavior-DietNutritionConcernVS": "ValueSet-shr-behavior-DietNutritionConcernVS.html",
+    "http://standardhealthrecord.org/shr/behavior/vs/PhysicalActivityLimitationVS": "ValueSet-shr-behavior-PhysicalActivityLimitationVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-behavior-PhysicalActivityLimitationVS": "ValueSet-shr-behavior-PhysicalActivityLimitationVS.html",
+    "http://standardhealthrecord.org/shr/behavior/vs/ReligiousPracticeStatusVS": "ValueSet-shr-behavior-ReligiousPracticeStatusVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-behavior-ReligiousPracticeStatusVS": "ValueSet-shr-behavior-ReligiousPracticeStatusVS.html",
+    "http://standardhealthrecord.org/shr/behavior/vs/ReligiousRestrictionVS": "ValueSet-shr-behavior-ReligiousRestrictionVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-behavior-ReligiousRestrictionVS": "ValueSet-shr-behavior-ReligiousRestrictionVS.html",
+    "http://standardhealthrecord.org/shr/behavior/vs/SleepQualityReasonVS": "ValueSet-shr-behavior-SleepQualityReasonVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-behavior-SleepQualityReasonVS": "ValueSet-shr-behavior-SleepQualityReasonVS.html",
+    "http://standardhealthrecord.org/shr/behavior/vs/SpecialDietFollowedVS": "ValueSet-shr-behavior-SpecialDietFollowedVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-behavior-SpecialDietFollowedVS": "ValueSet-shr-behavior-SpecialDietFollowedVS.html",
+    "http://standardhealthrecord.org/shr/behavior/vs/SubstanceAbuseTreatmentTypeVS": "ValueSet-shr-behavior-SubstanceAbuseTreatmentTypeVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-behavior-SubstanceAbuseTreatmentTypeVS": "ValueSet-shr-behavior-SubstanceAbuseTreatmentTypeVS.html",
+    "http://standardhealthrecord.org/shr/behavior/vs/SubstanceOfAbuseVS": "ValueSet-shr-behavior-SubstanceOfAbuseVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-behavior-SubstanceOfAbuseVS": "ValueSet-shr-behavior-SubstanceOfAbuseVS.html",
+    "http://standardhealthrecord.org/shr/core/vs/BodyPositionVS": "ValueSet-shr-core-BodyPositionVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodyPositionVS": "ValueSet-shr-core-BodyPositionVS.html",
+    "http://standardhealthrecord.org/shr/core/vs/BodySiteVS": "ValueSet-shr-core-BodySiteVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-core-BodySiteVS": "ValueSet-shr-core-BodySiteVS.html",
+    "http://standardhealthrecord.org/shr/core/vs/ClinicalFindingAbsentVS": "ValueSet-shr-core-ClinicalFindingAbsentVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-core-ClinicalFindingAbsentVS": "ValueSet-shr-core-ClinicalFindingAbsentVS.html",
+    "http://standardhealthrecord.org/shr/core/vs/ClockDirectionVS": "ValueSet-shr-core-ClockDirectionVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-core-ClockDirectionVS": "ValueSet-shr-core-ClockDirectionVS.html",
+    "http://standardhealthrecord.org/shr/core/vs/CodingQualifierVS": "ValueSet-shr-core-CodingQualifierVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-core-CodingQualifierVS": "ValueSet-shr-core-CodingQualifierVS.html",
+    "http://standardhealthrecord.org/shr/core/vs/DirectionalityVS": "ValueSet-shr-core-DirectionalityVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-core-DirectionalityVS": "ValueSet-shr-core-DirectionalityVS.html",
+    "http://standardhealthrecord.org/shr/core/vs/DiseaseFindingVS": "ValueSet-shr-core-DiseaseFindingVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-core-DiseaseFindingVS": "ValueSet-shr-core-DiseaseFindingVS.html",
+    "http://standardhealthrecord.org/shr/core/vs/LateralityVS": "ValueSet-shr-core-LateralityVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-core-LateralityVS": "ValueSet-shr-core-LateralityVS.html",
+    "http://standardhealthrecord.org/shr/core/vs/LowerBoundTypeVS": "ValueSet-shr-core-LowerBoundTypeVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-core-LowerBoundTypeVS": "ValueSet-shr-core-LowerBoundTypeVS.html",
+    "http://standardhealthrecord.org/shr/core/vs/ManifestationVS": "ValueSet-shr-core-ManifestationVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-core-ManifestationVS": "ValueSet-shr-core-ManifestationVS.html",
+    "http://standardhealthrecord.org/shr/core/vs/PerformanceGradingScaleVS": "ValueSet-shr-core-PerformanceGradingScaleVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-core-PerformanceGradingScaleVS": "ValueSet-shr-core-PerformanceGradingScaleVS.html",
+    "http://standardhealthrecord.org/shr/core/vs/PortionTotalityVS": "ValueSet-shr-core-PortionTotalityVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-core-PortionTotalityVS": "ValueSet-shr-core-PortionTotalityVS.html",
+    "http://standardhealthrecord.org/shr/core/vs/QualitativeDateTimeVS": "ValueSet-shr-core-QualitativeDateTimeVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeDateTimeVS": "ValueSet-shr-core-QualitativeDateTimeVS.html",
+    "http://standardhealthrecord.org/shr/core/vs/QualitativeFrequencyVS": "ValueSet-shr-core-QualitativeFrequencyVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeFrequencyVS": "ValueSet-shr-core-QualitativeFrequencyVS.html",
+    "http://standardhealthrecord.org/shr/core/vs/QualitativeLikelihoodVS": "ValueSet-shr-core-QualitativeLikelihoodVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeLikelihoodVS": "ValueSet-shr-core-QualitativeLikelihoodVS.html",
+    "http://standardhealthrecord.org/shr/core/vs/QualitativeValueScaleVS": "ValueSet-shr-core-QualitativeValueScaleVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-core-QualitativeValueScaleVS": "ValueSet-shr-core-QualitativeValueScaleVS.html",
+    "http://standardhealthrecord.org/shr/core/vs/SemiquantitativeDurationVS": "ValueSet-shr-core-SemiquantitativeDurationVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-core-SemiquantitativeDurationVS": "ValueSet-shr-core-SemiquantitativeDurationVS.html",
+    "http://standardhealthrecord.org/shr/core/vs/SemiquantitativeFrequencyVS": "ValueSet-shr-core-SemiquantitativeFrequencyVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-core-SemiquantitativeFrequencyVS": "ValueSet-shr-core-SemiquantitativeFrequencyVS.html",
+    "http://standardhealthrecord.org/shr/core/vs/SettingVS": "ValueSet-shr-core-SettingVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-core-SettingVS": "ValueSet-shr-core-SettingVS.html",
+    "http://standardhealthrecord.org/shr/core/vs/StatisticTypeVS": "ValueSet-shr-core-StatisticTypeVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-core-StatisticTypeVS": "ValueSet-shr-core-StatisticTypeVS.html",
+    "http://standardhealthrecord.org/shr/core/vs/ThreePriorityVS": "ValueSet-shr-core-ThreePriorityVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-core-ThreePriorityVS": "ValueSet-shr-core-ThreePriorityVS.html",
+    "http://standardhealthrecord.org/shr/core/vs/ThreeValueLogicVS": "ValueSet-shr-core-ThreeValueLogicVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-core-ThreeValueLogicVS": "ValueSet-shr-core-ThreeValueLogicVS.html",
+    "http://standardhealthrecord.org/shr/core/vs/TimeUnitOfMeasureVS": "ValueSet-shr-core-TimeUnitOfMeasureVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-core-TimeUnitOfMeasureVS": "ValueSet-shr-core-TimeUnitOfMeasureVS.html",
+    "http://standardhealthrecord.org/shr/core/vs/UpperBoundTypeVS": "ValueSet-shr-core-UpperBoundTypeVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-core-UpperBoundTypeVS": "ValueSet-shr-core-UpperBoundTypeVS.html",
+    "http://standardhealthrecord.org/shr/demographics/vs/AddressUseVS": "ValueSet-shr-demographics-AddressUseVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-demographics-AddressUseVS": "ValueSet-shr-demographics-AddressUseVS.html",
+    "http://standardhealthrecord.org/shr/demographics/vs/InsuranceProviderTypeVS": "ValueSet-shr-demographics-InsuranceProviderTypeVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-demographics-InsuranceProviderTypeVS": "ValueSet-shr-demographics-InsuranceProviderTypeVS.html",
+    "http://standardhealthrecord.org/shr/demographics/vs/TelecomQualifierVS": "ValueSet-shr-demographics-TelecomQualifierVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-demographics-TelecomQualifierVS": "ValueSet-shr-demographics-TelecomQualifierVS.html",
+    "http://standardhealthrecord.org/shr/demographics/vs/TelephoneTypeVS": "ValueSet-shr-demographics-TelephoneTypeVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-demographics-TelephoneTypeVS": "ValueSet-shr-demographics-TelephoneTypeVS.html",
+    "http://standardhealthrecord.org/shr/device/vs/RespiratoryAssistDeviceVS": "ValueSet-shr-device-RespiratoryAssistDeviceVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-device-RespiratoryAssistDeviceVS": "ValueSet-shr-device-RespiratoryAssistDeviceVS.html",
+    "http://standardhealthrecord.org/shr/device/vs/RespiratoryRateSettingVS": "ValueSet-shr-device-RespiratoryRateSettingVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-device-RespiratoryRateSettingVS": "ValueSet-shr-device-RespiratoryRateSettingVS.html",
+    "http://standardhealthrecord.org/shr/encounter/vs/EncounterTypeVS": "ValueSet-shr-encounter-EncounterTypeVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-encounter-EncounterTypeVS": "ValueSet-shr-encounter-EncounterTypeVS.html",
+    "http://standardhealthrecord.org/shr/encounter/vs/EncounterUrgencyVS": "ValueSet-shr-encounter-EncounterUrgencyVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-encounter-EncounterUrgencyVS": "ValueSet-shr-encounter-EncounterUrgencyVS.html",
+    "http://standardhealthrecord.org/shr/encounter/vs/EpisodeOfCareCompletionVS": "ValueSet-shr-encounter-EpisodeOfCareCompletionVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-encounter-EpisodeOfCareCompletionVS": "ValueSet-shr-encounter-EpisodeOfCareCompletionVS.html",
+    "http://standardhealthrecord.org/shr/encounter/vs/ReasonEncounterDidNotHappenVS": "ValueSet-shr-encounter-ReasonEncounterDidNotHappenVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-encounter-ReasonEncounterDidNotHappenVS": "ValueSet-shr-encounter-ReasonEncounterDidNotHappenVS.html",
+    "http://standardhealthrecord.org/shr/encounter/vs/ReferralSourceTypeVS": "ValueSet-shr-encounter-ReferralSourceTypeVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-encounter-ReferralSourceTypeVS": "ValueSet-shr-encounter-ReferralSourceTypeVS.html",
+    "http://standardhealthrecord.org/shr/encounter/vs/TreatmentCooperationVS": "ValueSet-shr-encounter-TreatmentCooperationVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-encounter-TreatmentCooperationVS": "ValueSet-shr-encounter-TreatmentCooperationVS.html",
+    "http://standardhealthrecord.org/shr/environment/vs/AnimalExposureVS": "ValueSet-shr-environment-AnimalExposureVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-environment-AnimalExposureVS": "ValueSet-shr-environment-AnimalExposureVS.html",
+    "http://standardhealthrecord.org/shr/environment/vs/CoinhabitantVS": "ValueSet-shr-environment-CoinhabitantVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-environment-CoinhabitantVS": "ValueSet-shr-environment-CoinhabitantVS.html",
+    "http://standardhealthrecord.org/shr/environment/vs/HomeEnvironmentRiskVS": "ValueSet-shr-environment-HomeEnvironmentRiskVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-environment-HomeEnvironmentRiskVS": "ValueSet-shr-environment-HomeEnvironmentRiskVS.html",
+    "http://standardhealthrecord.org/shr/environment/vs/IncomeSourceVS": "ValueSet-shr-environment-IncomeSourceVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-environment-IncomeSourceVS": "ValueSet-shr-environment-IncomeSourceVS.html",
+    "http://standardhealthrecord.org/shr/environment/vs/NonCashBenefitVS": "ValueSet-shr-environment-NonCashBenefitVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-environment-NonCashBenefitVS": "ValueSet-shr-environment-NonCashBenefitVS.html",
+    "http://standardhealthrecord.org/shr/environment/vs/ResourceStabilityVS": "ValueSet-shr-environment-ResourceStabilityVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-environment-ResourceStabilityVS": "ValueSet-shr-environment-ResourceStabilityVS.html",
+    "http://standardhealthrecord.org/shr/immunization/vs/ImmunizationNotGivenReasonVS": "ValueSet-shr-immunization-ImmunizationNotGivenReasonVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-immunization-ImmunizationNotGivenReasonVS": "ValueSet-shr-immunization-ImmunizationNotGivenReasonVS.html",
+    "http://standardhealthrecord.org/shr/lab/vs/ChangeFlagVS": "ValueSet-shr-lab-ChangeFlagVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-ChangeFlagVS": "ValueSet-shr-lab-ChangeFlagVS.html",
+    "http://standardhealthrecord.org/shr/lab/vs/HIVScreeningTestCodeVS": "ValueSet-shr-lab-HIVScreeningTestCodeVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-HIVScreeningTestCodeVS": "ValueSet-shr-lab-HIVScreeningTestCodeVS.html",
+    "http://standardhealthrecord.org/shr/lab/vs/HIVScreeningTestResultVS": "ValueSet-shr-lab-HIVScreeningTestResultVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-HIVScreeningTestResultVS": "ValueSet-shr-lab-HIVScreeningTestResultVS.html",
+    "http://standardhealthrecord.org/shr/lab/vs/HIVSupplementalTestCodeVS": "ValueSet-shr-lab-HIVSupplementalTestCodeVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-HIVSupplementalTestCodeVS": "ValueSet-shr-lab-HIVSupplementalTestCodeVS.html",
+    "http://standardhealthrecord.org/shr/lab/vs/HIVSupplementalTestResultVS": "ValueSet-shr-lab-HIVSupplementalTestResultVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-HIVSupplementalTestResultVS": "ValueSet-shr-lab-HIVSupplementalTestResultVS.html",
+    "http://standardhealthrecord.org/shr/lab/vs/RequestStatusVS": "ValueSet-shr-lab-RequestStatusVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-RequestStatusVS": "ValueSet-shr-lab-RequestStatusVS.html",
+    "http://standardhealthrecord.org/shr/lab/vs/TestInterpretationVS": "ValueSet-shr-lab-TestInterpretationVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-lab-TestInterpretationVS": "ValueSet-shr-lab-TestInterpretationVS.html",
+    "http://standardhealthrecord.org/shr/lifehistory/vs/CongenitalAbnormalitiesVS": "ValueSet-shr-lifehistory-CongenitalAbnormalitiesVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-lifehistory-CongenitalAbnormalitiesVS": "ValueSet-shr-lifehistory-CongenitalAbnormalitiesVS.html",
+    "http://standardhealthrecord.org/shr/lifehistory/vs/EducationalAttainmentVS": "ValueSet-shr-lifehistory-EducationalAttainmentVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-lifehistory-EducationalAttainmentVS": "ValueSet-shr-lifehistory-EducationalAttainmentVS.html",
+    "http://standardhealthrecord.org/shr/lifehistory/vs/EmploymentStatusVS": "ValueSet-shr-lifehistory-EmploymentStatusVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-lifehistory-EmploymentStatusVS": "ValueSet-shr-lifehistory-EmploymentStatusVS.html",
+    "http://standardhealthrecord.org/shr/lifehistory/vs/MilitaryServiceDischargeStatusVS": "ValueSet-shr-lifehistory-MilitaryServiceDischargeStatusVS.html",
     "http://standardhealthrecord.org/fhir/ValueSet/shr-lifehistory-MilitaryServiceDischargeStatusVS": "ValueSet-shr-lifehistory-MilitaryServiceDischargeStatusVS.html",
+    "http://standardhealthrecord.org/shr/lifehistory/vs/MilitaryServiceEraVS": "ValueSet-shr-lifehistory-MilitaryServiceEraVS.html",
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+    "CodeSystem-shr-medication-MedicationChangeTypeCS.json.html",
+    "CodeSystem-shr-medication-MedicationChangeTypeCS.ttl.html",
+    "CodeSystem-shr-medication-MedicationChangeTypeCS.xml.html",
+    "CodeSystem-shr-medication-ReasonMedicationNotUsedCS.html",
+    "CodeSystem-shr-medication-ReasonMedicationNotUsedCS.json.html",
+    "CodeSystem-shr-medication-ReasonMedicationNotUsedCS.ttl.html",
+    "CodeSystem-shr-medication-ReasonMedicationNotUsedCS.xml.html",
+    "CodeSystem-shr-observation-ExposureReasonCS.html",
+    "CodeSystem-shr-observation-ExposureReasonCS.json.html",
+    "CodeSystem-shr-observation-ExposureReasonCS.ttl.html",
+    "CodeSystem-shr-observation-ExposureReasonCS.xml.html",
+    "CodeSystem-shr-observation-ObservationNotMadeReasonCS.html",
+    "CodeSystem-shr-observation-ObservationNotMadeReasonCS.json.html",
+    "CodeSystem-shr-observation-ObservationNotMadeReasonCS.ttl.html",
+    "CodeSystem-shr-observation-ObservationNotMadeReasonCS.xml.html",
+    "CodeSystem-shr-problem-EvidenceQualityCS.html",
+    "CodeSystem-shr-problem-EvidenceQualityCS.json.html",
+    "CodeSystem-shr-problem-EvidenceQualityCS.ttl.html",
+    "CodeSystem-shr-problem-EvidenceQualityCS.xml.html",
+    "CodeSystem-shr-problem-GradeOrStageCS.html",
+    "CodeSystem-shr-problem-GradeOrStageCS.json.html",
+    "CodeSystem-shr-problem-GradeOrStageCS.ttl.html",
+    "CodeSystem-shr-problem-GradeOrStageCS.xml.html",
+    "CodeSystem-shr-problem-ProblemCategoryCS.html",
+    "CodeSystem-shr-problem-ProblemCategoryCS.json.html",
+    "CodeSystem-shr-problem-ProblemCategoryCS.ttl.html",
+    "CodeSystem-shr-problem-ProblemCategoryCS.xml.html",
+    "CodeSystem-shr-sex-ContraceptiveMethodCS.html",
+    "CodeSystem-shr-sex-ContraceptiveMethodCS.json.html",
+    "CodeSystem-shr-sex-ContraceptiveMethodCS.ttl.html",
+    "CodeSystem-shr-sex-ContraceptiveMethodCS.xml.html",
+    "CodeSystem-shr-sex-ContraceptiveMethodReasonCS.html",
+    "CodeSystem-shr-sex-ContraceptiveMethodReasonCS.json.html",
+    "CodeSystem-shr-sex-ContraceptiveMethodReasonCS.ttl.html",
+    "CodeSystem-shr-sex-ContraceptiveMethodReasonCS.xml.html",
+    "CodeSystem-shr-sex-ContraceptiveNotUsedReasonCS.html",
+    "CodeSystem-shr-sex-ContraceptiveNotUsedReasonCS.json.html",
+    "CodeSystem-shr-sex-ContraceptiveNotUsedReasonCS.ttl.html",
+    "CodeSystem-shr-sex-ContraceptiveNotUsedReasonCS.xml.html",
+    "CodeSystem-shr-sex-GenderIdentityCS.html",
+    "CodeSystem-shr-sex-GenderIdentityCS.json.html",
+    "CodeSystem-shr-sex-GenderIdentityCS.ttl.html",
+    "CodeSystem-shr-sex-GenderIdentityCS.xml.html",
+    "CodeSystem-shr-skin-PressureUlcerAssociationCS.html",
+    "CodeSystem-shr-skin-PressureUlcerAssociationCS.json.html",
+    "CodeSystem-shr-skin-PressureUlcerAssociationCS.ttl.html",
+    "CodeSystem-shr-skin-PressureUlcerAssociationCS.xml.html",
+    "CodeSystem-shr-skin-SupportSurfaceBodyPositionCS.html",
+    "CodeSystem-shr-skin-SupportSurfaceBodyPositionCS.json.html",
+    "CodeSystem-shr-skin-SupportSurfaceBodyPositionCS.ttl.html",
+    "CodeSystem-shr-skin-SupportSurfaceBodyPositionCS.xml.html",
+    "CodeSystem-shr-skin-SupportSurfaceCategoryCS.html",
+    "CodeSystem-shr-skin-SupportSurfaceCategoryCS.json.html",
+    "CodeSystem-shr-skin-SupportSurfaceCategoryCS.ttl.html",
+    "CodeSystem-shr-skin-SupportSurfaceCategoryCS.xml.html",
+    "CodeSystem-shr-skin-SupportSurfaceComponentCS.html",
+    "CodeSystem-shr-skin-SupportSurfaceComponentCS.json.html",
+    "CodeSystem-shr-skin-SupportSurfaceComponentCS.ttl.html",
+    "CodeSystem-shr-skin-SupportSurfaceComponentCS.xml.html",
+    "CodeSystem-shr-skin-SupportSurfaceFeatureCS.html",
+    "CodeSystem-shr-skin-SupportSurfaceFeatureCS.json.html",
+    "CodeSystem-shr-skin-SupportSurfaceFeatureCS.ttl.html",
+    "CodeSystem-shr-skin-SupportSurfaceFeatureCS.xml.html",
+    "CodeSystem-shr-vital-BloodPressureMethodCS.html",
+    "CodeSystem-shr-vital-BloodPressureMethodCS.json.html",
+    "CodeSystem-shr-vital-BloodPressureMethodCS.ttl.html",
+    "CodeSystem-shr-vital-BloodPressureMethodCS.xml.html",
+    "CodeSystem-shr-vital-BloodPressureQualifierCS.html",
+    "CodeSystem-shr-vital-BloodPressureQualifierCS.json.html",
+    "CodeSystem-shr-vital-BloodPressureQualifierCS.ttl.html",
+    "CodeSystem-shr-vital-BloodPressureQualifierCS.xml.html",
+    "CodeSystem-shr-vital-BodyHeightQualifierCS.html",
+    "CodeSystem-shr-vital-BodyHeightQualifierCS.json.html",
+    "CodeSystem-shr-vital-BodyHeightQualifierCS.ttl.html",
+    "CodeSystem-shr-vital-BodyHeightQualifierCS.xml.html",
+    "CodeSystem-shr-vital-BodyTemperatureQualifierCS.html",
+    "CodeSystem-shr-vital-BodyTemperatureQualifierCS.json.html",
+    "CodeSystem-shr-vital-BodyTemperatureQualifierCS.ttl.html",
+    "CodeSystem-shr-vital-BodyTemperatureQualifierCS.xml.html",
+    "CodeSystem-shr-vital-BodyWeightQualifierCS.html",
+    "CodeSystem-shr-vital-BodyWeightQualifierCS.json.html",
+    "CodeSystem-shr-vital-BodyWeightQualifierCS.ttl.html",
+    "CodeSystem-shr-vital-BodyWeightQualifierCS.xml.html",
+    "CodeSystem-shr-vital-HeartRateMethodCS.html",
+    "CodeSystem-shr-vital-HeartRateMethodCS.json.html",
+    "CodeSystem-shr-vital-HeartRateMethodCS.ttl.html",
+    "CodeSystem-shr-vital-HeartRateMethodCS.xml.html",
+    "CodeSystem-shr-vital-HeartRateQualifierCS.html",
+    "CodeSystem-shr-vital-HeartRateQualifierCS.json.html",
+    "CodeSystem-shr-vital-HeartRateQualifierCS.ttl.html",
+    "CodeSystem-shr-vital-HeartRateQualifierCS.xml.html",
+    "CodeSystem-shr-vital-RespiratoryRateMethodCS.html",
+    "CodeSystem-shr-vital-RespiratoryRateMethodCS.json.html",
+    "CodeSystem-shr-vital-RespiratoryRateMethodCS.ttl.html",
+    "CodeSystem-shr-vital-RespiratoryRateMethodCS.xml.html",
+    "CodeSystem-shr-vital-RespiratoryRateQualifierCS.html",
+    "CodeSystem-shr-vital-RespiratoryRateQualifierCS.json.html",
+    "CodeSystem-shr-vital-RespiratoryRateQualifierCS.ttl.html",
+    "CodeSystem-shr-vital-RespiratoryRateQualifierCS.xml.html",
     "codesystems.html",
     "downloads.html",
     "extensions.html",
@@ -935,6 +1128,11 @@
     "StructureDefinition-primitive-xhtml-extension.json.html",
     "StructureDefinition-primitive-xhtml-extension.ttl.html",
     "StructureDefinition-primitive-xhtml-extension.xml.html",
+    "StructureDefinition-shr-actor-Affiliation-extension-definitions.html",
+    "StructureDefinition-shr-actor-Affiliation-extension.html",
+    "StructureDefinition-shr-actor-Affiliation-extension.json.html",
+    "StructureDefinition-shr-actor-Affiliation-extension.ttl.html",
+    "StructureDefinition-shr-actor-Affiliation-extension.xml.html",
     "StructureDefinition-shr-actor-AgeAtDeath-extension-definitions.html",
     "StructureDefinition-shr-actor-AgeAtDeath-extension.html",
     "StructureDefinition-shr-actor-AgeAtDeath-extension.json.html",
@@ -975,6 +1173,11 @@
     "StructureDefinition-shr-actor-LanguageUsed-extension.json.html",
     "StructureDefinition-shr-actor-LanguageUsed-extension.ttl.html",
     "StructureDefinition-shr-actor-LanguageUsed-extension.xml.html",
+    "StructureDefinition-shr-actor-MedicalSpecialty-extension-definitions.html",
+    "StructureDefinition-shr-actor-MedicalSpecialty-extension.html",
+    "StructureDefinition-shr-actor-MedicalSpecialty-extension.json.html",
+    "StructureDefinition-shr-actor-MedicalSpecialty-extension.ttl.html",
+    "StructureDefinition-shr-actor-MedicalSpecialty-extension.xml.html",
     "StructureDefinition-shr-actor-NoPrimaryCareProvider-definitions.html",
     "StructureDefinition-shr-actor-NoPrimaryCareProvider.html",
     "StructureDefinition-shr-actor-NoPrimaryCareProvider.json.html",
@@ -1155,16 +1358,6 @@
     "StructureDefinition-shr-base-PerformerInstructions-extension.json.html",
     "StructureDefinition-shr-base-PerformerInstructions-extension.ttl.html",
     "StructureDefinition-shr-base-PerformerInstructions-extension.xml.html",
-    "StructureDefinition-shr-base-PriorityOfRequest-extension-definitions.html",
-    "StructureDefinition-shr-base-PriorityOfRequest-extension.html",
-    "StructureDefinition-shr-base-PriorityOfRequest-extension.json.html",
-    "StructureDefinition-shr-base-PriorityOfRequest-extension.ttl.html",
-    "StructureDefinition-shr-base-PriorityOfRequest-extension.xml.html",
-    "StructureDefinition-shr-base-RequestNotToPerformActionModifier-extension-definitions.html",
-    "StructureDefinition-shr-base-RequestNotToPerformActionModifier-extension.html",
-    "StructureDefinition-shr-base-RequestNotToPerformActionModifier-extension.json.html",
-    "StructureDefinition-shr-base-RequestNotToPerformActionModifier-extension.ttl.html",
-    "StructureDefinition-shr-base-RequestNotToPerformActionModifier-extension.xml.html",
     "StructureDefinition-shr-base-ShrId-extension-definitions.html",
     "StructureDefinition-shr-base-ShrId-extension.html",
     "StructureDefinition-shr-base-ShrId-extension.json.html",
@@ -2091,11 +2284,6 @@
     "StructureDefinition-shr-lab-Test.ttl.html",
     "StructureDefinition-shr-lab-Test.xml.html",
     "StructureDefinition-shr-lab-TestRequest-definitions.html",
-    "StructureDefinition-shr-lab-TestRequest-extension-definitions.html",
-    "StructureDefinition-shr-lab-TestRequest-extension.html",
-    "StructureDefinition-shr-lab-TestRequest-extension.json.html",
-    "StructureDefinition-shr-lab-TestRequest-extension.ttl.html",
-    "StructureDefinition-shr-lab-TestRequest-extension.xml.html",
     "StructureDefinition-shr-lab-TestRequest.html",
     "StructureDefinition-shr-lab-TestRequest.json.html",
     "StructureDefinition-shr-lab-TestRequest.ttl.html",
@@ -2185,6 +2373,11 @@
     "StructureDefinition-shr-medication-AdherenceLevel-extension.json.html",
     "StructureDefinition-shr-medication-AdherenceLevel-extension.ttl.html",
     "StructureDefinition-shr-medication-AdherenceLevel-extension.xml.html",
+    "StructureDefinition-shr-medication-MaximumDosePerTimePeriod-definitions.html",
+    "StructureDefinition-shr-medication-MaximumDosePerTimePeriod.html",
+    "StructureDefinition-shr-medication-MaximumDosePerTimePeriod.json.html",
+    "StructureDefinition-shr-medication-MaximumDosePerTimePeriod.ttl.html",
+    "StructureDefinition-shr-medication-MaximumDosePerTimePeriod.xml.html",
     "StructureDefinition-shr-medication-Medication-definitions.html",
     "StructureDefinition-shr-medication-Medication.html",
     "StructureDefinition-shr-medication-Medication.json.html",
@@ -2235,11 +2428,6 @@
     "StructureDefinition-shr-medication-NonAdherenceReason-extension.json.html",
     "StructureDefinition-shr-medication-NonAdherenceReason-extension.ttl.html",
     "StructureDefinition-shr-medication-NonAdherenceReason-extension.xml.html",
-    "StructureDefinition-shr-medication-OverTheCounter-extension-definitions.html",
-    "StructureDefinition-shr-medication-OverTheCounter-extension.html",
-    "StructureDefinition-shr-medication-OverTheCounter-extension.json.html",
-    "StructureDefinition-shr-medication-OverTheCounter-extension.ttl.html",
-    "StructureDefinition-shr-medication-OverTheCounter-extension.xml.html",
     "StructureDefinition-shr-medication-RouteIntoBody-extension-definitions.html",
     "StructureDefinition-shr-medication-RouteIntoBody-extension.html",
     "StructureDefinition-shr-medication-RouteIntoBody-extension.json.html",
@@ -2627,6 +2815,10 @@
     "ValueSet-shr-actor-LanguageQualifierVS.json.html",
     "ValueSet-shr-actor-LanguageQualifierVS.ttl.html",
     "ValueSet-shr-actor-LanguageQualifierVS.xml.html",
+    "ValueSet-shr-adverse-MedDRAVS.html",
+    "ValueSet-shr-adverse-MedDRAVS.json.html",
+    "ValueSet-shr-adverse-MedDRAVS.ttl.html",
+    "ValueSet-shr-adverse-MedDRAVS.xml.html",
     "ValueSet-shr-allergy-AllergenIrritantVS.html",
     "ValueSet-shr-allergy-AllergenIrritantVS.json.html",
     "ValueSet-shr-allergy-AllergenIrritantVS.ttl.html",
@@ -2931,6 +3123,10 @@
     "ValueSet-shr-medication-MedicationNonAdherenceReasonVS.json.html",
     "ValueSet-shr-medication-MedicationNonAdherenceReasonVS.ttl.html",
     "ValueSet-shr-medication-MedicationNonAdherenceReasonVS.xml.html",
+    "ValueSet-shr-medication-MedicationVS.html",
+    "ValueSet-shr-medication-MedicationVS.json.html",
+    "ValueSet-shr-medication-MedicationVS.ttl.html",
+    "ValueSet-shr-medication-MedicationVS.xml.html",
     "ValueSet-shr-medication-ReasonMedicationNotUsedVS.html",
     "ValueSet-shr-medication-ReasonMedicationNotUsedVS.json.html",
     "ValueSet-shr-medication-ReasonMedicationNotUsedVS.ttl.html",
@@ -2947,6 +3143,10 @@
     "ValueSet-shr-observation-ObservationNotMadeReasonVS.json.html",
     "ValueSet-shr-observation-ObservationNotMadeReasonVS.ttl.html",
     "ValueSet-shr-observation-ObservationNotMadeReasonVS.xml.html",
+    "ValueSet-shr-problem-DSMVS.html",
+    "ValueSet-shr-problem-DSMVS.json.html",
+    "ValueSet-shr-problem-DSMVS.ttl.html",
+    "ValueSet-shr-problem-DSMVS.xml.html",
     "ValueSet-shr-problem-EvidenceQualityVS.html",
     "ValueSet-shr-problem-EvidenceQualityVS.json.html",
     "ValueSet-shr-problem-EvidenceQualityVS.ttl.html",

From 9d52d975022656f89af81b9f05048721c8a850dc Mon Sep 17 00:00:00 2001
From: Jason Walonoski <jwalonoski@mitre.org>
Date: Wed, 26 Apr 2017 15:34:12 -0400
Subject: [PATCH 4/5] Update version.

---
 Gemfile.lock | 2 +-
 1 file changed, 1 insertion(+), 1 deletion(-)

diff --git a/Gemfile.lock b/Gemfile.lock
index b0c4dc6..7d2e39f 100644
--- a/Gemfile.lock
+++ b/Gemfile.lock
@@ -12,7 +12,7 @@ GIT
 PATH
   remote: .
   specs:
-    fhir_scorecard (1.8.1)
+    fhir_scorecard (3.0.0)
 
 GEM
   remote: https://rubygems.org/

From 5f78158a23c2c5b97cedae4c7259f7a693c5062c Mon Sep 17 00:00:00 2001
From: Jason Walonoski <jwalonoski@mitre.org>
Date: Tue, 2 May 2017 13:13:41 -0400
Subject: [PATCH 5/5] FHIR version 3.0.1

---
 Gemfile                |  2 +-
 Gemfile.lock           | 20 +++++++-------------
 fhir_scorecard.gemspec |  4 ++--
 3 files changed, 10 insertions(+), 16 deletions(-)

diff --git a/Gemfile b/Gemfile
index 5e41039..71fb080 100644
--- a/Gemfile
+++ b/Gemfile
@@ -5,7 +5,7 @@ gem 'rake'
 gem 'pry'
 
 # gem 'fhir_models', :path => '../fhir_models'
-gem 'fhir_models', :git => 'https://github.com/fhir-crucible/fhir_models.git', :branch => '3.0.0-release'
+# gem 'fhir_models', :git => 'https://github.com/fhir-crucible/fhir_models.git', :branch => '3.0.0-release'
 
 group :test do
   gem 'simplecov', :require => false
diff --git a/Gemfile.lock b/Gemfile.lock
index 7d2e39f..aac9bcf 100644
--- a/Gemfile.lock
+++ b/Gemfile.lock
@@ -1,18 +1,8 @@
-GIT
-  remote: https://github.com/fhir-crucible/fhir_models.git
-  revision: 767ea007a16a20a9522586072999b4e4e04a3e9c
-  branch: 3.0.0-release
-  specs:
-    fhir_models (3.0.0)
-      bcp47 (>= 0.3)
-      date_time_precision (>= 0.8)
-      mime-types (>= 1.16, < 3)
-      nokogiri (>= 1.6)
-
 PATH
   remote: .
   specs:
-    fhir_scorecard (3.0.0)
+    fhir_scorecard (3.0.1)
+      fhir_models (>= 3.0.0)
 
 GEM
   remote: https://rubygems.org/
@@ -25,6 +15,11 @@ GEM
     coderay (1.1.1)
     date_time_precision (0.8.1)
     docile (1.1.5)
+    fhir_models (3.0.1)
+      bcp47 (>= 0.3)
+      date_time_precision (>= 0.8)
+      mime-types (>= 1.16, < 3)
+      nokogiri (>= 1.6)
     i18n (0.8.1)
     json (2.0.3)
     method_source (0.8.2)
@@ -56,7 +51,6 @@ PLATFORMS
 
 DEPENDENCIES
   awesome_print
-  fhir_models!
   fhir_scorecard!
   minitest (~> 5.3)
   minitest-reporters
diff --git a/fhir_scorecard.gemspec b/fhir_scorecard.gemspec
index c52c7c8..ede2a32 100644
--- a/fhir_scorecard.gemspec
+++ b/fhir_scorecard.gemspec
@@ -7,9 +7,9 @@ Gem::Specification.new do |s|
   s.email = "jwalonoski@mitre.org"
   s.homepage = "https://github.com/fhir-crucible/fhir_scorecard"
   s.authors = ["Jason Walonoski"]
-  s.version = '3.0.0'
+  s.version = '3.0.1'
 
   s.files = s.files = `git ls-files`.split("\n")
 
-  # s.add_runtime_dependency 'fhir_models', '~> 1.8'
+  s.add_runtime_dependency 'fhir_models', '>= 3.0.0'
 end